A 20 year old female came to my clinic with hair loss. She was suffering from loss of hair in patches on her scalp and was extremely anxious about this problem. She had tried all other possible therapies but none had shown any results. On examination I found typical patches of hair loss indicating Alopecia Areata. On further case-taking I found out that this had started 2 years ago. On questioning her about what happened two or three years back I was told that her mother had expired suddenly which was a shock to her.

WHAT IS ALOPECIA AREATA?

Alopecia areata is defined as a non-scarring, inflammatory loss of hair affecting men, women, and children. This hair loss problem is still a mystery to the physicians and people doing research. But of late the one theory that seems to make sense is that Alopecia Areata is an auto-immune disorder. This means that the person's own immune cells prevent the hair follicles from producing hair.

WHAT ARE THE TRIGGER FACTORS FOR ALOPECIA AREATA?

Like I have written earlier no one knows for a 100% what causes this disorder but the theory of auto-immune disorder is widely accepted. For an auto-immune disorder to surface there has to be a trigger factor. Here are a few potential trigger factors suggested:-

1. Mental and Emotional stress - this is considered as one of the most likely triggers for the development of Alopecia areata. Psychological stress can give rise to an underlying auto-immune disorder which is dormant in the body.
2. Shock or sudden extreme stress - the loss of a near or dear one, divorce, accident are considered as sudden extreme stress. In a number of cases it has been observed that alopecia areata has occurred after such an episode.
3. Injury to the skin - people who are susceptible to developing alopecia areata will have loss of hair wherever she or he gets a cut, scrape or abrasion.
4. Physical stress - it has been observed that some people develop this hair disorder after suffering from another major illness like fever, viral infection, cancer, radiation etc… Also a physical injury like a blow to the head can trigger the hair loss.
5. Allergies - if you are genetically prone to develop allergic conditions like asthma, urticaria, eczema, etc… then you are more susceptible to developing alopecia areata which is more extensive and prolonged in nature.
6. Chemicals - some people believe that certain chemicals like pesticides have the potential to trigger Alopecia.
7. Viral and bacterial infections - there are certain viral infections of the hair follicles that can give rise to loss of hair. However these theories are doubtful but what is possible is that these virus or bacteria stimulate the person's own immunity giving rise to inappropriate reactions against the hair cells.
8. Pregnancy and hormones - it has been observed that hormonal fluctuations do affect the course of Alopecia areata. Puberty and menopause are two very periods for a female. Alopecia could be triggered during these periods. Also it has been noticed that a woman suffering from alopecia can go into remission or have regrowth of hair during pregnancy.
9. Genetics - no one can prove for a certainty that Alopecia areata is a genetically linked disorder but there is a higher incidence of it within some families. What the research groups have concluded is that the individual is more susceptible to develop Alopecia if it is present within the family but an environmental trigger is required.

SIGNS AND SYMPTOMS OF ALOPECIA AREATA

Alopecia Areata has many different presentations but loss of hair is the main problem. The pattern of hair loss varies in each case. Some people suffer from a single circular patch while others have a more diffuse form where there are no distinct patches and the hair loss is all over.
Some people have loss of hair in a serpent fashion known as Ophiasis. In this case the person has loss of hair all around the margins. Alopecia totalis indicates complete loss of hair on the scalp. Here the surface of the scalp becomes very smooth.
Alopecia universalis means a complete loss of hair all over the body. This is a very severe form where the person loses all eyelashes, eyebrows, pubic hair, underarm hair and hair from other parts of the body.

TREATMENT

There are several different forms of treatment available for this problem. However very few have found to be effective and all have their set of side-effects. Some physicians even give their patients steroid injections in the scalp, which is very dangerous especially for children. Alopecia Areata by itself is not a serious disorder but it is more a cosmetic problem which can damage a person.
Some people do have a spontaneous re-growth without any medication but this is quite rare. If we consider the auto-immune theory as being right then we need to treat the individual's own immunity taking the trigger factors into consideration. This is exactly how we treat Alopecia Areata in Homoeopathy with good results. We take the presentation or pattern of hair loss into account along with the other mental and physical symptoms. We try to stimulate the patient's own hair cells to re-grow.

APIS MELLIFICA

My 20 year old female patient whose case has been described at the beginning received this remedy. She had all the symptoms of Apis Mellifica. After hearing the bad news of her mother's death her disorder surfaced. She had a lot of grief and would weep practically every day. She said her hair felt very painful and would fall. There were a few bald patches in her scalp.
She also suffered from skin allergies. This patient would develop red spots all over. This would burn and sting her like an insect bite.
All her problems would be worse from heat and in hot weather. Only cold air or bath would make her feel better.
Apis Mellifica 200, 5 pills 4 times a day helped her a great deal not only physically but also emotionally.

FLUORIC ACID

I had another very interesting case of a 30 year old man who developed patches of baldness on his scalp. He was afraid that he was developing premature baldness. But he had the typical presentation of Alopecia areata. Even the hair left appeared brittle and fragile.
All this started a year ago. On examination I found that even his nails appeared brittle as if they would just crumble. I asked him about past illnesses and he told me that he had a bad episode of fever one and a half years back which was not diagnosed. This fever had remained for nearly one month but all the tests were inconclusive. He had also been given several different types of antibiotics intravenously.

I gave him Fluoric acid 200, 5 pills in repeated doses which helped bring the lost hair back.

BARYTA CARB

This is a very popular remedy especially used in cases of children and the aged. Here the child suffers from hair fall which creates areas of baldness. A Baryta carb child's constitution is fat, with delayed learning to walk and talk, have difficulty in concentrating.
There maybe moist crust formation on the scalp with falling of hair. The child may also suffer from swollen glands along with this problem. These children like to be alone and dislike company. They are very shy and will not mix or play with other children.

Baryta Carb 200, 5 pills 4 times a day will help in these cases.

PHOSPHORIC ACID

This is another very useful remedy for treating Alopecia where the symptoms are present. Here the loss of hair could be triggered by stress especially mental stress. Here the patient will say that he feels weak mentally and cannot think or remember anything.
The hair may turn prematurely gray and become thin. The hair falls out in patches especially after some emotional grief or sorrow.
Even the hair from the beard falls out. Here the patient feel extremely listless and weak especially after loss of fluids or emotions. Only warmth makes him feel better.

Phosphoric acid 1M, 5 pills 4 times a day should be given in order to bring the person back to health.

Readers are advised that the medical advice offered in this column pertains to generalised treatment of condition. Kindly consult your doctor before self-medication.