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Dr. G. T. Jackson read a paper recently before the New York county medical society on baldness and its treatment. He described four varieties of baldness, or alopecia : 1°. Alopecia adnata, the congenital form ; 3°. A. senilis ; 8°. A. prematura; 4°. A. areata. A. senilis is that form which occurs in old age, or after the age of forty-five, and is often preceded or accompanied by grayness of the hair. Its cause is a gradual hardening of the subcutaneous tissues of the scalp and a diminution of blood-supply, followed by an obliteration of the hair follicles. It is but one expression of that general lowering of nutrition incident to advancing years.
When the scalp is atrophied, nothing can be done in the way of treatment, but prophylaxis may do a great deal in postponing those changes. A. prematura is that form of baldness which occurs before the forty-fifth year. Of this there are two varieties, - the idiopathic and the symptomatic. The former occurs most commonly between the ages of twenty-five and thirty-five, and is not due to any antecedent or concomitant disease. It differs from the senile form in occurring at an earlier age, and in being unaccompanied by other signs of diminished physical vigor, such as loss of teeth, dullness of sight and hearing. The chief cause of this variety is heredity. Every one has known of families in which the fathers and sons have become bald at a very early age. Another cause is improper or deficient care of the scalp. It is a common practice for men to souse the head daily in water. Ellinger has noted this habit in eighty-five per cent of his cases of baldness.
Thinkers and brain-workers are very often bald. Eaton found, in the audiences attendant upon churches and operas in Boston, that from forty to fifty per cent of the men were bald ; while in cheap museums and at prize-fights the percentage was only twelve to twenty-five. Stiff hats may cause baldness by compressing the arteries that supply the scalp. Tight and unventilated hats make the scalp warm, and cause it to perspire, thus favoring baldness. King says that baldness of the vertex is due to compression by stiff hats of the arteries which supply that part. The little tuft of hair often observed on the top of the forehead is nourished by arteries which escape pressure.
That women do not become bald so often as men is probably because they preserve the cushion of fat under the scalp longer than men do. They do not wear their hats as much as men; nor are these so close-fitting, or made of such impermeable material. They also give more attention to the hair, and do not wet the head so often. Of all these reasons, Dr. Jackson regards the preservation of the fat and connective tissue of the scalp, and the greater care of the scalp, as the most important. The treatment of this variety of baldness is mainly one of prophylaxis and hygiene. In families where it is hereditary, this should begin at birth, and continue through life.
The scalp should be kept clean by an occasional shampoo of soap and water, borax and water, or some such simple means. This should not be repeated oftener than once in two or three weeks ; and after the washing, the scalp should be carefully dried, and vaseline or sweet-almond oil applied. Women should dry the hair by the fire or in the sun, and not dress it until dry. The hair should be thoroughly brushed and combed daily, for five or ten minutes, with vigor sufficient to make the scalp glow. For this a brush should have long and moderately stiff bristles, set in groups widely separated from each other. Such a brush will reach the scalp, and brush out the dust.
A comb with large, smooth teeth should be used with the brush, to open up the hair to the air. Pomades should not be used, and the daily sousing of the hair discontinued. Women should not use bandoline, nor pull or twist the hair, nor scorch it with curling-irons, nor smother it under false hair. Easy-fitting, light, and ventilated hats should be worn, and working under hot artificial light should be avoided. Mr. Goninlock, writing on baldness in the Popular science monthly, gives it as his opinion that it is due principally to the high hat and the hard felt hat, and to any other covering that constricts the blood-vessels which nourish the hair-bulbs. Few, he says, will escape the evil effects of twenty or thirty years of rigid tight-fitting hats, the destructive process being delayed only by the length and frequency of respites from this tourniquet of fashion.
This article was originally published in Science (June 24, 1887).
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