BALDNESS. Under the title ALOPECIA the general types of baldness have been con sidered. Premature alopecia, or the general affection of the young and middle-aged, de serves greater consideration. Alopecia pre sendis, or premature baldness, is recognized as of two distinct varieties, the idiopathic and the symptomatic. In the idiopathic variety that oc curs before the age of 45 there does not seem to be any disease of the scalp or of the general nutrition to explain it. It is a gradual and pro gressive loss of hair, thinner and thinner hairs replacing those that have fallen out, until the follicle will not produce hair. It is usually symmetrical, beginning at the tonsure or run ning back from the temples. The skin is usual ly left thin and hard.
In the symptomatic form some general dis order or a definite disease of the scalp is the cause. This latter is usually a scaly dandruff; the general causes may be syphilis, tuberculosis, fevers or local destructive conditions. Dan druff is the most frequent accompaniment and cause of baldness. Dandruff is really at least three different diseases of the skin, but the general character is that of a general seborrhea) dermatitis; that is, a mild inflamma tion with excessive fatty secretions. This is
frequently due to digestive disturbances, and is closely dependent upon the general health of the entire body. The hair falls out as in the idiopathic form. The dandruff usually con tinues until the hair is gone, and then ceases, Treatment should be begun early, particu larly in those whose families have tended to baldness. The details of treatment require pro fessional advice. The large number of hair tonics in the market speaks well for the general inutility of all of them. Cleanliness, frequent dry-brushings, and shampoos once in every two or three weeks, are safe measures, and tend to keep up the general hygiene of the scalp. Chloral, ointment of mercury, cantharides, sul phur, tar and resorcin are successful in some cases in checking baldness. Consult Jackson, 'Diseases of the Skin' (1900); Jackson and McMurty, 'A Treatise on Diseases of the Hair> (Philadelphia 1912); Joseph, 'Lehrbuch der haarkranIcheiten) (Leipzig 1910). See DAN DRUFF.