Whether you're a man or a woman, beauty isn't always pretty. Sometimes we're faced with an unexpected problem, such as thinning hair. Other times we battle a problem we've had for years, like acne or excessive sweating. Such problems tend to have an unfortunate and usually unwarranted association with poor hygiene and thus carry a social stigma that can cause people extreme embarrassment. If the condition is chronic, such embarrassment can lead to emotional problems.
Parasitic infestations are one such problem to which enormous social stigma attaches. Just as bedbugs have recently made a resurgence, so have head lice and scabies, a mite responsible for skin infestations that cause severe itching. Contrary to popular belief, these infestations are unrelated to grooming practices. The eggs of the scabies mite or the louse can be picked up from a head rest in the first class section of an airplane just as easily as they can be transferred from the head rest of a seat on a city bus or from the collar of the coat hanging next to yours at the theater.
Scabies appears as brown spots or threadlike lines on the skin of the hands and arms, near the genitalia, or in skin folds. Head lice announce their presence by causing an intense itch at the nape of the neck and near the ears. On close inspection, the egg sacs (called nits) will be visible on the hair shaft. One way to reduce your chances of getting head lice is to avoid trading, borrowing, or lending hair accessories, brushes, combs, or even hats.
Repeated treatment with a lice shampoo containing permethrin, available at your local pharmacy, will probably be needed to kill the adult lice and the nits. Wait two days between treatments. Do not use conditioner after you shampoo, since it makes the hair shaft too slick for the medicine to adhere to it. A nit comb, which looks similar to a flea comb, should be used repeatedly to comb out lice and nits that remain behind. Lindane, a prescription medication, should be used only as a last resort, since it can cause seizures and in rare cases has even been fatal. If your doctor prescribes it, follow the instructions carefully. Permethrin cream or lindane is also used to treat scabies. All members of the household must be treated if one member has lice or scabies, even if symptoms are not apparent. Bed linens and clothing should be washed in hot water (at least 130 degrees) and dried in a hot drier or ironed.
Perhaps the only good news about such infestations is that, with persistence, they can be cured.
Thinning Hair or Balding
For those who are losing their hair, permanent fixes are harder to come by. The most common kind of baldness, or alopecia, is called male pattern baldness. It's caused by a combination of genetic inheritance and the presence of specific male hormones, or androgens, and usually causes a receding hairline and hair loss at the crown of the head. If your hair is thinning, cutting it more often won't make it grow faster or thicker. Closely cropped hair is arguably more attractive, however, than a monklike fringe or a comb-over. If you're really confident, embrace your baldness by shaving your head (carefully!). Women who are self-conscious about their thinning hair can consider wearing a wig or wiglet (partial wig).
Rogaine (minoxidil) is an over-the-counter topical medication that will regrow a modest amount of hair, mostly in the crown, in some people. Hair transplant or replacement is the most expensive option for men and women with thinning hair. Modern hair transplantation uses micrografting to transfer hair follicles from donor sites (areas of thicker hair growth, such as the back of the head) to bald or thinning areas.
Unwanted Body Hair
Unwanted body hair can be just as distressing as baldness, particularly for women who have hair on their chin or upper lip. Shaving such hair often yields cosmetically unsatisfying results. A hair remover product may produce a better result if it doesn't cause too much skin irritation. Another option for light-skinned people is to bleach the hair to make it less noticeable. Those with bigger budgets can consider electrolysis or laser treatments, permanent and effective but expensive and time-consuming ways of keeping hair from growing back.
A new prescription cream called Vaniqa slows growth of facial hair by inhibiting an enzyme necessary for hair growth. The product doesn't work for all women and is somewhat more effective in white women than in women of color. It takes effect slowly, with results (if any) not noticeable for 4 to 8 weeks. The cream must be used continuously, or the normal rate of hair growth may resume. Spironolactone is an old, inexpensive effective medication that can reduce hair growth in women. It is generally prescribed at 100-200mg per day but may have several minor side effects, including breast tenderness.
Chronic excessive sweating of the palms, face, armpits, or feet is a nervous system disorder known as hyperhidrosis. This condition can be detrimental in social and professional situations, and people often go to great lengths to manage the disorder. Several treatments are available:
- Anticholinergic medications like glycopyrrolate, oxybutynin, or benztropine may be useful in controlling perspiration, but they often have unacceptable side effects.
- Use of an electrical current to disrupt sweat glands may help, but this therapy requires time-consuming daily treatments.
- Injection of Botox into the armpits is very effective in reducing perspiration. This treatment may work on the palms and face as well, but the paralyzing effect of the drug limits its usefulness in these areas.
- A surgical procedure can cure the condition by severing the nerves responsible for sending the signals that trigger excessive sweating. This procedure is also effective for those who blush inappropriately. However, the procedure carries several serious risks and must be performed under general anesthesia.
Most of us have had to deal with acne at some point in our lives. Acne is an inflammatory condition that occurs when sebaceous glands in the hair follicles become plugged with dead skin cells, sebum, and bacteria. It's most common on the face, shoulders, back, and chest. Acne occurs more frequently among adolescents because hormonal changes during puberty enlarge the oil glands. However, it can affect a person of any age. As with baldness, acne is primarily related to heredity and hormonal factors. It is unrelated to poor hygiene practices. As anyone who has had it knows, acne can't be treated or prevented simply by washing your face. Of course, if you wear makeup, make sure it's an oil-free formulation. Wash your face or shower as soon as possible after exercise to reduce bacterial populations on the skin.
Over-the-counter medications containing benzoyl peroxide or salicylic acid may be effective in managing acne, but many people suffer with the condition—or watch their children suffer—far too long before consulting a dermatologist or family doctor. Prescription topical antibiotics and retinoids (medications containing vitamin A) are often highly effective. Severe, intractable acne may require treatment with isotretinoin (Accutane), an oral vitamin A preparation available by prescription. Patients who take this drug must be closely monitored for side effects, and women of childbearing age must ensure they don't become pregnant while taking isotretinoin and for a short time afterward, since the drug is known to cause birth defects. Treatment lasts about four months. The drug's effects are dramatic, often clearing severe acne completely, and the change is usually permanent.