The presence or absence of hair is a matter of beauty. Loss of hair is termed as ALOPECIA. Excess of hair is termed as HYPERTRICHOSIS; it is named HIRSUTISM when growth follows patterns of adult male. Another problem with which patients come to us is abnormalities of hair shafts.
Nearly 2% population suffer by Alopecia Areata. Usually it occurs on scalp only but sometimes may involve other part of body too. Pattern of hair loss in Alopecia Areata is different from Male pattern Baldness. Usually hair loss more on one side of scalp(Head).Hairs loss is Rapid in this condition. Alopecia Areata is an Autoimmune disorder, it means body’s own immunity produces antibodies against hair roots. And those antibodies destroy the hair roots .Usually hair falls in patches. There may be more then one patch on head. Sometimes hair falls from all of the scalp(head) and this is known as Alopecia Totalis. And sometimes this process goes further and hair falls from all over the body and now it is called Alopecia Universalis.
- non scarring:
- alopecia areata
- male pattern alopecia
- traction alopecia
- ring worm
- hair shaft abnormalities
- non scarring:
- congenital(ectodermal dysplasias)
- immunological(alopecia universalis)
- ALOPECIA AREATA :
- immunological-association of thyroid diseses,vitiligo,atopy.
- genetic inheritence
- emotional trauma
- Clinical features:-
- Common in both sexes, starts at any age.
- Lesion-circular patch of alopecia.
- No scaling, no inflammation.
- Presence of exclamation mark hair at the edge of the lesion is pathognomonic. (It is the hair which is broken off about 2-3mm from the scalp due to constriction in the shaft. The broken hair is paler and narrower than normal hair.)
- Site: scalp, beard, sometimes-eye lashes, eye brows.
- Single lesion-recover within few months, regrowth begins usually at the
- Some patients lose all the hair from the scalp- ALOPECIA TOTALIS.
- Few patients lose the hair from whole body- ALOPECIA UNIVERSALIS
- Differential diagnosis:
- Tinea Capitis:
- fungal infection
- scaling present
- hair can be plucked easily & painlessly from the lesion.
- no exclamation mark hair.
- Cicatricial Alopecia:
- alopecia preceeded by papules & pustules.
- pigmentation & scaling.
- evidence of primary disease like DLE, lichen planus
. ANDROGENIC ALOPECIA(MALE PATTERN ALOPECIA:
Occurs because of progressive transformation of terminal hair follicles of scalp into vellus follicles
- Genetic- familial
- Hormonal-androgen dependent
- Associations -anxiety
- monosymptomatic hypochondriasis
- hyperandrogenism(in women)
hair loss is relentless with the tendency to follow the pattern in the family.
- MALE – typical presentations
- FEMALE – androgenic alopecia should be diffrentiated from the other causes of diffuse hair loss like telogen effluvium,& hair loss in endocrine disorders.
- TRACTION ALOPECIA :
- any constant traction can lead to alopecia.
- Hot combing (straightening of hair)
- Tight hair styles
- Clinical features: Incidences-frequent in girls & Sikh males
- frontal area
- margin of scalp
It starts with short broken hair, folliculitis &occasional scarring.
- Progress: reversible-in early stages
- Pattern of hair loss
- tight hair styles
- absence of exclamation mark hairs &scaling
- presence of folliculitis.
- TELOGEN EFFLUVIUM :
Diffuse hair loss.
- prolonged birth
- surgical trauma
- emotional stress
- Clinical features:
- Diffuse hair loss occurring 2-3months after the precipitating stimulus
- varying degree of hair loss
- regrowth of hair in 2-3months
- anemia-associated disease.
- PATCHY HAIR LOSS DUE TO SKIN DISEASE:
- BACTERIAL FOLLICULITIS – small area of non-scarring alopecia.
- FUNGAL INFECTIONS – non-cicatricial alopecia.
- PSORIASIS(RARE) – reversible
- LICHEN PLANUS – scarring alopecia
- DISCOID LUPUS ERYTHEMATOSUS – cicatricial alopecia.
It is the presence of terminal hair in women, exhibiting male pattern.
- hormonal- PCOD, menopause, cushing syndrome, hyperprolactinaemia
- Clinical features:
- Excess growth of terminal hair in beard, chest, shoulder, periareolar & infraumbilical region.
- begins at puberty & progresses with age.
- psychological overtones.
- Investigation: Gynecological evaluations, sonography, hormonal study.
It is an excess growth of terminal hair but one which does not follow an androgen induced pattern.
- spina bifida
- melanocytic naevi
- post inflammatory
- hypertrichosis lanugiosa
- hepatic porphysis
Homeopathy offer very effective and permanent cure for most of cases of hair falling. In homeopathy more than 95 drugs are available for hair falling. Selection of medicine depends on Individual features of patient,modalities,behavior pattern, mental attitude,reactions,temperature modalities and coexisting disorders. Homeopathy cure effectively common baldness,Alopecia Aerata, hair falling during pregnancy and after childbirth. Treatment of Hair falling takes long time to cure. Even you will not find any sign of improvement in first few weeks,but take medicines with patience.
Homoeopathic medicines for disease of hair
Nat.mur – white dandruff, alternating with cattarh or loss of smell.
Phosphorus – copious dandruff, falling off of hair in bunches. Itching of scalp.
Graphites – dandruff with eczema or other eruptions. Falling of hair. Burning on vertex.
Sepia – dandruff in circles, like ring-worm. Moist scalp. Pimples on forehead near hair. Loosing of hair after chronic headache.
Sanicula – scaly dandruff over the scalp, eye-brows and other hairy parts.