American Medical Association Family Medical Guide - American Medical Association [769]
Treatment with the topical over-the-counter medication minoxidil (available in a 2 percent solution for women and a 5 percent solution for men) produces a fine growth of downy hair in some men and women in 4 to 6 months. In 6 to 12 months, the new hair may eventually be about the same thickness as the rest of the hair. However, hair growth stops if the treatment is stopped. An oral medication called finasteride has been shown to be effective in about half of cases of male pattern baldness. It may take more than 6 months for the drug to produce noticeable results. To treat baldness in women, the blood pressure medication spironolactone is prescribed to lower the levels of the male hormones that are often linked to hair loss in women.
Folliculitis
Folliculitis is infection of the hair follicles, which can occur anywhere on the skin or scalp. Most cases are caused by staphylococcal bacteria and usually result from hair-removal methods such as shaving, tweezing, or waxing. A type of folliculitis can develop from exposure to a bacterium called Pseudomonas aeruginosa, which can survive in hot tubs.
Symptoms
Folliculitis is characterized by an itchy, bumpy, red rash (see page 125) that appears within 2 days of exposure to the bacterium. The bumps may develop into dark red tender lumps (nodules) or may develop small, pus-filled blisters.
Diagnosis and Treatment
Your doctor will suspect folliculitis by the appearance of the rash or if you have used a hot tub within the past 3 days. For mild cases, treatment is usually unnecessary because the infection tends to clear up on its own. Your doctor may recommend a topical antibiotic cream or lotion to apply to the rash to eliminate the bacteria, and an oral or topical medication to reduce the itching.
For severe cases, a doctor may prescribe an oral antibiotic such as tetracycline, minocycline, ciprofloxacin, penicillin, or cephalosporin to take for 4 to 6 weeks. If you have chronic or recurring infections, your doctor will recommend letting your hair grow in the affected area for at least 3 months to help clear up the infection. If the folliculitis resulted from exposure to bacteria in a hot tub, your doctor will tell you how to control the pH (acid) and chlorine content of the water in the hot tub to eliminate bacteria and prevent more from growing.
Paronychia
Paronychia is infection of the cuticle or skin fold at the base or sides of a nail. The infection is usually caused by a bacterium (such as staphylococcus or pseudomonas) or a fungus (such as Candida) and is common in people who spend a lot of time with their hands in water. The infection comes on suddenly when it is caused by bacteria. A fungal infection, which is usually less painful, develops slowly and frequently becomes chronic.
Symptoms
The symptoms of paronychia include a swollen, red, and painful cuticle or nail fold (see page 127). The cuticle may lift away from the base of the nail; if you press on the nail, pus may come out. When the fold of the nail is affected, a blister of pus (called a whitlow) develops on the side of the nail. The skin around the nail may also be affected. The cuticle no longer protects the root of the nail, allowing the root to be damaged and deforming or discoloring the nail. In a fungal infection, the nail can become thick, white, and powdery.
Diagnosis and Treatment
A doctor can usually diagnose paronychia by its appearance. He or she may take a scraping from the nail to grow in a laboratory for examination under a microscope to identify the bacterium or fungus.
Your doctor will treat a bacterial nail infection (in its early stages) with antibiotics, and a chronic fungal nail infection with an antifungal cream. If you have a pus-filled blister, he or she may pierce the blister, which will relieve the pain and speed healing.
How to Keep Your Nails Healthy
The following guidelines can help you keep your