treatment of alopecia areata is in many cases by no means as satisfactory as one might wish. Patients sometimes go from one physician to another, and fortunate is he who happens to take charge of the case at the time when the unknown cause has ceased to act and the hair is disposed to return. Unfortunate is he, however, if he jumps at the baseless conclusion that his plan of treatment in this case is wonderfully efficacious and will cure other cases with equal rapidity.
But treatment in alopecia areata, although it may not be productive of brilliant results, is capable of doing some good in the way of hastening a cure; and since the patient usually demands some kind of treatment, the physician is certainly justified in doing the best he can under the circumstances. The practical question at once arises, "What is the best thing that he can do?"
The first step to be taken is to prevent any possible spread of the disease to those who come in contact with the patient. If only in deference to the view held by excellent authorities that the affection is of a contagious nature, it is well to insist that every patient should have his or her own brush and comb and use no others. As to whether children with alopecia areata should be allowed to attend school, a difference of opinion might arise according to the opposite views held as to its contagious nature. But since the disease is only slightly, if at all, contagious, it would hardly seem justifiable to keep a child at home who is undergoing proper local treatment.
Whatever will stimulate the scalp and draw the blood to the pale, hairless patches will tend, in my opinion, to promote the growth of hair. And this can be done without the infliction upon the patient of either pain or discomfort. Nearly all of the powerfully stimulating applications are parasiticide in their action, and are therefore indicated, whether one believes in the neurotic or the parasitic origin of the disease. The beneficial effect results from the artificial congestion of the patch, whether the action of this be to arouse the dormant nerve filaments or to check the development of a micro-organism.
The galvanic current is perhaps the best stimulant that can be used; but as the patient cannot conveniently have electricity applied two or three times a day, it is more advisable to prescribe some stimulating lotion or ointment. The liquor ammoniae fortior U. S. P. I have used for many years and in many cases; and, while it may be no better than other stimulating applications which tend to redden the skin, it has certainly
