THERAPEUTICS OF

ALOPECIA

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 HAIR ANATOMY
• We have approximately 5 million hairs on our
body.
• Of these, about 150,000 are found on our scalp.
• The only parts of our body where there are no
hair follicles are the palms, soles, lips, tip of the
penis, clitoris, and labia minora

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• Hair is actually composed of a protein
called keratin
• A strand of hair has three layers. The
outermost layer is called the cuticle.
• The innermost layer is called the medulla.
• Between these two layers is the cortex. The
bulk and strength of hair is from this
compact area of cells

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• Each hair grows from a pocket in the skin called the hair
follicle.
• During its growing phase, the follicle has a bulb-shaped
bottom, the center of which is called the dermal papilla .
• The papilla is fed by very small blood vessels, which
bring it food and oxygen and take wastes away.
• The papilla is highly sensitive to hormones. It is here
that hormones and chemicals secreted by your body (or
injested as a medicine) work on the hair, making it grow
faster, slower, or not at all

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• The purpose of hair is to keep the warmth in.
• Warm-blooded mammals require a warm body
temperature to survive .
• A tiny hair muscle attached to each hair follicle,
called the arrector pili, contracts when in a cold
environment (or when fearful).
• This causes the hair to be pulled downwards so it
stands up straight (goose-bumps or gooseflesh),
and warm air is actually trapped between each
hair.

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 Phases of hair growth
• Phase of growth (anagen) (2-10 yrs)
• Phase of involution (catagen) (1-3wks)
• Phase of rest (telogen) (3 months)

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• Hairs fall off after the visible resting period
& new hair cycle starts.

• Upto 100 hairs are shed from the scalp in

normal health.
• The duration of anagen which determines
the length of hair differs according to
hereditary, sex, age, body region &
follicular size.
• Hair grows in anagen about 0.35mm/day.

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 ALOPECIA
• Greek word alopex meaning fox disease.
• Visible and excessive loss of hair from the scalp
leading to the production of baldness is known as
alopecia.
• Alopecia is grouped into 3 types:
• 1) diffuse
• 2) localised
• 3) cicatrial alopecia
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1) DIFFUSE ALOPECIA

• There is excess hair loss from all over the scalp.

• There are 3 main types:

• 1) Telogen effluvium

• 2) Anagen effluvium

• 3) Androgenic alopecia

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TELOGEN EFFLUVIUM

• This is due to stimuli which induce more hairs to

go into catagen phase and subsequently into
telogen phase and fall off.
• This occurs due to fevers
» Child birth
» Abortions
» Cessation of oral contraceptives
» Surgical operations
» mental stress
» Nutritional deficiencies
» Hypo/ hyperthyroidism
» Drugs- anti hypertensives

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• Telogen hairs have a club like swelling at the root and
their length is less than that of normal hairs.

• Usually it takes 2-3 months for alopecia to become

evident after its induction.

• Prognosis usually good.

• TREATMENT: Identification of the cause & its

removal.

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ANAGEN EFFLUVIUM

• Here growth in anagen phase is interrupted & this leads

to weakness and brittleness of hair.

• Usual causes are cancer chemotherapy, exposure of

scalp to radiation etc.

• Hair re grows when toxic drug is withdrawn.

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ANDROGEN ALOPECIA

• It is the male pattern alopecia caused by the increased

sensitivity of hair follicles to androgens.
• This is genetically predisposed & transmitted as
autosomal dominant.
• Thining of hair usually begins between 12 & 40 years.
• The successive duration of anagen shortens & and the
follicles become smaller & the hairs become shorter &
thinner & subsequently alopecia results.
• Baldness is limited to the frontal, temporal & vertical
areas of scalp
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2) LOCALISED ALOPECIA.
ALOPECIA AREATA:
• It is a non cicatrical type of patchy loss of hair without
any other change in skin.
• Occurs in young adults and children.
• Lesions frequently occur in scalp, beard, moustache, and
eyebrows.

ALOPECIA TOTALIS
• Complete loss of scalp hair.

ALOPECIA UNIVERSALIS
• When alopecia involves whole body.
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Alopecia areata

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Alopecia totalis in a woman

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Alopecia totalis

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FUNGUS INFECTION
• Tinea capitis may cause patchy loss of hair in which
the broken hair stumps appear as black dots.
• Hair can be easily pulled out from follicles.

TRICHOTILLOMANIA
• A compulsive disorder in which hairs are pulled out
& hairs are broken at different levels, resulting in
patchy hair loss.

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Secondary Syphilis

• This causes irregular patchy of hair mainly on the posterior

aspect of the scalp. This has a characteristic moth-eaten
appearance.

3) Cicatrical Alopecia

• Cicatrical alopecia is due to inflammation resulting in

destruction of hair follicle as occurring in injury, gumma,
SLE , lichen and others.

Folliculitis Decalvans
• In this condition there cicatricial alopecia following the
occurrence of follicular pustules and papules.
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THERAPEUTICS

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 PHOSHORUS
• Round patches on scalp completely deprived of
hair;
• Falling off of the hair in large bundles on the
forehead and on the sides above the ears;
• The roots of the hair seem to be dry; the denuded
scalp looks clear, white and smooth;
• Dandruff copious, falls out in clouds.
• Bald spots on the head, which are dry and scaly,
are characteristic of Phosphorus.
• Dandruff, roots of hair get gray and the hair
comes out in bunches.
• The head sweats easily.
• The most important remedy in alopecia areata.
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 ACID FLUOR
• Alopecia. (syphilitic)

• Caries of skin. Especially adapted to chronic

diseases with syphilitic and mercurial history.
• Glabella region bloated. Complaints of old age,
or the prematurely aged, with weak, distended
blood vessels.
• Caries of ossicles and mastoid, with copious
discharge; worse warmth. [Silica; worse cold.]
• Exostosis.
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 Lycopodium clavatum
• Hair becomes gray early; hair falls off
after abdominal diseases; after
parturition
• With burning, scalding, itching of the scalp,
especially on getting warm from exercise
during the day.
• PREMATURELY OLD LOOKING
PEOPLE.

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 Staphysagria
• Hair falls out, mostly from occiput and
around the ears, with humid, foetid eruption
or dandruff on the scalp.
• Hair pulls out without pain after the
slightest effort.

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 Vinca minor
• Hair falls out in single spots and white
hair grows there.
• spots on head oozing moisture, the hair
matting together.
• Falling of the hair with great itching of the
scalp

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 Phosphoricum acidum
• Gnawing grief changes hair of the young to
gray.
• Falling of hair from general debility, ESP
AFTER TYPHOID.

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 Carbo vegetabilis
(vegetable charcoal)
• Disintegration and imperfect oxidation is the
keynote of this remedy.
• The typical Carbo patient is sluggish, fat and lazy
and has a tendency to chronicity in his complaints.
Patient seems to be too weak to hold out.
• Persons who have never fully recovered from the
effects of some previous illness.
• Carbo vegetabilis has falling of the hair after
parturition or severe illness
• Aches from any over-indulgence. - Hair feels
sore, falls off easily; scalp itches when getting
warm in bed.
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 ARSENIC ALBUM
• Periodical burning pains, with restlessness;
with cold skin.
• Scalp itches intolerably; circular patches of
bare spots; rough, dirty, sensitive, and
covered with dry scales; extending
sometimes even to forehead, face and ears.
• Bald spots neat the forehead nightly burning
and itching; dandruff.
• Scalp very sensitive; cannot brush hair.
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 Natrum muriaticum
• Has the symptoms of easy falling out of the
hair; it falls out when touched or combed.
• This is quite frequently seen in nursing women.
• Hair falls out if touched; mostly on forepart of
head, temples and beard;
• scalp very sensitive; face shining as if greasy.
• Especially anemic ladies.

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 Baryta carbonica
• Baldness, especially of the crown, in young
people.
• Scalp very sensitive to touch, aggr. from
scratching

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 AURUM METALICUM
• Syphilitic alopecia.

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 CALCAREA CARB
• Hair falls out, especially when combing;
dryness of hair.
• Great sensitiveness of scalp, with yellowish
or white scales on scalp.
• sensation of coldness of outer head

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 SEPIA
• Hair fall after chronic head aches.
• Especially suited to middle aged women.

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 THUJA
• White scaly dandruff.
• Hair dry & falling out.

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 MANCINELLA
• LOSING HAIR AFTER SEVERE ACUTE
DISEASES.

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 BADIAGA
• Dandruff; scalp sore , dry tetter like.

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 WIESBADEN
• Hair falls & grows rapidly
• Hard, brittle & lustreless hair.

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 THALLIUM
• Hair falls out after excessive perspiration
of scalp after exhausting diseases.

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 References
• Homoeopathic therapeutics, samuel
lilienthal
• Homoeopathic materia medica & repertory,
w. boericke
• Text book of medicine , k. v. krishnadas
• wikepedia

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