This document discusses therapeutics for alopecia (hair loss). It begins by describing hair anatomy and the hair growth cycle. It then discusses the causes and types of alopecia, including telogen effluvium, anagen effluvium, androgenic alopecia, alopecia areata, alopecia totalis, alopecia universalis, and cicatrical alopecia. Diagnostic techniques and general management approaches are also covered. The document concludes by describing several homeopathic remedies that can be used to treat different types and causes of alopecia, including phosphorus, flouroic acid, lycopodium, arnica, staphysagria

1. Therapeutics for
Alopecia
Dr.Praveen Kumar Rai
BHMS.,MD (MM)

2. Anatomy of Hair
• We have approximately 5 million hairs on our body.
• Of these, about 150,000 are found on our scalp.
• Hair Density;-
– @Birth: 1135/cm2
– 1 year: 795/cm2
– 20-30: 615/cm2
– 30-50:485/cm2
– 80-90:435/cm2

3. • 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

4. • 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.

5. • 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

8. Physiology of hair
• The growth phase of scalp hair is approximately 1000
days (range, 2 to 6 years).
• Hair in other areas, such as the eyebrows and
eyelashes, has a shorter growth phase (1 to 6 months).
• Scalp hair grows 0.3 to 0.4 mm/day, or approximately
6 inches a year.

9. • Each hair follicle perpetually goes through three
stages in the hair growth cycle:
– Catagen (transitional phase),
– Telogen (resting phase), and
– Anagen (growing phase).

12. • Approximately 90% to 95% of hairs are in the anagen
phase, and
• 5% to 10% are in the telogen phase.
• Up to 100 telogen hairs are lost each day from the
head, and about the same number of follicles enter
anagen.
• The duration of anagen determines the length of hair,
and the volume of the hair bulb determines the
diameter.

13. • 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.

14. Uses of Hair
• 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.

16. • Greek word alopex meaning fox disease.
• It is a non-scarring, inflammatory disease in which
there is 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:-
• Diffuse
• Localised
• Cicatrial alopecia

17. •About 25% of patients have a family
history disorder
•Alopecia may affect men, women and
children alike.
•Although this is not a life threatening
disease, alopecia often has severe
psychological and sociological implications,
as at times the condition can result in
complete hair loss and cause disfigurement.

18. Causes for Alopecia
• The exact cause of alopecia is presently not known,
although it is generally, agreed that it is a disease
of the autoimmune system.
• In addition there is believed to genetic component in
some cases and some studies have shown a link with
stress.
•

19. • An alopecia the affected hair follicle are mistakenly
attacked by own immune system (white blood cells),
• Possibly due to chemical called cytokines resulting in
the arrest of anagen(hair growth) stage.

20. External/Seasonal Causes:-
• Winter excessive use of hair sprays and gel ,
• improper use of hair coloring agent,
• excessive used of electric hair curlers,
• dry indoor heating ,
• infrequent washing of hair ,
• inadequate rinsing hair after washing
• stress or anxiety.
• Truamatic

21. Internal Cause:-
• Hormonal imbalance ,
• poor hygiene,
• allergic hypersensitivity.
• Lack of rest,
• excessive consumption of sugar,
• fat starch, improper nutrition.
• Hereditary predisposition .
• Excessive perspiration
• over active oil gland.

22. Types of Alopecia
• 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

23. • LOCALISED ALOPECIA
• ALOPECIA AREATA:
• ALOPECIA TOTALIS
• ALOPECIA UNIVERSALIS
• Cicatrical Alopecia

24. TELOGEN EFFLUVIUM
• This is due to stimuli which induce more hairs to go
into Catagen phase and subsequently into Telogen
phase and fall off..
» Child birth
» Abortions
» Cessation of oral contraceptives
» Surgical operations
» mental stress
» Nutritional deficiencies
» Hypo/ hyperthyroidism
» Drugs- anti hypertensives

25. • Usually it takes 2-3 months for alopecia to become
evident after its induction.
• Prognosis usually good.
• Identification of the cause & its removal.

26. 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.

28. ANDROGENic 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.
•

29. • 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

31. 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.

33. ALOPECIA TOTALIS
• Complete loss of scalp hair.

34. ALOPECIA UNIVERSALIS
• When alopecia involves whole body.

35. 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.

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

37. • Traction Alopecia :-
– Traction alopecia is usually due to excessive pulling or
tension on hair shafts as a result of certain hair styles.
– It is seen more often in women .
– Prolonged traction alopecia can stop new hair follicles
developing and lead to permanent hair loss.

38. Diagnostic Techniques
• Hair pull,(grasping a group of 50 to 100 scalp hairs).
• Applying gentle traction from the base to the terminal
ends and repeating this in various areas of the scalp
• Normally only three to five hairs total are dislodged
on six to eight such hair pulls.
• more than three to five hairs per hair pull is
pathologic

39. Why to Treat…….?
• Lead to,,,,,
– Less Attractive.
– Low self Esteem.
– Looks older.
– Weaker
– Less productive

40. General Management
• Don’t comb hair when its wet.
• Wipe hair with soft cloth.
• Don’t take Head bath daily.
• Use Shampoo,which is mild(Less pH).
– Dilute it with water before applying.
• Apply Hair oil,but don’t keep for day along,instead
wash it off within half an hour.
• Massage gently.

41. • Better avoid applying hair gels.
• Avoid consumption of Fatty foods,oily foods.
• Avoid hard water drinking & taking Bath.
• Dietery;-
– Have plenty of fruits,green vegetables.
– Protein rich food
– Iron rich food
• Last but not the least Don’t take more tension about
Hair loss

45. Phosphorus
• Round patches on scalp completely deprived of hair;
• 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.
• Falling off of the hair in large bundles on the
forehead and on the sides above the ears;

46. Flouric Acid
• 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.]
• New hair dry and break off .
• Often hair matts at the end .

47. Lycopodium
• 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.

48. Arnica
• Improve the blood circulation to the hair root.
• Reduces hair fall and promotes hair growth.
• It enriches the scalp with nutrients which help to
cure and control dandruff.
• It is natural scalp coolent and hence prevents scalp
disease.
• Used as Hair oil.

49. 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.

50. 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

51. Phosporic Acid
• Gnawing grief changes hair of the young to gray.
• Falling of hair from general debility, ESP AFTER
TYPHOID.

52. Borax
• Hair rough and horny.
• Tangles at tips, sticks together.(Tubercular)
• If these bunches are cut off,they form again, cannot
combed smooth (fluor.ac.,Lyco.,Psorinum.,Tub.).
• Hair can’t be combed smooth-especially occiput, sides
and ,vertex. temples., beared,

53. Carbo veg
• Disintegration and imperfect oxidation is the keynote
of this remedy.
• 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.
• 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.

54. Arsenic Alb
• 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.

55. Natrum Mur
• 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.

56. Jaborandi
• Good indicated remedy in the treatment of Alopecia.
• hypodermic use of it, in many cases of baldness, will
completely restore the hair, from its wonderful action
upon the skin.

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

58. Calc 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
• Hair fall out especially when combing especially
during confinement.

59. Tuberculinum
• It is Antitubercular medicine.
• Plica polonica (Swelling and bleeding of hair follicle
,so that knit together); [vinca.minor,psorinum]
,several bad cases permanantly cured after borex
&Psorinum fail.
• Chronic eczema; itching intense ; worse at night in
tubercular children.

60. Sepia
• Hair fall after chronic head aches.
• Especially suited to middle aged women.
• Great fall of hair after; chronic headaches or at
climacteric and menopause .
• Especially from vertex and occiput,worse when
combing .
• Itching of root of hair.
• Hair fall out when touched,in nursing women (
Nat .mur).

61. Sulphur
• Hair fall after parturition.
• Hair fall from occiput and eyelashes .
• Dandruff, hair dry ,falling of scalp sore to touch,
itching violently agg <when getting warm in the bed
and washing .
• Hair grey ,offensive ,dry ,cold and hard.

62. Thuja
• White scaly dandruff.
• Hair dry & falling out.

63. Graphitis
• Even the on the sides of the head, vertex and nostrils
falls out.
• Dry ,tangled , matted or brittle hair.
• Perspiration of scalp,greying of hair .
• Dandruff ,like milk crusts.

64. Selenium
• Hair fall off on head ;when combing, also of
eyebrows, whisker,vertex eyelashes and
genital.(Syphilis)
• Tingling itching on scalp.
• Which feel tense and contracted.
• Does not want hair touch.

65. Mancinella
• LOSING HAIR AFTER SEVERE ACUTE
DISEASES.

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

67. References
• Fitzpatricks Dermatology in General Medicine.
• API Textbook of Medicine.
• Homoeopathic therapeutics, samuel lilienthal
• Homoeopathic materia medica & repertory, w.
boericke
• Allens Key notes & characteristic symptoms
• www.hpathy.com
• www.similima.com
• www.remedyfinder.com