DEAR DR. DONOHUE: I don’t know how important you consider this, but believe me, it is very important to me. I have bald spots on my scalp, and I am only 27. It started with one. I didn’t pay much attention to it, and it went away. Well, it came back, and now I have a number of them. I read that liquid vitamins massaged into the spots will regrow hair. Is this so? If not, what does work? – D.J.

ANSWER: You have alopecia areata. It’s a condition where hair is lost in round scalp patches that measure from 0.4 to 1.6 inches (1 to 4 cm) in diameter. It happens to both men and women, and it often comes on relatively early in life – in the 20s or even before.

It results from the immune system turning on hair follicles and inflaming them. The inflamed hair follicle accelerates hair shedding to the point where a bald patch forms. No replacement hair grows as long as there is even a smidgen of inflammation in the follicle.

The course of alopecia areata is unpredictable. A bald patch might regrow hair, only to lose it again at a later date. New patches often appear. For quite a few people, however, the entire process lasts only a year.

Treatments are chosen based on the extent of involvement and the age of the patient. Cortisone is the greatest anti-inflammation drug available. Since the basis of alopecia areata is inflammation, injecting the bald patch with a cortisone drug suppresses inflammation and can often stimulate hair growth. Minoxidil, the liquid hair-restorer, can sometimes coax hair to grow. Anthralin cream, which is spread on the bald patch, is another medicine that has had some success in bringing back hair. Vitamins massaged into the scalp don’t restore hair.

In a few instances, alopecia areata is part of the picture of another illness, such as lupus, thyroid gland disturbances and pernicious anemia.

You would be well-served by consulting a dermatologist.

DEAR DR. DONOHUE: I need information about epididymitis. I am currently under treatment for it, but I cannot find much information about it. How do you get it? – X.R.

ANSWER: The epididymis (EP-uh-DID-uh-miss) is a comma-shaped structure that’s stuck to the top and back of each testicle. It consists of many coiled tubules that serve as a place for sperm maturation and for sperm transport out of the testicle.

Epididymitis is an inflammation of those tubules. The infecting germ often comes from a nearby urinary-tract site like the prostate gland or the urethra, the drainage tube that runs from the bladder through the penis.

Sometimes the cause of infection is a sexually transmitted germ, like the gonorrhea germ. That is often the case in men who have many sexual partners.

The two most common symptoms of epididymitis are pain and swelling of the testicle. Some men experience painful urination and a need to urinate frequently.

If there is a discharge from the penis, that material can be cultured to pinpoint the precise bacterium causing the infection. That is a definite plus, since an antibiotic with known effectiveness against that particular germ can be prescribed, and that all but assures successful treatment.

If culture evidence is impossible to obtain, then an antibiotic with a wide spectrum of activity against the more common bacterial causes of epididymitis is chosen. Bactrim is an example.

DEAR DR. DONOHUE: When I swallow, I hear gurgling noises in my throat, and sometimes I get a sour fluid that fills my mouth. My doctor thinks I might have a Zenker’s diverticulum. What is that, and how is it treated? – B.P.

ANSWER: A Zenker’s diverticulum is a pouch that forms in the back of the throat. It can catch food as it is swallowed. Food trapped in the pouch provokes coughing, makes gurgling noises, can lead to bad breath and can produce swallowing difficulties.

An X-ray taken after a person swallows barium shows the diverticulum.

Surgical removal of the diverticulum is the treatment.

DEAR DR. DONOHUE: You neglected to give all the options for treatment of carpal tunnel syndrome. I am an occupational therapist specializing in hand therapy. A good majority of carpal tunnel patients get complete relief with therapy, especially when they begin treatment early. Please mention this option to your readers. – K.F.

ANSWER: I consider occupational therapists to be medicine’s unsung heroes. I endorse all treatments by occupational therapists and hope my readers will take advantage of the therapy they offer.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.