Clinical management of Hairfall in Ayurveda

CONTEMPORARY REVIEW

CAUSES:

• Nutritional defeciences
• Hormonal imbalances
• Stress – Physical or mental.
• Acute febrile illness – fever due to typhoid, malaria, dengue etc.
• Scalp infections, Dandruff.
• Chemicals, shampoo, creams, gels, pollution.
• Chemotherapy, radiation

TYPES:

• Telogen effluvium- Anagen effluvium
• Androgenetic Alopecia(Male and Female pattern hair loss)
• Alopecia areata

Telogen effluvium: Its a form of hair fall characterized by diffuse, often acute, hair shedding. It is the shedding of resting or telogen hair after some metabolic stress, hormonal changes, or medication.

Anagen effluvium: It is commonly associated with chemotherapy. Chemotherapy induces anagen or growing phase hair to abruptly enter into telogen phase and when hair starts shedding balding is seen.

Androgenetic Alopecia:

Male and female pattern hairloss- genetically predetermined disorder due to an excessive response to androgens, characterized by progressive loss of terminal hair of the scalp anytime after puberty. It follows a distinct pattern of baldness in male and female.

Treatment :

• Minoxidil
• Finasteride
• Transplants

Aloepacia Areata: It is a chronic, immune-mediated autoimmune disorder which targets the anagen hair follicles without permanent damage to the follicles, generally presents with patchy hair loss. R_x may include corticosteroids, immunotherapy.

                      

Ayurveda Review:

Khalitya   and    Indralupta

these are the two conditions presenting with hairfall.

References seen in classics: 

           Charaka Samhita: Trimarmiya Chikitsitam adhyaya

           Sushruta Samhita: Kshudra rogadhikara

           Astanga Hridaya: Shiroroga adhyaya under Kapalarogas

Others conditions were hairfall is a laxana:

            Darunaka (Kesha chyuti)

           Pandu (Sheernaroma)

            Raktapradoshaja vikara (Indralupta)

            Asthipradoshaja vikara(Kesha dosha)

Charaka chikitsa. 26/132:  Teja(dehoshma) along with Vatadi doshas go to the  kesha bhoomi and burn it, resulting in Khalitya.

Astanga hridaya. Uttara.23 adhyaya:  the pitta present in romakupa along with vata results in hairfall (khalitya) and when the samprapti progress with the involvement of kapha and rakta , blocks the roma kupa from further producing hair (indralupta).

CAUSES:

• Excessive intake of lavana(salt) and kshara(alkali).
•  च.चि.26/109 : Dushta pratishyaya(Chronic rhinosinusitis)
• Pitta prakriti(body constitution)-Kshipra khalitya(early/fast hairfall)

CHIKITSA:

Indralupta:

• Siravyadha(bloodletting),
• gaaDa pracchanna(deep microinjuries) followed with lepa of teekshna dravyas(Astanga hrdaya. Ut.24/28-30).

Khalitya:

• Shodhana,
• Sneha nasya, 
• Shiroabhyanga(head massage with medicated oil),
• Lepa, pradeha(thick medicinal paste)(Cha.chi. 26/263).

Yogas/Classical formulations:

• Anutaila nasya, shadbindu taila, vidaryadi taila or ghrita nasya
• Bhringamalaka taila, Neelibhringadi taila
• Prapoundarikadi taila

CLINICAL APPROACH:

Agni, pitta, vata and manas are needed to be taken care of.

Also the sapta dhatus – rasa, rakta, mamsa, medas, asthi, majja and shukra dhatu to be taken care of.

A vaidya needs to use the yukti to analyse the pathophysiology of different types of hairfall conditions and then plan the treatment protocol which can deliver the desired results.

Treatments:

• Panchakarma /external therapies:
• Pratimarsha nasya
• Pariseka
• Shiro abhyanga
• Pichu
• Talam

Machine therapies which can be adopted:

• Laser comb/helmet
• Dermaroller
• Platelet rich plasma therapy.

RESULTS IN MY PATIENTS: