(From The Medical World, September 27th, 1935).
BALDNESS may be considered a scourge of civilization, as it is practically unknown among savages.
Thousands of so-called scalp specialists are fleecing the gullible of millions annually for treatments of various sorts, none of which seem to be of the slightest avail in stopping the process of falling hair.
Why should baldness be so exclusively confined to men ?.
Lack of space forbids enumerating the various supposed causes, likewise the multitude of remedies. However, it is well to consider the following :–.
1. Male and female scalps are identical, differing in size only.
2. Every germ found in a male scalp may also be found in a female scalp. The hair follicles, tissue and blood supply are identical in both sexes.
3. I know of no disease that is a common cause of permanent baldness.
4. A shiny female scalp is rare; but there are millions of shiny male domes.
5. Symptoms and sequelae of disease (omitting organs of generation) manifest no variation, regardless of gender.
6. Could any disease have special predilection for the upper anterior portion of the scalp?.
Pathological ductless glands have been recently exploited as a prominent cause of cranial alopecia. Again women are rarely affected, yet the glands are identical.
If alopecia (cranial) is caused by disease, I am at a loss to know why baldness rarely occurs behind the ears (only). The anterior part of the scalp is affected and the hair on other parts of the body is unmolested.
Unable to substantiate the version of our eminent authors regarding aetiology, prognosis and treatment, I cite no references and quote no authors; but present a new departure in considering alopecia traumatica, which I will definitely show is due to an unsuspected hat. My findings are the results of dissection, Craniometry and clinical investigation. Heretofore, research has been chiefly confined to the scalp and constitutional diseases. Craniometry has not been considered.
The hair is lost only on that part of the scalp supplied with blood from the temporal arteries, and no other part of the body. Why the partiality?.
On the section of the scalp supplied by the occipital and posterior auricular arteries, the hair remains normal.
Alopecia traumatica is found in men whose skull is broadest over the temporal bones. Here the temporal arteries pass over the bulging bones in such a course that a hat cannot help compressing them to a dangerous degree. On the other hand, the long skull on the sides of which the hat does not fit so closely offers more protection to the blood supply of the scalp.
Dissection of the temporal veins and arteries in a bald head will reveal that the veins and arteries have been injured by the hat band pressure and the lumen diminished, distorted, and the walls contracted. Veins above this point enlarged and arteries diminished in size.
Treatment (prophylactic): It is not possible to restore the hair of which the roots are already destroyed. The only treatment that is of any avail is to protect the hair still remaining. Remove the cause of baldness by preventing the slightest pressure over the temporal region. Merely stretching the hat is not sufficient as the point of contact over the temples remains the same, as the hat will resume its former shape when placed on the head.
Medicine taken internally or applied externally is absolutely useless.
The man with a long skull flattened on the sides is rarely bald. The oval skull that bulges at the temporal region is usually bald.
There is a fortune awaiting the hat manufacturer who may devise a type of hat slightly more convex at this point bridging over the temporal arteries and veins to permit normal circulation without perceptibly distorting the hat. Such a hat will be welcomed with avidity by the man with an oval or broad skull; who certainly can anticipate baldness if he persists in wearing the present type of hat.
Should the gentler sex cut their hair short and wear a tight- fitting hat, they will soon show symptoms of alopecia traumatica.
However, in the future when proper protection is given the blood supply of the scalp, we can be confident of seeing fewer bald- headed men.