American Medical Association Family Medical Guide - American Medical Association [768]
• Don’t pull or stretch your skin while shaving, and don’t shave twice over the same spot.
• After shaving, rinse the area thoroughly and pat it dry.
Pilonidal Cyst
A pilonidal cyst or abscess is inflammation of the sinus or space just above the cleft of the buttocks. The sinus becomes inflamed and fills with pus when one or more hairs become trapped beneath the skin. The condition is common in young men, especially in men who have a lot of body hair. It is thought to result from repeated friction, which pushes the hairs back into the skin.
Diagnosis and Treatment
A doctor can usually diagnose a pilonidal cyst by its appearance and the symptoms.
Your doctor may drain the sinus by removing the pus and trapped hairs. You must keep the area around the sinus clean and dry to prevent a recurrence. A pilonidal cyst that recurs (which is common) must be removed surgically.
Baldness
Baldness in older men is a natural process. Hereditary baldness tends to run in families on either the mother’s or the father’s side of the family. It is normal for women to have some hair loss throughout life. For men and women, hair loss may follow major psychological or physical stresses such as surgery or a debilitating illness or accident. But the hair usually grows back eventually.
In some people, hair loss can result from an overactive or underactive thyroid gland (see page 901), consuming an inadequate amount of protein, an iron deficiency (see page 610), or taking large doses of vitamin A. Having radiation therapy (see page 23) or chemotherapy (see page 23) or taking some medications (such as for arthritis, depression, heart disease, or high blood pressure) can also cause hair loss in some people. Hair follicles can be affected by any disorder that affects the skin, such as systemic lupus erythematosus (see page 920), lichen planus (see page 1071), or ringworm (see page 1073). Some people injure the roots of their hair by pulling on their hair to create a particular hairstyle. Some people constantly pull out their hair (including the eyebrows and eyelashes) as a nervous habit, sometimes stripping these areas completely of hair.
Alopecia areata
Alopecia areata is a disorder that usually causes patchy hair loss (although it can cause complete baldness). In alopecia areata, round, bald patches (see page 127) appear suddenly. The exposed scalp has normal skin and sometimes a few, fine, white hairs that may be abnormally narrow at the base. The cause of alopecia areata is unknown, but stress may be a factor in triggering it. A person with alopecia areata may also have pitted fingernails. In rare cases, a person has permanent hair loss all over the body, including in the armpits, pubic area, eyebrows, and eyelashes.
Unwanted Hair
Excessive hairiness (hirsutism) is usually not a sign of a health problem. However, you should see your doctor about excessive hair growth because hirsutism and hypertrichosis (hair growth in moles or in places not normally covered by hair) can result from a disorder or may be side effects of medication. In these cases, treating the underlying condition may correct the problem.
Temporary hair-removal methods include shaving, tweezing, waxing, and depilatory creams, lotions, or sprays. Hair can also be bleached to be less noticeable. Eflorinithine, a topical enzyme inhibitor available by prescription, does not remove hair but slows the growth of unwanted facial hair in women. The only permanent methods of hair removal are electrolysis and laser hair removal.
Baldness caused by alopecia areata often stops on its own within a few months, and the hair usually regrows eventually. To stimulate hair growth, a doctor may recommend applying minoxidil or a corticosteroid cream, or he or she may inject corticosteroids directly into the scalp or prescribe medication to help dampen the abnormal immune response. However, treatments for alopecia areata are not always effective.
Treatment
The treatment of baldness depends on the cause, the location of the hair loss, and on how extensive