WHAT CAN BE DONE TO PREVENT BALDNESS? (Apr, 1917)
“Every theory, you see, is as sound as a dollar. Any one of them is sufficient to sell a hair tonic or commend a new treatment.”
All those damn quacks, claiming they have a cure!
“A modern method which is of undoubted potency in the treatment of premature loss of hair is the ultra-violet ray. This must not be confused with the comparatively useless violet ray lamp.”
WHAT CAN BE DONE TO PREVENT BALDNESS?
by William Brady M.D.
ALOPECIA, as physicians call it —they always tack a fancy title an a disease when they know little or nothing about it— ‘ comes in many forms. There is alopecia adnata, which signifies that some people are born bald. Then we have alopecia senilis, implying that a favored few live long enough to achieve it. But the most painful, the most cowardly type of baldness is alopecia prematura, which is thrust upon us by our friend the barber in his tonsorial operations.
The baldness of children is a rare condition in which there is a congenital absence of hair follicles or an arrested development of the hair follicles or roots. We know nothing of the cause, and can give no advice in regard to escaping it.
The baldness of old men, beginning well along past middle age, is an expression of general lowering of nutrition and tendency to atrophy incident to advancing years, appearing earlier or later according to the physiological and not the chronological age of the individual.
A fourth form of baldness is called alopecia areata, baldness in irregular spots, due, in some cases, to a parasitic invasion of the denuded area; in others apparently caused by grave nutritional disturbance accompanying some serious ailment of the nervous system, and in still others being a symptom of constitutional disease.
Theories in explanation of premature baldness are put forward in bewildering array by numerous authorities, not including the barbers themselves, and most of the theories have some foundation in fact. The subject is comparable with tuberculosis. It may be granted that there are innumerable contributing or predisposing factors which tend to lower resistance in one way or another, but only one essential factor for the transfer of the disease, namely, infection.
Thus, Dr. Pincus dwelt upon the hereditary factor, which he said was inherently a tight or stretched scalp muscle peculiar to certain families. Indeed, Pincus considered this the only predisposing cause of premature baldness.
Professor Jamieson vigorously upheld the theory that premature baldness is more frequent among brain workers because the same nerves supply brain coverings and the scalp itself and irritation or congestion of the brain reflexly disturbs the nutrition of the scalp. Plausible, isn’t it, brainy reader?
Dr. King, however, puts forward the compression theory, attributing baldness to the compression by hatbands and tight caps of the frontal, temporal and occipital arteries which nourish the scalp. He ascribes to differences in the shape of the head the varying areas of baldness in different individuals, insisting, for instance, that the tuft often preserved in the middle of the forehead owes its life to the fact that it is nourished by two little arteries which escape pressure by passing up the forehead in concavities between the frontal eminences. Others take issue with him, and ascribe the persistent forelock to the fact that it lies over the belly of the scalp muscle, is freely movable, and has a less tense substratum for its bed.
Professor Ellinger considers the daily wetting of the hair an important cause of premature baldness. Water forms an emulsion with the natural oil or sebum of the scalp and hair, and this emulsion dries and plugs the hair follicle, damming up the sebum in the follicle and so producing atrophy or wasting of the hair root. Every theory, you see, is as sound as a dollar. Any one of them is sufficient to sell a hair tonic or commend a new treatment.
The abnormally tight or stretched scalp which Pincus deems the important factor may be brought about, he asserts, by anxiety of mind, depression of spirits which the subject struggles against, though not by reverses which the subject takes philosophically. This theory does not fit well with the popular idea of the good-naturedness of bald-headed men— but as a matter of fact bald pates are no better natured than men with movie adornment of the loveliest kind. The foolish, apologetic smile on the countenance of a bald-headed man is no criterion of the way he treats his wife.
Dr. Parker, some years ago, presented a strong thesis in support of the idea that certain toxins formed in the lungs when breathing is habitually shallow or the subject confined in bad air, are concerned in the production of premature baldness. He declared that insufficient expansion of the upper part of the lung, the apex, was accountable for the trouble, and that women, being chest breathers perforce, seldom go bald.
Getting down to the real science of alopecia, there are three characteristic stages. First, unnatural oiliness of scalp and hair, which is called seborrhoea, that is, excessive flow of sebum from the oil glands which discharge their secretion upon the base of the hair shaft, and normally keep the skin and hair soft and pliable. Second, dandruff, known as seborrhoea sicca, drying of the secretion and the unsightly scales and crusts that fall upon the shoulders. Finally, falling of the hair.
Lassar and Bishop contributed to our knowledge the contagious character of dandruff. They took dandruff scales from the head of a student who was losing his hair, mixed them with a little vaseline and rubbed the material into the back of a guinea pig, much as a barber might massage your scalp for you, if you were foolish enough to let him. The pig presently became bald. Professor Sabouraud rallies to the support of his colleagues by discovering that the whole business, seborrhoea, dandruff and falling hair, is caused by a very minute parasite which burrows its way down alongside of the hair shaft, reaches the oil gland always connected with the hair shaft, sets up chronic irritation and inflammation of the gland, causing its excessive outpouring of oil, and finally arrives at the follicle or hair root, which it proceeds to destroy, not so rapidly, of course, but just as surely in the end as does the electric needle. Upon this pestiferous microbe Sabouraud has conferred the title micro-bacillus Sabouraudii. And it is the most tenacious little bug a man ever got in his bonnet!
Now we have the whole matter before us as clear as any one could wish. Resistance lowered by heredity, faulty personal hygiene, unhygienic clothing, bad care of scalp. Bugs gratuitously contributed by the barber, who doesn’t know how to be sterile or aseptic, in the first place, and sees no need of it in the next place—for unfortunately Sabouraud’s ubiquitous little germ is as invisible as “cold” microbes in the gentle spray of an open-face sneeze.
We’ve got the bug. What are we going to do about it? Just rub in some antiseptic and kill it? That would seem the simplest thing in the world to any but the medical mind. Alas, it can’t be done. As a matter of fact, no antiseptic substance has yet been discovered which will destroy germs in the living tissues of the body (in, not on the surface) without dangerously injuring the tissues. We have no antiseptic powerful enough to kill germs in the skin without destroy- ing the skin itself. Many a remedy purports to accomplish this miracle, it is true, but it can’t be done. Such germs as may have invaded the hair follicles must be destroyed, if at all, by the natural defensive forces of the body. Our preventive effort should be directed toward aiding these natural defensive forces and warding off further invasions and reinforcement of the enemy.
If there is an agent which, without seriously injuring the scalp, possesses real germicidal power in the tissue of the scalp, it is light. All the sunlight the scalp will stand, short of sunburn or sunstroke, is beneficial to the vitality of the hair. The reason why dark-haired people more commonly become bald than light haired people is that dark hair excludes light from the scalp. Yet the Indians did not go bald—but, then, they never visited a barber shop, so they harbored no micro-bacilli to destroy their hair. Possibly ultra-violet (not the violet ray) light may be a good substitute for sunlight. The ultra-violet light may be applied cold, thus making a larger dose applicable than the subject can stand in the heat of the sun. Of course, sunlight includes ultraviolet as well as violet rays.
Cleanliness aids nature’s defensive forces by removing irritation. A shampoo, however, is rather an evil necessity of civilized life and not particularly beneficial to the hair. Animals living wild require no scrubbing to keep themselves perfectly clean. The dust and grime of civilization, retained upon the body by clothing, makes bathing and shampooing more or less essential for cleanliness. The frequency of a shampoo is insignificant—it must be done often enough to keep the scalp clean. The kind of soap is also insignificant—any soap fit for the skin is fit for the hair and scalp. But it is very important to rinse the scalp and hair several times to remove all soap, with several changes of first warm and then cooler water. It is also important to dry the hair and scalp as thoroughly and promptly as possible, and then to rub into the scalp any oil, such as vaseline, in small quantity, just sufficient to replace the oil removed by washing. Medicaments may be incorporated with this oily application, such as salicylic acid or sulphur or resorcin (1% or 2% of either) for excessive oiliness of the scalp and hair, or higher proportions for more troublesome dandruff.
Brushing and massage are measures of the utmost value in postponing baldness. From the very ease with which a man’s hair is dressed he neglects to brush it enough to stimulate the scalp. Something like a hundred strokes of the brush each night and morning would be a fair amount of brushing for the average scalp.
The hair brush should be one which is not injured by boiling. There are at least two popular brushes which meet this demand—the so-called prophylactic and the ideal. The former is better for men’s hair and the latter for women’s. The brush should be shampooed as often as the scalp, and at least dipped in boiling water to disinfect it. A man should lose no time in getting home from the barber shop to take a thorough shampoo, including the hair brush.
Massage of the scalp is the remedy which has given more than one alleged hair tonic a reputation. Outside of a few medicaments which seem to exert some effect upon oily and dry dandruff, it is foolish to imagine that irritants or chemicals of any sort can improve the growth of the hair. A “hair tonic” is about as logical a thing as a tooth tonic, a skin tonic, a nail tonic or a brain food. And pasting a French name on it doesn’t alter the fact in the least.
It is questionable whether the manipulations a barber calls massage are worth while. The purpose of scalp massage is to increase the nutrition of the hair follicles by improving the blood supply. The blood supply is poor because of the tightness of the scalp, as we have already explained. Massage, therefore, should loosen the scalp by lifting it up in folds and rolling these folds between the fingers. It is an exercise, and better when done by the individual himself. Grasp the scalp with the wide open hand, forcibly draw the fingers toward the palm, heaping up a little fold of scalp under them. Go over the entire scalp in this way, changing hands occasionally, for the hand soon tires, until the whole head glows.
A modern method which is of undoubted potency in the treatment of premature loss of hair is the ultra-violet ray. This must not be confused with the comparatively useless violet ray lamp. The ultra-violet ray is colorless; it is the actinic or chemical ray beyond the violet in the spectrum, and capable of inducing powerful physiological changes which the violet light cannot produce at all. The ultra-violet ray is obtained from a powerful electric light which is passed through a lens in which cold water continuously circulates, absorbing the heat but not the light. The cool ray is then focused upon the area to be treated through a quartz lens, not an ordinary glass lens. The ultra-violet apparatus simply places the power of sunlight, which we know is the greatest germicide and the strongest stimulant of growth and nutrition man can endure, within the control of the physician, at any time of any kind of day or night. In the average case of falling hair, when there is not an excessive seborrlioea (oily condition of scalp or dandruff), three treatments with the ultra-violet ray, given fortnightly, stop the process. In more advanced cases further treatments are desirable. Perhaps the ultra-violet ray—which of course no barber or other unskilled operator can manage—and massage offer the greatest hope to the victim of premature loss of hair.
Eternal cleanliness is the price of a good head of hair. Premature baldness will prevail until the coming of the aseptic barber and the aerated lid.