Alopecia areata, but focal alopecia, visually looks like lichen. On the scalp, bald spots are formed, having a round or oval shape, they are completely smooth without a single hair. The disease can last several years, small foci of lesion during this time grow and unite in large islands.
Such a pathology can appear in people of different ages, in some patients who are ill after treatment, hair grows on bald spots again, while in others they remain as if trimmed. It is characteristic that the hairs can fall out not only on the head, but also on the whole body.
This video describes what alopecia areata and what are the forms of such an ailment:
Classification and localization
Foci of baldness can appear not only on the head, but also on the eyebrows, eyelashes, mustache and beard. Loss can be on one or two sides.
- In men most often it is observed focal hair loss, which begins with the top of the head, if you do not take any measures, then the disease will progress, and a person can be left without them at all. Focal alopecia in the stronger sex is uneven, most of the loss of strands is observed on the crown, they practically do not grow there, and if any appear, they are much shorter than healthy strands and resemble a fluff.
- Among women this type of baldness is milder, since female hormones predominate in them, the disease is sluggish in nature. But with hormonal disruptions, when testosterone prevails in the body, baldness becomes total.
- In children such an ailment is accompanied not only by the loss of locks on the head, but also by the loss of eyelashes and eyebrows.
About 10% of patients with this disease have plate deformation, they can become very thin to acquire a yellowish tint and even fall out.
Alopecia areata are classified as autoimmune diseases, this is evidenced by its hereditary predisposition, impaired regulation of the immune response and the frequent detection of organ-specific antibodies.
Photo focal alopecia areata
Causes of occurrence
It is impossible to establish them exactly, this type of alopecia can begin by chance for a person, but there are a number of factors that can push this disease to appear:
- Heredity. Children by genes receive from their parents not only good signs, but also various diseases. If baldness was observed along the male line, then it can also occur in their children.
- Autoimmune processes. Cells of the immune system itself block hair growth or destroy it. But the treatment in which they act on these cells does not give much improvement, so this reason is still unprovable.
- Infectious diseases. Serious illnesses can cause hair loss, not only on the head. Such a deviation can be observed with various fungal infections of the skin.
- Stress. In some patients, baldness began after a moral shock.
- Injuries and cuts. Sometimes, a person hitting his head can harm his curls and severely injure their follicles, which can lose hair.
Symptoms of alopecia areata
In both sexes and even in children, the manifestation of the disease occurs in the same way, with this process there is a massive loss of hairs in a certain area. Zones of baldness can be several, without timely therapy, you can wait for their growth and connection.
The main symptoms include the following:
- smooth skin surface, sometimes a small fluff is visible on it,
- an inflammatory process is observed at the site of hair loss,
- the bald area takes an oval or round shape,
- the place where the hair began to fall out can itch, but this is extremely rare,
- the skin in the affected area may turn red, wounds are present on it,
- the hairs can remain in their places, but they become very brittle and this results in places that seem to be shaved.
Diagnostics and analyzes
Usually an experienced specialist can determine the type of alopecia even with a visual examination. To make sure the diagnosis is correct, he can use a dermatoscope. In almost every case, scraping is taken in places where curls fall out to exclude lichen, and other diseases similar in their symptoms. If a person is accompanied by signs of other diseases, such as lupus or syphilis, then a blood test is taken.
At the first signs of baldness, a child needs to undergo all possible diagnostics in order to accurately establish the cause of this phenomenon, it should be shown to a trichologist and dermatologist. After passing the tests, you may need to visit related specialists to exclude diseases accompanied by baldness:
- Neurologist - psychological trauma and unequal shocks,
- Endocrinologist - Thyroid,
- Pediatrician - pneumonia, chickenpox, helminthiasis,
- Gastroenterologist - vitamin deficiency, gastroduodenitis.
A simple and effective method is rubbing therapeutic ointments and increasing your immunity. In no case should you delay a visit to the doctor and be treated on your own, the disease can progress, and as a result the number of lost hairs will increase.
Treatment of focal baldness in children is complex, for them therapy involves:
This video is dedicated to the treatment of focal alopecia
The cause of many diseases is a lack of vitamins, so it is so important to determine which of them is missing a sick person. In the event of a bald spot, the first thing you need to do is buy vitamin complexes that contain hair vitamins: E, A, Group B, F and D. Nicotinic and folic acid are also needed.
As an external agent, hormonal ointments are used, which, thanks to the corticosteroids contained in them, slow down the work of immune cells that destroy follicles. But they can only help in the initial stage. In more advanced cases, injections with corticosteroids are used, after which the hair quickly grows on the affected areas, but after the injections cease to be administered, the locks can again fall off to prevent this, the injection treatment is repeated once a year.
It refers to adjuvant treatment, effective in an integrated approach. Her popular methods used for this disease include:
- Darsonvalization. The impact on the lesions with a weak pulsed current.
- PUVA therapy. It involves irradiation of the skin with ultraviolet light.
- Phototherapy. It also uses ultraviolet light, but after taking a long course of such therapy, there is a risk of developing skin cancer.
- Cryotherapy. It involves exposure to scalp with snow from carbonic acid.
For the treatment of alopecia areata, several effective agents are used:
- Minoxidil. It is not as effective as in the treatment of androgenetic alopecia, but everything improves the situation and over time contributes to hair restoration. The drug has side effects, but with a short application it is safe.
- Oral contraceptives help with hormonal disruptions in women. They make up for the loss of female hormones.
- Dithranol Most often it is used for psoriasis, but with focal alopecia, it acts effectively, and even with prolonged use it is safe.
- Sedative drugs - Persen, Novopassit, which are used to relieve stress and normalize the mental state of a person who has discovered a bald patch or the cause of its occurrence, have become constant stressful situations.
- funds for local irritation, which stimulate the growth of curls.
- Andralitin is an immunomodulator that improves cell regeneration.
- Traditional medicine in the case of focal prolapse is ineffective without the use of complex therapy, rubbing the scalp, onion, garlic, red pepper and horseradish root into the skin is among the available formulations.
- In advanced cases, when it was not possible to restore most of the hair, their transplantation was not used, but some experts do not recommend resorting to this expensive treatment, since due to unexplored pathology of the disease, it is difficult to predict the outcome of the process and to predict the survival of transplanted curls.
- The use of a gluten-free diet is explained by the fact that many children have gluten intolerance, and hair loss occurs precisely because of this, after changing the diet, their hair is restored.
Baldness does not affect any other human organs, it has only an unpleasant psychological effect. Moreover, his treatment in men takes a very long time, and it takes time and effort.
It happens that patients have a small focus of baldness, and the doctor does not prescribe him any means. The fact is that alopecia areata can begin and end on its own, so you need to wait three months under the supervision of a doctor, and then, if the hairs themselves do not recover, pick up medication.
The exact prognosis of such a disease is difficult to establish, in some people the hair is restored completely, while in others the affected areas remain smooth. In children, it can pass without a trace, but in case of relapse, the child may be left without a part of the hair.
You will find even more useful information about this ailment in this video:
Treatment of alopecia areata
Treatment of alopecia areata is carried out by introducing glucocortecosteroids into pathological foci, the meaning of this therapy is the immunosuppressive effect of drugs. If the affected area is more than 50% of the scalp on which hair growth occurs, then treatment with corticosteroids does not have the desired effect.
To date, topical treatment with drugs containing corticosteroids has been found to be ineffective even in combination with carriers that contribute to a deeper penetration of hormonal drugs.
Topical immunosuppressive therapy for alopecia areata can be carried out using dinitrochlorobenzene, squaric acid dibutyl ether and diphenylcyclopropenone.
Properly selected systemic use of steroids can reverse rapidly progressing alopecia areata.
It is possible to suppress active lymphocyte clones by immunotropic drugs.
In some cases, photochemotherapy is effective, as well as some adjuvant methods of exposure to lesions.
When choosing methods for treating alopecia areata, the constitution of patients and background diseases are taken into account.
The use of biogenic stimulants can accelerate tissue repair processes. To correct certain blood counts, preparations containing leech saliva extract may be recommended. In some forms of alopecia areata, zinc preparations may be indicated.
External means of concomitant therapy include a wide range of irritating agents (turpentine ointment, efcamon), stimulators of creatinocyte proliferation processes, drugs that improve tissue nutrition, and also contribute to improving tissue microcirculation. Externally, medicines containing silicon can also be used, which can improve the structure of the hair, or drugs whose therapeutic effect is due to exposure of the placenta to the affected areas of the skin.
Here is a list of the most popular treatments:
In practice, in the treatment of alopecia areata, drugs from naphthalan alcohol, tinctures of hot pepper, flies, chilibuh are widely used. Their effectiveness in some cases can be explained by a small stimulating effect, but in most cases the placebo effect takes place.
Patients may be recommended massage or cryomassage of the scalp, applications with paraffin (ozokerite), a ten-day course of treatment with d'Arsonval currents, diathermy of the sympathetic nodes in the cervical vertebrae, ozone therapy of the scalp.
Of the methods of physico-pharmaceutical effects, electrophoresis is most often used with a solution of reserpine, aminophylline, etc.
In some cases, a physical and biological effect based on a reflexotherapy effect is effective. Classical acupuncture, electropuncture, as well as exposure to certain types of electromagnetic radiation, the use of laser, ultraviolet, and microwaves have gained the greatest popularity in the treatment of alopecia areata from the whole variety of methods.
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Alopecia in women is a pathological hair loss caused by hair loss. The disease leads either to a partial thinning of the integument, or to its complete disappearance in some parts of the human head and body. There are several types of baldness in women - it is focal (breeding), diffuse.
Many men around the world are faced with such a problem as loss of hair. Despite the fact that representatives of a strong half of humanity are most susceptible to alopecia, this problem is not of exclusive sexual nature. Women are also prone to baldness, but in view of.
Proven popular recipes for hair treatment include ingredients that are used in professional medical cosmetics - amino acids, vitamins, minerals, fatty acids and other substances that stimulate hair growth, activating hair follicles.
Before a particular treatment strategy is chosen, the doctor will perform a comprehensive hair diagnosis. For this, an ultraviolet or infrared lamp can be used. If other health problems are found, it will be necessary to involve doctors of other specialties in the treatment process.
In addition to the term focal alopecia, you can find the phrase nesting alopecia, or alopecia areata. All this will mean the same pathology. As for the reasons why hair begins to fall out, they are still not precisely defined. In addition, it is unknown how the disease will proceed in the future.
Loss of hair as a result of age-related changes occurring in the body of a man is called male androgenic alopecia. This process depends on the production of hormones - androgens. This form of baldness is more common in males. In this connection, trichologists receive a lot of complaints like this.
Patients are often interested in the question of whether the transplant operation will be in vain. After all, hair that is transplanted by surgery can fall out just like your own, and the operation itself takes a lot of time and is not cheap.
What is alopecia
In essence, this ailment is attributed to pathological lesions, which has been known to mankind for a long time. But the exact causes of the disease have not yet been established. The following version is considered the most probable: the human body accepts existing hair follicles as something foreign to it and tries to get rid of them.
A distinctive feature of nesting from other types of baldness is that hair loss is circular, that is, hair loss begins in the form of a small circle that gradually expands.
Both sexes are affected equally. And, the worst thing about this type of baldness is that it mostly affects only young (under 25 years old) and children. You must admit that older people can more easily accept that they are balding than youth.
The following varieties of alopecia areata are distinguished:
- diffuse. Hair falls out on top of the head,
- local In this case, hair loss occurs in one area. In this case, the lesion focus has clearly defined boundaries,
- total alopecia. Hair loss occurs throughout the scalp, and is complete. This form of the disease is not observed in children,
- subtotal. More than forty percent of the hair on the head falls out,
- officialization. The loss in this case occurs along the edges of the scalp,
- universal form. In this case, the hair falls all over the body. This form often develops in children.
The occurrence of lesions is spontaneous, it is impossible to predict where the next lesion will jump out. They can remain in their original form, can grow, and also disappear spontaneously.
Having begun to appear alone, the lesion often often develops quickly and easily to a universal or total form. Moreover, the transition between the forms is almost imperceptible.
The causes of the disease
As mentioned above, the exact causes of the disease have not yet been established. But all the same, all doctors recognize that the origins of the disease must be sought in the childhood of the patient. Also, the cause may be a malfunction in the immune system, as discussed above. That is, the immune system, for some reason, recognizes the hairline on the body, in particular on the head, as alien to the human body and begins to get rid of it.
The disease can also be caused by exposure to environmental factors, in particular, poor ecology. Hair loss begins after intense emotional distress.
Due to the uncertainty of the reasons, treatment is different in men and in women.
Treatment of alopecia areata
Due to the fact that the exact causes of the disease have not been identified, a universal method of treatment does not exist. It is in each case selected individually. But all the same, there is something in common.
For example, the use of glucocorticosteroids is widespread. They can be of artificial origin or natural. In the latter case, the synthesis of the substance is carried out from the adrenal cortex of animals - dogs, rabbits or horses.
But, before starting treatment with hormones, it is customary to use irritating agents. As the latter are used anthralin, ammonium, carbolic acid, croton oil, hot pepper.
It was found that after such therapy, the hairline is able to recover. Even if several years have passed after baldness. But there is one “but”: this method is effective only in one case, if not more than 50% of the hair has fallen out. Otherwise, you can’t even start treatment with this method.
Another method of treatment is with the help of sensitizers, drugs that increase cellular sensitivity. Otherwise, this method is called topical immunosuppressive therapy. This technique is recognized as the most successful in the treatment of nasal baldness. In addition to sensitizers, this method uses immunotropic drugs that have a detrimental effect on white blood cells and immune cells - lymphocytes and white blood cells.
Often, photochemotherapy is used in treatment - this is when phototherapy is applied to the skin. The method works most effectively when used together with sensitizing drugs. The only drawback of this treatment is that it can harm the patient. So, during the treatment process, the victim's immunity is suppressed, and any infection can affect him. Even the simplest.
External treatment with turpentine ointment and keratinocyte stimulants are some help - these are cells of the outer layer of the epidermis. They contribute to the rapid growth of hairline.
Physiotherapy is not forgotten - scalp massage, paraffin treatment, current treatment (currents d, Arsonval). Well, the classical methods are acupuncture and electropuncture.
Doctors often use the placebo effect. - this is when the patient simply believes that this remedy will help him, and accepts it, but at the same time this remedy does not have these characteristics.
For those who do not want to take various drugs, there is one way - this is waiting. Some doctors call this method lazy treatment. It consists in the fact that you just need to wait a certain time. About half a year. As practice shows, in most cases, the baldness that has just appeared begins to grow again. And, there is hope that there will be no relapse.
Usually, the waiting method is recommended by the doctors themselves to those patients in whom baldness is in the first stage.
Medical expert articles
Alopecia areata (syn.: Circular, or focal, alopecia, pelada) is characterized by the appearance of rounded foci of baldness.
Patients with alopecia areata (GA) make up about 2% of dermatological patients. Men and women are equally prone to alopecia areata with a peak incidence between the ages of 20 and 50.
Causes and pathogenesis
The causes of alopecia areata have not been established. Alopecia areata is a heterogeneous clinical syndrome, in the development of which emotional stress, acute and chronic infections, physical trauma, and genetic factors play a role. The genetic heterogeneity of this disease explains its clinical polymorphism, well known to doctors.
Alopecia areata is considered as an organ-specific autoimmune disease, as evidenced by a hereditary predisposition, an increased frequency of detection of organ-specific antibodies and impaired T-cell regulation of the immune response.
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Classification of alopecia areata
A single classification of the disease does not exist. Depending on the area of the lesion, focal alopecia is distinguished (one or several large, up to several centimeters in diameter, foci of alopecia), which in case of an unfavorable course of the disease can overtake into subtotal, total and universal forms. Subtotal alopecia is diagnosed while maintaining small areas of hair growth on the scalp; total absence of hair on the scalp is typical. Universal (malignant) alopecia is characterized by the absence of hair at all places of hair growth.
In addition to the forms of the disease, which differ in the area of the lesion, three more types of alopecia areata are distinguished: ophiasis (serpentine form) - hair loss in the occipital region with the spread of damage to the auricles and temples, pinpoint (pseudo-syphilitic) - the occurrence of small (several millimeters) contiguous foci, shearing - rounded foci of breaking off hair.
Differential diagnosis is performed with cicatricial alopecia (pseudopelada), scalp mycosis, small focal alopecia with secondary syphilis, trichotomy, artifactal diffuse alopecia, with alopecia with congenital dystrophy of the hair shaft.
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Drug treatment: choice of drugs
Depending on the alleged causes, drugs for the therapeutic treatment of alopecia should be selected. So, with a lack of vitamins in the body and anemia, iron preparations are recommended:
In conjunction with them, vitamin B-6 or 2 complexes are often prescribed.
If baldness is caused by fungal infections, are indicated for the appointment:
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With endocrine pathologies, when not only the oxen on the head, but also the eyebrows are subject to loss, prescribe:
- levothyroxine sodium and the hormone T4: L-thyroxine and its analogues,
- Tireokomb and Yodokomb, Iodtiroks and Tireotom in the framework of complex hormonal treatment.
In case of severe nervous shocks, it is recommended to consult specialists such as a psychologist or even a psychiatrist. Do not think anything bad. Simply, if eyelashes, eyebrows begin to fall out with the hair, then rarely does anyone remain calm. This is especially true for women.
If the cause of severe hair loss became nonsense nerves, then in this case everything can only get worse. Therefore, the help of specialists will be necessary.
With hair loss, a person has a feeling of discomfort and therefore it is necessary to reduce its manifestation. For example, use sunscreen during the hot season. Such as ointments, creams, dark glasses. A wig or some headdress is required on the head.
For more details on the occurrence and treatment of alopecia, see the video
Signs of Alopecia areata
In most cases, focal alopecia in men and women occurs without any symptoms, but about 15% notice itching and burning in the affected areas. In severe stages (total and universal baldness), severe headaches can begin, weakness is observed.
Alopecia areata in women, men and children, as a rule, begins with the loss of a small area of hair (focus). About 80% of all patients have one lesion site, two lesions occur in 13%, and the rest have multiple lesions.
Patients are more likely to notice hair loss on the head, but focal alopecia can develop in men on the beard and mustache in both sexes, the process can begin with loss of eyebrows or hair on the extremities. It is possible that focal alopecia will occur on both the head and body.
Forms of alopecia areata
Depending on the area of the foci:
- Local alopecia has about 1-3 characteristic lesions on the head or beard. The diameter of the focus is 1 cm or more. 3 months after the onset of the disease, without any treatment, the sites may overgrow, or for a long time be without any changes.
- The reticular type is characterized by the appearance of numerous, small, separate “bald” areas
- The tape-shaped form is characterized by the fact that the lesion sites merge with each other and they are located in the occipital region or behind the ears - this is an ophiasis, but if the frontotemporal region suffers, then this is sisafio. In older directories, this form is called marginal nasal baldness, it is difficult to cure. It is more common in women and children, can be combined with atopic dermatitis.
- The subtotal form occurs when the disease progresses slowly, the number of lesion sites and their area increases, in some places of the head there are still separate islands with long hair, but if it is easy to pull for them, then they freely fall out. Eyebrows and eyelashes may become thinner.
- Total alopecia - in this case, the head is left without hair. Total hair loss develops quickly enough from 3 to 6 months. In 30% of those suffering from a total form, it occurs within the first 4 months after the onset of the disease. It is very difficult to imagine how the disease will evolve further - in some cases there is a slow restoration of hair, in some cases it goes into a universal form.
- Universal alopecia is the next stage after the total form, it is characterized by the absence of hair on the face and body. There is a complete loss of eyebrows, eyelashes, beard, mustache, on the body there may be a partial or complete disappearance of vellus hair.
In more than 75% of cases with the universal and total type, atopic or associated with intracranial pressure diseases were detected.
These forms of baldness are quite rare, the development of total and universal alopecia was recorded only in 7% of patients.
Depending on the initial location of alopecia areata:
- The shape of barbae is isolated to indicate foci in the beard and mustache
- Superciliary and ciliary form is the initial loss of eyebrows and eyelashes
Additionally, you can highlight:
- The diffuse type, which is characterized by the fact that there is not complete hair loss in the affected areas, the hair becomes like an “exclamation point”.
- Nikolsky’s ringworm - not everyone agrees that this is a manifestation of alopecia areata, because the peculiarity of this form is the appearance of patches with broken hair in the frontal region, which are easily and painlessly pulled out. These patients are characterized by various disorders of the nervous system: epilepsy, schizophrenia, hysteria, etc. A distinctive feature is the sudden onset, rapid, but not complete development (i.e., the total form never arises), and then after a few weeks, even without treatment the disease recedes.
- The phenomenon of Marie Antoinette (sudden graying) - the rapid loss of colored hair, only gray hairs remain.
Alopecia areata in men and women is classified by the mechanism of development and association with other diseases:
- The usual type is found in most cases, it is not associated with any disease. Occurs at the age of 20–40 years, often manifests itself in local form, complete remission can quickly occur (up to 6 months), the average duration is 3 years, and it does not always require medical treatment.
- The atopic type is predominantly children's, a single lesion can persist for about a year, then go into a subtotal or multi-focal form, and in 75% of cases it ends with a total form.
- The prehypertensive type occurs in adolescents, in the family history of which hypertension is recorded. The appearance of numerous foci is characteristic (reticular type), in 4 out of 10 cases there is a gradual development of the total form
- An autoimmune type of alopecia areata is diagnosed when autoimmune diseases and endocrinological disorders are detected. It usually occurs at a later age after 40 years, it is difficult to treat, in 1 out of 10 patients the disease flows into a total form.
- In some cases, a mixed type of alopecia areata is fixed.
Alopecia areata in women and men has different degrees of severity:
- Mild severity of hair falls in places (locally), the type of alopecia is normal, less often mixed or atopic, is more likely to have a favorable outcome
- A moderate degree is characterized by an increase in the number and size of lesion sites, while there is resistance to treatment and a constant spread of the process of loss to nearby areas of the hairline.
- A severe degree is diagnosed with subtotal, total and universal alopecia, with concomitant autoimmune or prehypertensive diseases, nails can be affected. Has a poor prognosis.
If a child under 5 years of age exhibits changes in the structure of nails, atopic reactions of the body and rapidly developing hair loss, then the probability of resuming hair growth tends to 0.
Alopecia areata causes
The causes and treatment of alopecia areata are interrelated, but the causes of focal alopecia in adults and children are not so easy to determine, because they are multifactorial.
The causes of focal alopecia in humans have been studied since ancient times, theories about the parasitic origin of the disease, neurological, etc. are considered.
Currently, the following factors are distinguished:
- The relationship of alopecia areata with infectious, dermatological, immune, neurological diseases. Measles, rubella, atopic dermatitis, vitiligo, lichen planus, autoimmune thyroiditis, hypothyroidism, collagenosis. According to foreign researchers, atopic dermatitis was detected in 20% of patients with alopecia areata.Gastrointestinal diseases also play a significant role, perhaps this is due to the fact that the proper nutrition of the hairline is disturbed, for example, a connection was observed between nonspecific colitis and focal alopecia
- Vascular disorders, in patients there is a violation of the proper blood supply to the dermal areas responsible for the hairline, a change in some blood properties is noted.
- Various disorders of the thyroid gland
- Hormonal imbalance
- The effects of stress, nervous tension, and mental illness have long been established. Almost a quarter of patients with GA have various mental, emotional difficulties.
- Hereditary, genetic factor
- Autoimmune theory, in which it is believed that the immune system perceives hair follicles as foreign agents, and begins to fight them, for example, it is believed that with sudden graying, the immune system fights pigment hair.
All of the above factors can affect the occurrence of GA either in total or separately, most of them entail an incorrect immune response to the body’s own cells, so the autoimmune reaction may not be the root cause, but a consequence of the described disorders.
Diagnosis of alopecia areata
Nest alopecia in women and men needs proper diagnosis, it includes:
- An external examination, in which it is necessary to exclude concomitant dermatoses, which can be "simulants" of HA. It is necessary to examine not only the head, but the whole body, pay attention to the nails.
- With a light pull on the hair rods, an area of loosened hair is identified, which frames the area of loss, the diameter of this zone can be up to 2 cm larger than the center of loss.
- Under a magnifying glass or a microscope, the roots of the fallen hair are examined, they will determine what stage of growth they are in (telogen, anagen, catagen).
- Trichoscopy is performed to more accurately study various indicators of the hair bulb, its shaft, scalp, and also to exclude the possibility of other dermatoses.
- To monitor the dynamics of development, it is necessary to photograph the patient, it will allow to evaluate therapy for a long course of the disease.