FALLING. HAIR SIR,—It is a pity that Miles Howard, in
his article on 'Falling Hair,' has perpetrated so many obsolete and misleading theories. Whilst most dermatologists will admit that the cause of patchy baldness (alopecia areata), total loss of scalp hair (alopecia totalisY and complete hair loss on the scalp and body (alopecia universalis) is unlikely to be due to a single organic cause, it is equally true that few nowadays are pre- pared to blame stress or psychological factors. It is evident that your contributor has not read the de- tailed and careful study by his colleague Dr. Ida Macalpine (a psychiatrist) published in the British Journal of Dermatology in April, 1958, which in- vestigated this problem. Her conclusions state plainly that there is `no evidence for the widely held view that psychological factors—mental illness, anxiety or mental shock—play a significant part in causing or precipitating the disorder.' This statement is backed by reports of 125 cases observed over a seven-year period and bears the stamp of careful ob- servation.- The importance of not labelling any dis- order psychosomatic without certain and unequivocal reasons is that the search for organic causes is re- tarded and progress in medical science delayed. Another aspect arises when medico-legal factors have to be considered. Unfounded theories of this type raise false hopes for litigants and the resultant arguments in the witness box belittle the medical profession in the eyes of the law.
Regarding the equally fallacious statements put forward in the article suggesting that washing the hair can cause male-type baldness and that 'for a few men loss of hair means loss of virility,' I can only shudder at the suggestion. In fact, the opposite is probably true, and I would remind Miles Howard of the seaside competition held some years ago at a northern resort for the man with the baldest head, and another for the man with the hairiest chest. The same man won both I—Yours faithfully, 14 St. John Street, Manchester, 3 GEOFFREY AUCKLAND
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