For thirty years now, I have been asking what ails my scalp and suddenly I seem to be getting some answers.
I am not going to write a scientific paper, it’s not my forte. What I am good at though is observation and this is what I am going to record here. I will venture to make some hypothesis or extrapolations from observing what is happening to my scalp to see if it can serve as a model for what may be happening inside my body. In other words is what is happening on my head a reflection of what is happening inside?
Alopecia areata is a type of baldness that affects both men and women. It manifests first as bald patches of different sizes that may grow large enough to result in complete baldness, it is characterised by its relapsing remitting nature. There is some evidence that thyroid deficiencies might be a factor, but mostly the medical profession put it down to stress and auto-immunity.
Of course we know that Cpn is a cortisol loving beast and stress does induce the production of cortisol, so no surprise there. And Cpn could also be the culprit in thyroid problems and we all know from the evidence produced on this website that Cpn is implicated in what are classed as auto-immune diseases.
The complete baldness has happened to me on two occasions, once after the birth of my second child and then more recently in my fifties.
1998 dark hair starting to fall out
It first started after the birth of my son, but disappeared completely during pregnancy only to return with a vengeance after Ella was born. This bears a similarity to the experience of women MS sufferers who often have a significant relapse after giving birth. After six years of complete baldness it slowly grew back to a complete pelage, and stayed fairly normal for 10 to 12 years, a long remission maybe. Then out it came again, with maybe the saving grace that any white hair I had, being made of stronger stuff, remained as a thin layer saving me from complete baldness. Whether this was related to stress (I was teaching at the time), Cpn (which of course is stress related) or dwindling hormones is debateable; maybe a combination of all three.
2002 not much dark hair left
The way I understand it is thus: during pregnancy the immune systems is somewhat quieted to avoid foetal rejection, which could explain why my hair was blooming as well as the rest of me. But that was also the time when maybe Cpn was taking hold in my scalp, for when the cat is away the mice will play… Once the cat came back there was an almighty battle where fur flew and baldness resulted. Given time (6 years) and without the help of antibiotics, it seems as though my immune system managed to reduce the Cpn load in my scalp enough to allow my hair to grow again. For ten years my immune system was in control, but slowly the Cpn gained ground, helped also by the stressing factor of teaching.
Now comes the interesting bit: what has happened since I started the CAP.
Nothing changed during the initial phase of Doxycycline and Azithromycin, no sensations, no hair loss. But 20 minutes after taking the first Metronidazole tablet, there was a tight sensation around my temples and the nape of my neck, roughly in the area where Caesar would have worn his laurels. Nothing more, no dramatic shedding of silver, no itchiness, no pain. This sensation lasted for a couple of days and then disappeared. It takes about 6 to 8 weeks for any sign of change in the scalp, so all I could do was wait. This sensation was repeated at each Metronidazole pulse on different parts of my scalp.
After a couple of months I saw a hint of dark hair beginning to grow where Caesar’s crown would rest, and then around my own crown, so what everyone was saying was true, the CAP did make your hair grown again. But I’d also heard that it made your hair fall out, and sure enough I did start loosing more white hairs than usual but so long as the dark hair was growing I was not complaining.
About 4 months after starting the treatment I noticed some itching and tender spots on my scalp, these are the usual signs for me of a renewed attack of alopecia on my scalp. Of course I was concerned, but in other places the dark hair was still growing. A month later I notice that I had very small bald patches, maybe the size of a dime appearing in the middle of the crop of dark hair, where I had felt the tell tale signs earlier. These patches are a lot smaller than is usual for me when hair falls out and they seem to be self contained not spreading outward as was usual for me.
This is all good news, but does it explain anything about Cpn? As stated earlier I am not a scientist and anything I extrapolate from these observations can only be conjecture. However, using the model provided by my scalp it might help me to understand what is going on inside me body.
There appears to be a general assault on the Cpn colonies, I have never seen one of these lesions but if my hair is a mirror of what is happening inside, these are circular and grow from a central point, expanding at the circumference, therefore getting larger and eventually merging into one to complete baldness. Places where my scalp has been injured at one point or another during my life seem to react differently to the rest of it. The hair grows back first in those places. Some areas of my scalp have been slow to grow back and some are revisited time and time again and others seem pretty stable.
Once the CAP started to take effect there seemed to be a general dying off of Cpn which resulted in a light growth of hair, later following more pulses the same areas were addressed again resulting in dying off in the centre of each patch, forming concentric patches of much smaller size.
So if similar things are happening inside my body, it may be very difficult to discern any changes for quite some time, the improvements might be so slight as to go unnoticed and as each area is revisited again and again, with consequential discomfort. It could even appear as if the condition is getting worse. There is no change in the way my scalp feels unless Cpn issues are being addressed, so equally it may be difficult to notice anything feeling better elsewhere. The recovery time for hair follicles is six to eight weeks in my experience, if this is the same for other tissue it could be difficult to discern any improvements for a few months.
After ten months of treatment, I have enough hair for my head to look fairly normal, there are still and number of areas where the hair has not regrown and areas where new hair has fallen out again, but the balance is on the side of regrowth. Maybe when my hair has regrown completely and there are no new patches appearing I may be able to say, other symptoms permitting, that the treatment is complete and I can then go onto intermittent therapy instead.