Prognosis. Most cases are curable although they may be persistent and have a tendency to recurrence. When the scalp is involved, except in the infantile type, it should always be borne in mind that the resulting baldness may be permanent.
Treatment. Physiological measures are often necessary because, despite the probable parasitic cause, the underlying predisposing factors are those most apt to cause a continuance of the disease. The correction of faulty digestion and the relief of constipation are most essential. In fact, any disorder which might have a causal relation to the cutaneous disturbance should be regulated so as to prevent a continuance. In this particular, a daily cold bath with or without the addition of rock salt has often worked well. Exercise, sleep, clothing and the most private personal habits may need regulation. Lactobacillin in some form is often useful to relieve intestinal fermentation. Spinal stimulation by galvanic or high-frequency currents may be useful and the latter agent, applied directly to the involved area, will often obviate the need of strong local treatment because, besides the removal of the irritating crusts and scales, stimulation is often desired. The X-rays are frequently curative if applied in repeated small doses and this measure alone is superior to any of the older local methods. Gentle frictions with some plain oil or fat will loosen the scales which may then be removed. Cleansing with a non-irritating soap and hot water will likewise clean the surface which, after drying, should be anointed with some non-medicated oil or fat.
The eczematous forms frequently need medicated soaps containing sulphur, resorcin or salicylic acid, or tincture of green soap may be applied to the surface with sufficient hot water to make a lather. If these methods of cleansing are not sufficient, one of the following lotions may be used: sulphur 1 dram, alcohol and rose water each 2 ounces, glycerin 1/2 ounce; sulphuric ether and biborate of soda each 3 drams dissolved in 10 ounces of distilled water; or mercuric chlorid solution (1:1000). Delicate or sensitive skins take kindly to alkaline aqueous solutions as cleansers, such as ammonia, potassium carbonate, sodium bicarbonate and borax. These may be followed by some mild antiparasitic ointment in place of the non-medicated oils. Ointments are seldom used for the oily form of seborrhea or in the types involving the genitals, umbilicus and axillae. In these cases the lotions mentioned above or finely powdered boric acid (1part to 4 of starch or talc), powdered salicylic acid (1 part to 9 of starch) or compound stearate of zinc may be used. If ointments are desired or necessary, any one of the following may prove useful, using a base of cold cream, fresh lard, vaseline or zinc oxid ointment: sulphur, 40 to 60 grains to the ounce; resorcin, salicylic acid, betanaphthol, ammoniated mercury or calomel, 5 to 40 grains to the ounce. Frequently in seborrhea of the scalp, less often in other types, the functional tone of the skin may be improved by the addition of strong agents, such as the following; resorcin, the tinctures of capsicum, cantharis or nux vomica, or the fluid extracts of ergot or pilocarpin. These may be incorporated in a simple ointment in the proportion of 10 to 60 drops to the ounce or better, in many cases, lotions embodying the same amounts of these substances may be dissolved in 1 dram of boroglycerid and 7 drams of rose water. Occasionally severe, persistent types have been benefitted by the hypodermic use of an autogenous culture or a stock vaccine of acne bacilli.
My chief enthusiasm for the internal pathogenetic treatment of these cases is based upon the fact that again and again clinic patients who would not, or could not, carry out the proper local treatment, have been cured by the properly indicated remedy. In all cases it is fair to suppose that this means is most effective as an adjuvant, if not the chief method of treatment. See Agaricus, Am. mur., Bryonia, Calcarea acet., C. carb., Chelidonium, Colchicum, Hydrastis, Kali brom., K. mur., K. sulph., Kreosotum, Mercurius viv., Mez., Nat. arsen., N. mur., Acid nitricum, Pet., Phosphorus, Selenium, Sepia., Sul. and Vinca.
American homeopath, he directed several hospitals in New York.
Professor of dermatology.
Served as Lieut. Colonel during the 1st World War.
See his book online: American homeopathy in the world war