alopecia areata journal club -160716052003.pptx

alopecia areata - journal club

1. DEPARTMENTAL JOURNAL CLUB HOD – Dr.Samar Chhaterjee MODERATOR – Dr.Trupti Lakshmi PRESENTER- DR K. Lakshmi Prasanthi DEPARTMENT OF homoeopathic Materia Medica DATE :23-10-2025

2. Alopecia Areata cured with Individualized Homoeopathy Medicine – An Evidence based Homoeopathy Case Report Dr. Sivakumar K.* Research Officer (H)/Scientist-1, Clinical Research Unit for Homoeopathy, Dimapur, Nagaland. Received: 17.01.2022 Revised: 16.02.2022 Accepted: 01.03.2022 Published: 20.03.2022

3. ALOPECIA

4. Definition : Alopecia is defined as the loss of hair from areas where hair normally grows Partial or complete baldness or loss of hair .

5. Forms of Alopecia: There are different types of alopecia. the main types of hair loss are: Alopecia Areata (AA) Alopecia Totalis (AT) Alopecia Universalis (AU) Alopecia Barbae Androgenetic Alopecia (AGA) Scarring Alopecias ( Cicatricial Alopecias )

6. Alopecia Areata (AA) : Alopecia areata is a common autoimmune condition that causes sporadic hair loss. Hair falls out in little patches about the size of a quarter in the majority of cases. For the most part, hair loss is limited to a few spots , however it can be more severe in certain circumstances. It can sometimes result in total hair loss on the scalp (alopecia totalis )or, in severe cases, the entire body (alopecia universalis). Anyone ,regardless of age or gender, can be affected, albeit the majority of instances occur before the age of 30.

7. Alopecia Areata (AA)

8. Alopecia Totalis (AT) Alopecia totalis is a more advanced form of alopecia areata which results in total loss of all hair on the scalp.

9. Alopecia Totalis (AT)

10. Alopecia Universalis (AU) Alopecia universalis is the most advanced form of alopecia areata which results in total loss of all hair on the body , including eyelashes and eyebrows.

11. Alopecia Universalis (AU)

12. Alopecia Barbae Alopecia barbae is alopecia areata that is localised to the beard area . It can be a single bald patch or more extensive hair loss across the whole of the beard area.

13. Alopecia Barbae

14. Androgenetic Alopecia (AGA) Also known as male pattern baldness or female pattern baldness . It is a thinning of the hair to an almost transparent state , in both men or women. It is hereditary in both men and women, it's linked to having an excess of male hormones (androgens) around the hair follicles, which can block hair growth. Women are more likely to develop androgenic alopecia after menopause, when they have fewer female hormones. Most cases of hair loss are due to androgenic alopecia.

15. male pattern baldness

16. female pattern baldness

17. Scarring Alopecias ( Cicatricial Alopecias ) : Scarring alopecias refers to a group of rare disorders which cause permanent hair loss. Caused by any inflammatory processes which causes permanent damage to hair follicles.( burns, bacterial infections, autoimmune diseases )

18. Scarring Alopecias

19. Other Types Traction Alopecia : Traction alopecia is a kind of hair loss in which repeated tension or pulling causes mechanical damage to the hair follicle. Telogen Alopecia : Telogen effluvium is a common cause of transient hair loss caused by the excessive shedding of resting or telogen hair following a systemic shock . The growth of new hair continues Because of the form of the root, telogen hair is also known as club hair Anagen Alopecia : Anagen alopecia is characterized by the sudden losing of most or all of the hair on the scalp, as well as hair from the eyebrows, eyelashes, and other body parts.

20. Causes The following are the most common causes of alopecia: Hereditary or genetic factor. Hormonal imbalance. Scalp infection - dandruff, eczema, ringworm, psoriasis, etc. Pregnancy or childbirth. Drug abuse and excess use of cosmetics on the hair. After terminal illnesses, chemotherapy or radiation therapy. Poor nutrition and unhealthy eating habits. Other factors like pollution, water quality, air quality and other toxic products in the environment

21. Sign and Symptoms Loss of hairs from scalp, and body. The most prominent symptom of alopecia areata is patchy hair loss . Coin-sized patches of hair begin to fall out, mainly from the scalp. Any site of hair growth may be affected, though, including the beard and eyelashes. The loss of hair can be sudden, developing in just a few days or over a period of a few weeks.

22. There may be itching or burning in the area prior to hair loss. The hair follicles are not destroyed and so hair can re-grow if the inflammation of the follicles subsides. Alopecia areata can also affect the fingernails and toenails , and sometimes these changes are the first sign that the condition is developing. There are a number of small changes that can occur to nails: Changes in Nails- Pinpoint dents appear , White spots and lines appear, Nails become rough thin , split & lose their shine.

23. Additional Clinical Signs Include: Exclamation mark hairs - Where a few short hairs that get narrower at their bottom and grow in or around the edges of bald spots, Cadaver hairs - Hairs broken before reaching the skin surface, Regrowth of white hair in areas affected by hair loss.

24. Investigations Important investigations include are: Full blood count Renal and liver function tests Iron studies Thyroid function Autoantibody screen and Syphilis serology.

25. Several systemic diseases, particularly iron deficiency and hypothyroidism , can cause diffuse non-scarring alopecia . Hair pull tests may help to establish the ratio of anagen to telogen hairs but require expertise for interpretation. Scrapings and pluckings should be sent for mycology if there is localised inflammation. Scalp biopsy and direct immunofluorescence of scarring alopecia may confirm a diagnosis of lichen planus or discoid lupus erythematosus but expert interpretation is needed.

26. INTRODUCTION Alopecia areata (AA) is an autoimmune disorder characterized by patches of non-scarring hair loss affecting scalp and body hair. This condition may affect the eyebrows, eyelashes and beard. [1] AA is the most prevalent autoimmune disorder and the second most prevalent hair loss disorder after androgenetic alopecia. The lifetime incidence of AA is approximately 2% worldwide. [2] The disease may be limited to one or more discrete, well-circumscribed, round, or oval patches of hair loss on the scalp or body.

27. But in some cases, it may affect the entire scalp is known as alopecia totalis or the entire body is known as alopecia universalis. In diffuse alopecia areata cases prognosis may be bad. In most patients the onset is within the first 3 decades of life, although alopecia areata can start any age. The sex incidence is probably equal. Psychosocial stress has been reported to play a role in the onset and/or exacerbation of alopecia areata. AA is associated with psychiatric and medical comorbidities including depression, anxiety, and several autoimmune disorders.

28. Diagnosis is made by Clinical history, the pattern of alopecia, clinical examination, in diffuse cases, trichogram and biopsy are advised. In conventional medicine there is no preventative therapy or cure and it is increased global burden of disease, a systematic review on epidemiology and burden of alopecia areata had concluded. Whereas the homeopathy system of medicine will offer promising results in the treatment of alopecia areata with individualized homeopathic medicine, and also it can treat root cause to prevent recurrence and ensure healthy hair growth. This case report further provides evidence for individualized homeopathic medicine effectiveness in the treatment of alopecia areata.

29. CASE REPORT: A 15 years old boy consulted at OPD of Govt. Homoeo Dispensary, Panjal , Kerala, with multiple hair loss patches over the scalp. Complaints started at the age of 10 years as loss of hair over vertex region of the scalp, after that he was consulted a dermatologist, and taken some treatment, initially there was some regrowing of hair but after that, he had developed 2 more other lesions in occiput and frontal region of the scalp. The boy had a history of atopy in childhood, his skin was sensitive and dry, and he had dandruff with itching scalp. His parents were concerned about his condition tried conventional treatments but could not get benefit much.

30. On local examinations, hair loss patches were present over the scalp, multiple patches on vertex, frontal, and occiput region, and on close examination, there were short broken hair present at the edge of patches which are known as 'exclamation mark’. With the history, pattern of hair loss and pathognomonic feature of exclamation mark on examination lead the diagnosis of alopecia areata. 15th October 2019 was his first consultation, specific remedy for alopecia areata Selenium 30C was given weekly once for 1 month. But no positive change was noted, after that detailed case taking was done.

31. The boy was social, wants company, talkative and bold , but sensitive to trifles and offends easily , anxiety about alopecia condition, has fear of thunderstorm , average in studies, desire fish and chicken but chicken causes urticarial rashes over the skin, his perspiration was profuse which leaves yellow stains on innerwear and his thermal reaction was chilly.

32. METHODOLOGY/TREATMENT GIVEN: All the symptoms obtained from detailed case taking were analysed as in table no.1, characteristic symptoms were converted to rubrics, Kent repertory was selected for repertorization , and is done through similimum ultra software as in table no.2.

33. Analysis of Symptoms: Mental generals Physical generals Characteristic particulars Social and Talkative Oversensitive Desires company Fear of Thunder storm Desire Cold Drinks Desires fish Desire Chicken Profuse perspiration Hair loss Patches Dandruff Urticaria < Chicken

34. On 20/11/2019 has been given Phosphorus 0/3, 1dose, OD in the morning for 1 month. Phosphorus Medicine was selected based on individualization, repertorization and in consultation with Materia medica . Along with medicine diet and regimen also recommended and advised some exercises, relaxation techniques to relieve stress. On subsequent follow-ups, potency was changed based on the assessment of improvement in bald patches. Follow-up of the patient was assessed monthly or as required. The date‑wise detailed follow-ups are summarised in Table no.3. No adverse effects were noted during the period treatment.

35. Results The bald patches on the head showed new hair growth. Initially, Phosphorus 0/3 showed improvement. However, much significant improvement was observed with higher potency Phosphorus 0/6, 0/12. Bald patches on the head completely disappeared within 1 year of homeopathic treatment (Figures 1-3).

36. Date Complaints Prescription Remarks 20/11/2019 Hair loss patches multiple, Sensitive skin, urticaria. Phosphorus 30 doses, OD Remarks 0/3, To repeat daily for fasten cure 18/12/2019 Hair loss patches same as previous. Dandruff disappeared, generally better. Repeat Rx for 1 month Patient was generally better. 21/01/2020 Small hair growth started in hair loss patches. Dandruff also disappeared. Phosphorus 30 doses, 0/3, Hair growth started , so repeated same prescription

37. 25/03/2020 Hair growth stand still otherwise patient was better phosphorous 0/6 30 doses OD for 1 month Improvement standstill ,potency increased 23/04/2020 Visible hair growth present in hair loss patches Repeat Rx for 2 months. Expected improvement 30/06/2020 Moderate hair growth in all patches Repeat Rx for 2 months. do 28/08/2020 Hair growth was standstill. Phosphorous 0/12 30 doses OD for 1 month Improvement standsill . Potency Increased.

38. 30/09/2020 All patches filled with thick density of hair Repeat Rx for 2 months. Total near cure of Alopecia areata. 25/11/2020 Normal density of hair growth, no other complaints except frequent coryza, running nose. Tuberculinum 1M , 1 dose , SL for 30 days Complement remedy to remove tendency to cold. 29/12/2020 to 22/11/2021 Patient was under my consultation for various minor ailments during this period Had given indicated medicines for existing ailments Observed one year, no recurrence patches developed.

39. Alopecia areata mostly presented as one sided local disease. The patient was presented with multiple hair loss patches over the scalp. This case was treated with individualized homoeopathic medicine, the case was cured with complete regrowth of hair in bald patches without any recurrence in the follow up period. As there is no effective treatment in modern medicine, mainline treatment is immunotherapy in diffuse tropical cases, intralesional corticosteroids in localized hair loss patches. Willemsen et al used hypnosis to treat alopecia areata. A case study reported a positive role of Homoeopathy when individualized medicine used in treating AA. In this case after careful repertorization , case in taking consultation and with materia medica Phosphorus was selected.

40. Psychological stress has been reported to play a role in the onset and/or exacerbation of alopecia areata. Patients whose alopecia is stress-reactive may suffer from depressive illness, a potentially important consideration in the overall management of such patients. In this case along with medicine, diet and regimen including stress relieving activities also advised. This case showed marked improvement which proved correct selection of medicine.

41. In this case, since the patient suffering from complaints for 5 years, was anxious and worried about disease and desperately desire for regrowth of hair in bald patches. So Millesimal scale of potency was used to repeat the medicine as required and to fasten the cure. 50 millesimal scale of potency is a new dynamization scale of method introduced by Dr. Samuel Hahnemann in 6th edition of organon of medicine, in which produce medicines highest development of power and mildest action, which however, if well chosen, touches all suffering parts curatively, in acute cases may be repeated in short intervals, in chronic cases it is best to begin with lowest degree of dynamization and when necessary advance to higher and may be repeated as required to fasten the cure, by that such a local disease will often then disappear in a wonderful way.

42. So in this case treatment started with Phosphorus 0/3, daily one dose in morning and slowly increased to 0/6 and 0/12 potency for achieving speedy cure. As expected, total cure was achieved in 1 year of time. By that this case showed effective role of homoeopathic medicine in treating of Alopecia areata when prescribed on homoeopathic principles. Since it is a single case study and Alopecia areata is associated with a variable and unpredictable remission, well-designed randomized control studies may be taken up for providing gold standard evidence.

43. CONCLUSION : Homoeopathy is a system of medicine based on the principle of ‘’Similia Similibus Curentur ’’. It treats patient as a whole and not just symptoms. After careful case taking, analysis and repertorization done systematically, then the selection of the right medicine with a suitable scale of potency and dosage results in remarkable cures. Complete hair re-growth and without any recurrence of bald patches in observation period is documentary evidence. This case showed a positive role of Homoeopathy in treating Alopecia areata. LIMITATIONS OF THE STUDY However, as this is a single case study and Alopecia areata is associated with a variable and unpredictable remission, well-designed randomized control studies may be taken up for scientific validation of results.

44. CONSENT : I hereby certify that the patient has been given consent for his images and other clinical information to be reported in the journal. The patient understands that his name and other contact details will not be published, and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed. ACKNOWLEDGEMENT : I sincerely thankful to Dr. Chaturbhuja Nayak, former Director General, CCRH, Ministry of Ayush , Govt. of India for valuable guidance in scientific writing. We acknowledge the support and cooperation of staff at Govt. Homoeo Dispensary, Panjal .

45. CONFLICT OF INTEREST : Author declares that there is no conflict of interest. GUARANTOR : Corresponding author is guarantor of this article and its contents. SOURCE OF SUPPORT : None HOW TO CITE THIS ARTICLE : Sivakumar K. Alopecia Areata cured with Individualized Homoeopathy Medicine – An Evidence based Homoeopathy Case Report. Int. J. AYUSH CaRe . 2022; 6(1):70-75.

46. Merits Evidence-Based Case Documentation: The paper provides detailed case documentation with follow-up records, repertorization charts, prescriptions, and photographs before and after treatment, which strengthens the clinical evidence. Systematic Case Management: The author follows a structured case-taking process—totality of symptoms, repertorization (Kent’s Repertory), and remedy selection through Materia Medica —demonstrating sound homoeopathic methodology. Mentioned the limitation of the case report Integration of Organon Principles: The discussion connects treatment rationale with the 6th edition of Hahnemann’s Organon of Medicine (LM potencies and repetition principles), showing theoretical grounding.

47. Demerits Single Case Study Limitation: The report represents only one patient without control or comparative data, limiting generalizability and statistical validity. Lack of Objective Measurement Tools: No standardized dermatological assessment scales (e.g., SALT score or dermatoscopic evaluation) were used to quantify hair regrowth objectively. No Laboratory or Immunological Evidence: The case lacks supportive laboratory investigations or histopathology to confirm autoimmune activity or physiological improvement. Publication Bias and Limited Peer Review Rigor: As a case report in a niche AYUSH journal, it may not have undergone extensive peer review comparable to mainstream biomedical journals. Author himself physician and researcher there will be a chance of bias No explanation why the specific power of LM Potency was selected than other potencies.

48. Homoeopathic Management Vinca minor - It works well in cases where there is a tendency for hair to fall in spots which are then replaced by white hair . Along with this, itching and violent scratching over the scalp may also be present. Flouric acid - Fluoric Acid is among the top grade homeopathic remedies for alopecia areata. It helps in the regrowth of hair in the bald patches . Itching of head ; baldness. Congestion of blood to scalp; the new hair is dry, breaks off and falls out . Hair falling out after typhoid fever . Alopecia areata. Must comb frequently, it mats so at the end.

49. Mancinella - When Itching in the scalp with sticky discharge and formation of the crusts. Silent mood and self consciousness. Head feeling light and empty. Characteristics symptoms of mancinella is falling of hair after acute sickness. Jaborandi - It has been used as a remedy for baldness with excessive perspiration from all parts of the body. Phosphorus - Violent itching on scalp. Dandruff copious, falls out in cloud, hair comes out in bunches . Scaly, baldness of single spots. Phosphoricum Acidum - Grief and sorrow, as well as fevers, cause hair to turn grey early, become flaxen and oily, and fall out. Itching on the top of the head. Any sort of grief leading to hair fall. Early graying of hair with Progressive thinning of hair, Difficult comprehension of things. Patient lives in the state of shock for long. and Craves juicy things.

50. Natrum Muriaticum - When touched, hair falls out, mainly on the forepart of the head, temples, and beard; scalp is extremely sensitive. Face is oily, shiny, and appears to be greasy. Itching on the scalp and the nape of the neck. Scabs on the head; dermatitis that is raw and oozing a corroding fluid that is damaging the hair, a gluey discharge, and matting hair. Baryta carb- Hair loss, baldness, especially on the head. On the scalp, there is a moist crust and a dry eruption . Eczema on the scalp ; those born for more are able to control the eruption with ointment and application. Baldness is common among young people . Arsenicum Album : Itching in the scalp, circular patches of bare spots, rough, filthy, balding and coated in dry scales , burning and itching dandruff at night Scalp is quite sensitive, and I am unable to brush my hair.

51. Lycopodium : - Hair is falling out in clumps. Eczema; oozing behind the ears. On the forehead, there are deep furrows. Gray hair and premature balding Hepar Sulph :- She could barely bear to have anything touch her head or comb her hair due to her extremely sensitive and painful scalp. Burning and itching from a humid scald. Hair falling out, a terrible, really sore pimple, and significant bald areas on the head . hair loss after mercurialization or a persistent headache . head sweating coldly. Selenium Metallicum : Hair falling out when combed, as well as eyebrows, whiskers, and genitalia; tingling itching on the scalp at night; bleeding after scratching; tension and a feeling of constriction in the scalp; and emaciation of the face and hands. Pain in the scalp, like hair is being ripped out. Silica Terra : Eruption on the back of the head and behind the ears that is dry, pungent smelling, scabby, and itchy ; when scratched, it feels burning and becomes more severe and discharges pus. itching pustules, bulbous swellings, and hairy neck; extremely sensitive to pressure, contact, laying on it, and when being wrapped in a warm blanket. Open fontanelles; an emaciated physique with an excessively huge head and a waxy-pale face; a heated, swollen abdomen; and foul-smelling stools. violent scalp itching A itchy, moist scald-head. shedding from the hair. Hair loss and early baldness.

52. THANK YOU !!