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Treatment of diffuse (symptomatic) alopecia areata
Last reviewed: 04.07.2025

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The prognosis for diffuse (symptomatic) alopecia is favorable in cases where it is possible to establish the cause of hair loss and eliminate it. Usually, when questioning the patient, it is easy to find out the cause of the acute onset of alopecia (childbirth, infectious diseases, myocardial infarction, blood loss, starvation, cytostatic and radiation therapy, and many others. However, with a gradual development of the disease, even the most thorough collection of anamnesis may be unproductive, since the patient is often unaware of the presence of concomitant diseases (pituitary gland, thyroid gland, kidneys, etc.) or intoxications (poisoning with mercury salts, waist, etc.).
To determine the role of a particular factor in the development of symptomatic alopecia, a thorough examination of the patient is necessary using clinical, biochemical, endocrinological and toxicological methods. Along with traditional toxicological methods of quantitative analysis of the mineral status of the body, spectral analysis of biosubstrates has been used in recent years, which makes it possible to simultaneously determine more than 20 elements, including toxic ones. Such a comprehensive characteristic of macro- and microelemental status allows solving the problem of its individual correction, taking into account the complex, antagonistic or synergistic interaction of minerals. Among other biosubstrates used for testing, hair is of the greatest interest, which is preserved for a long time under normal conditions, as already noted, can serve as an objective indicator of the microelement situation in the whole organism and in the environment.
For the treatment of acute and chronic poisoning with arsenic compounds, mercury, chromium, bismuth and other metals, hydrocyanic acid and its salts, iodine and bromine salts, specific antidotes - complexones (unithiol, sodium thiosulfate, pentacin, etc.) are traditionally used. In recent years, so-called biologically active food supplements (BAFS) containing vitamins, macro- and microelements, herbal extracts and other natural complexes have been increasingly used for this purpose. Modern BAFS have the ability to remove toxic microelements and radionuclides from the body, without causing significant side effects, unlike known complexing agents.
The same preparations are used for individual correction of mineral imbalance. Currently, second-generation preparations are widely used, in which vital macro- and microelements are contained in the form of a complex with bioligands (natural carriers of minerals). As examples, we will cite the preparations ZINCUPRIN and ZINCUPRIN-FORTE:
Compound:
Cincuprin: 1 tablet contains 0.031 g zinc aspartate (6 mg Zn) and 0.0026 g copper aspartate (0.5 mg Cu).
Cincuprin-forte: 1 tablet contains 0.15 g zinc aspartate (30 mg Zn) and 0.0143 g copper aspartate (2.5 mg Cu)
Directions for use:
Cincuprin: children from 1 to 5 years old - 1 tablet per day; children from 5 years old and teenagers - 1-2 tablets per day. Preferably after meals, can be washed down with milk.
Cincuprin - forte; for adults - up to 3 tablets per day. Preferably after meals, can be washed down with milk
Note:
- Do not use in case of renal failure, Wilson's disease, or simultaneously with antibiotics.
- To increase the effectiveness of use and prevent possible side effects, it is recommended to determine the content of zinc and copper in the body by analyzing hair, blood, etc.
Packaging: 50 tablets.
According to A.V. Skalny, the optimal combination is a rational combination of dietary supplements and food diet.
Currently, there are third-generation supplements on the market, the minerals of which are contained in chelated form (from the English chel - claw, metal surrounded by amino acid), which facilitates their better absorption. As an example, we will cite the drug CALCIUM MAGNESIUM XEJIAT.
Composition: 1 tablet contains:
- Calcium (chelate, citrate) 250 mg
- Magnesium (chelate, oxide) 125 mg
- Phosphorus (chelate) 100 mg
- Vitamin D (fish oil) 133 IU
Directions: 2 tablets 2 times daily with meals.
Other identified diseases and background disorders also require adequate correction.
In cases where hair loss is suspected to be related to a specific medication, the physician must decide whether to discontinue the medication or replace it with another harmless remedy. Unfortunately, the only evidence that a medication is involved in hair loss is the restoration of hair growth after the drug is discontinued and the increase in hair loss when it is re-prescribed. If discontinuing the medication is not possible, for example, when treating malignant neoplasms, the patient is advised to cut their hair short before it begins to fall out and to wear a wig until hair growth resumes.
Patients suffering from diffuse alopecia also need psychological support, and some of them need help from a neuropsychiatrist. They should be told that hair loss precedes the growth phase of a new hair shaft, and they should be encouraged to be patient, explaining that the hair growth rate is only 0.25 mm per day. Thus, the hair will reach 10 cm in length only after 400 days. If psychotherapy is ineffective, antidepressants are prescribed.
Although eliminating the cause of the disease leads to spontaneous recovery, to accelerate the rate of hair growth and improve the patient's emotional state, it is recommended to prescribe trichogenic agents (Regaine, etc.) and physiotherapeutic treatment (massage, d'arsonvalization, microattacks, electrotrichogenesis, etc.)