Alopecia areata (commonly called as Alopecia) is a condition that causes hair to fall out in small patches, which can be unnoticeable. These patches may connect, however, and then become noticeable.
Studies have shown that around 2% people in the world have Alopecia. Some studies have also reported that more men have it compared to women, but this might also be because of higher concern of women regarding hair loss and subsequent treatment. The disorder can occur at any age and the lifetime incidence appears to increase at an almost linear rate. Male patients may be more likely to be diagnosed in childhood, while females are more likely to have symptoms in adolescence and have simultaneous nail involvement or autoimmune diseases.
Alopecia is considered as an autoimmune disease in which the immune system, which is designed to protect the body from foreign invaders such as viruses and bacteria, mistakenly attacks the hair follicles, the structure from which grow. This can lead to hair loss on the scalp and elsewhere.
In most cases, hair falls out in small, round patches about the size of rupee coin. In many cases, the disease does not exceed beyond a few bare patches. In some people, hair loss is more extensive. Although uncommon, the disease can progress to cause total loss of hair on the scalp- Alopecia areata totalis or complete loss of hair on the scalp, face and even the whole body- Alopecia areata universalis.
Causes of Alopecia Areata
The common cause of Alopecia Areata is an autoimmune disease in which the body’s immune system attacks the hair follicles. Hair follicles are supposed to be immune privileged parts meaning the immune system is not supposed to attack them.
The cells of immune system attack the rapidly growing cells in the hair follicle. The affected hair follicles become small and drastically slow down hair production. Fortunately, the stem cells that continuously supply the follicle with new cells do not seem to be targeted. So, the follicle retains the potential to re-grow hair.
T-Lymphocytes clog on the hair follicles causing inflammation thereby suppressing hair growth. Babies could also be born with congenital alopecia.
Some studies have also shown that alopecia can be caused due to genetic conditions.
Risk factors for Alopecia
- Positive family history of Alopecia Areata. If your parents or grandparents had alopecia, you are at high risk of getting the condition.
- People suffering with autoimmune diseases like Arthritis, type 1 Diabetes and celiac disease.
- Exposure to environmental chemicals that lead to abnormal proliferation of Lymphocytes and Cytotoxic cells could also lead to alopecia areata.
- The common diagnostic sign is presence of bald patches on the scalp.
- The patches are normally round or oval in shape but in some people, they could have irregular shape.
- Trichoscopy- It will show yellow dots or hyperkeratotic plugs which confirms the diagnosis
Biopsy of the hair follicles can also be done for histologic analysis.
Ayurved aspect of Alopecia: Indralupta
Alopecia could resemble to Indralupta described in Ayurveda. Involvement of pitta and vata imbalance is very prominent in the initial stage. Later, kapha and rakta (blood) take part in the pathology. So, in the management of Indralupta, importance is given to reducing/ pacifying general pitta and vata, and local kapha and rakta.
In Ayurvedic texts and manuscripts, Vagbhat had described very beautiful samprapti (pathophysiology) of Indralupta. The vitiated kapha will create the blockage in the Hair blood circulation and due to that hair will start falling and new hair growth will not be seen in that particular area.
The Vata dosha takes vitiated kapha in different places. Hence Indralupta can be developed in any part of body including scalp hair, beard and mustache etc. In the general practice we can observe two types of Indralupta- First one is Pitting/sinking skin in hair loss area and second one is Tight skin in Hair loss area.
This condition should always be examined by the physician either by scalp analysis or by generalised examination and the treatment should be started under medical supervision. If time slap occurred and the hair roots vanished completely then it is very much difficult to grow hair in such condition. In the most of patients, the patches spread due to negligence and reaching out to the doctor late.
Apply onion juice, Jaipal seeds (Jamal gota) on affected area. The hair can be seen in 4- 5 days after using Jaipal seed. But if the hair growth is not seen by using this then we should take medical advice for the same.
As per Ayurveda, Indralupta can be treated using internal medicines, Lepa (application of medicinal paste), cupping therapy, and leech therapy. Medicines that reduce kapha are recommended for internal use. Ayurveda believes hair to originate from the “Asthi” or bone tissue, and therefore, to treat hair loss, medicines to strengthen bone are given orally on a long-term basis. Treatment differs based on the stages of the condition. In some patients, indralupta reaches to med (fat tissues) and asthi (bone) dhatus, which are considered to be incurable. In such cases treatment is different than the patients with less chronic condition.
Snehapan: Oral administration of ghee or oils processed with bitter and astringent herbs. It is very useful in balancing increased Pitta dosha.
Shiroabhyanga: Massaging the scalp daily for 10 to 15 minutes with fingers activates the hair follicles by ensuring blood circulation.
Lepana: paste of Croton (Jamal gota) seeds can be applied on the affected area.
Nasya or nasal administration of medicine helps to treat alopecia and other hair disorders.
Leech therapy: The leech therapy will always give excellent results in AA. Leech sucks an impure blood (deoxygenated blood) from affected area and it will remove vitiated kapha so that the proper blood circulation can be maintained. As the proper blood circulation maintain to the hair follicle, we can see the hair growth in that particular area.
Cupping therapy: The suction effect pulls blood with pitta and kapha into the area of skin underneath the cup. This saturates the surrounding tissue with fresh blood and promotes new blood vessel formation.
Hence rather than starting with steroids, it is always better to take advice from ayurvedic consultations to treat Indralupta.
About the author of this post: Dr. Anjali Sachin Thul BAMS, PGDEMS, PGDCC (Consulting Skin and Hair practitioner, Pune) at “Dr. Thul’s Skin and Hair Clinic”.
A graduate of the Tilak Ayurved Medical College, Pune (MUHS Nashik University) and a post-graduate diploma in emergency medical services from Ruby hall Clinic, Pune. She has acquired post graduate Diploma in Cosmetology from Indian Institute of Laser and Aesthetic Medicine, Pune. Specializes in non-surgical Hair Loss Management and non-surgical Facial Cosmetology procedures like Peels, PRP, MDA, Skin Brightening therapy, Leech therapy for Hair loss. Etc. Her dedication and hard work have made ‘Dr. Thul’s Skin & Hair Clinic’, the first and last stop in the field of cosmetology and Trichology by treating the patient entirely according to the teachings of Ayurveda, a 5000-year-old Indian medicine, with the aim of detoxifying, rejuvenating and vitalizing the human body. Offering everyone services in hair and scalp treatment when almost none existed. The center encompass comprehensive services in the cosmetology and trichology segment.
(This article is for information purposes only. For proper diagnosis and treatment, please consult with the author of this post, or the dermatologist near you.)
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