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A case study on Ayurvedic management of Alopecia areata (Khālitya)

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AAMJ ISSN: 2395-4159
Anveshana Ayurveda Medical Journal Case Report

A case study on Ayurvedic management of Alopecia areata (Khālitya)

Jitender Kumar 1 Prasanth Dharmarajan 2

Abstract

Alopecia areata is also known as spot baldness. It is a common autoimmune skin disease
causing hair loss on the scalp, face and sometimes on other areas of the body[i]. Alopecia
can be the cause of psychological stress, individuals with it may experience social phobia,
anxiety and depression[ii]. In modern medicine topical or injected corticosteroids are used
to treat this condition. In Ayurveda it can be correlated to Khālitya one of the kṣudra roga[iii].
Vāta, Pitta, Kapha and Rakta are involved in Khālitya as mentioned in the texts [iv]. In the
present case study, a case of Alopecia areata was managed with Ayurvedic medicines and
bloodletting therapy (Pracchāna). Patient presented with patches of baldness on head and
chin with redness and itching since 2 years. Virechana was adopted first, then Pracchāna
was done along with some internal and external medications. Regrowth of hairs was
achieved completely. Patient felt relieved of itching and redness of scalp also. This case
study reveals the potential of Ayurvedic management of Alopecia areata and may form a
basis for further detailed study of the subject.

1
PG Scholar, 2 Assistant Professor, Department of Panchakarma, All India Institute of Ayurveda,
New Delhi.

CORRESPONDING AUTHOR
Dr. Jitender Kumar
PG Scholar,
Department of Panchakarma,
All India Institute of Ayurveda,
New Delhi, (India). http://aamj.in/wp-
content/uploads/Volume3/Is
Email: jitenderk331@gmail.com sue1/AAMJ_1196_1199.pdf

AAMJ / Vol. 3 / Issue 2 / March – April 2017

 Jitender & Prasanth : A case study on Ayurvedic management of Alopecia areata (Khalitya)

INTRODUCTION hair loss. He had undergone allopathic treatment but that

provided him only temporary relief. With these com-

A
lopecia areata is the commonest cause of patchy plaints, patient approached the AIIA New Delhi.
hair loss. It may be regarded as an immune-me- History of past illness: - There was no relevant past his-
diated type of hair loss [v]. The condition affects tory.
0.1% to 0.2% 0f the population and occurs in both males Family history: - No member of the family had history of
and females [vi]. A single round or oval patch of complete such illness.
baldness develops rapidly usually over the vertex or in Personal history:
the occipital region. There are no subjective symptoms Diet vegetarian
and the denuded area of scalp is of normal color and
Micturition 4 - 5 times/day, 0 - 1/night
texture. Patches in the beard may occur alone or in asso-
Appetite good
ciation with the scalp. Ridging or pitting of the nails ac-
Sleep adequate, rarely disturbed
companies in severe cases. The cause is still disputed. A
Bowel habit Irregular
history of acute emotional stress or anxiety preceding the
onset is common, Focal sepsis and unidentified agent Addiction nil
have been also suggested [vii]. Histopathology shows peri-
follicular and intrafollicular inflammatory cell infiltrate Aṣṭhavidha Parīkṣa:
composed mainly of lymphocytes described as swarm of
bees’ appearance [viii]. In Ayurveda it can be correlated 82/min, regular, normal in char-
Nādī (pulse)
to Khālitya one of the kṣudra roga. The prognosis is al- acter
ways uncertain. In many cases regrowth is complete in Mala (stool) often constipation
6-7 months but in others may require a year. About one Mūtra (urine) frequency - normal
third never recover completely from initial attack and re- Jihvā (tongue) coated
currences are common. In modern medicine treatment is Śabda (speech) clear
unsatisfactory has no effect on long term progression. Po- Sparśa (touch) Normal
tent topical or injected steroids may be of limited use[ix] Drika (eyes) Normal
because hair is lost again when the treatment is discon-
Akruti (built) madhyam
tinued and they should not be prescribed. These drugs
can cause serious side effects.
Systemic Examination: - On examination, patient was
found to be conscious and well oriented to time, place
Case Report and person. Assessment of Central nervous system, car-
A male patient of age 25 years with O.P.D no.145825 diovascular system, respiratory system and musculoskel-
dated 09.01.2017 admitted in I.P.D of AIIA with com- etal system of patient was found within normal limits clin-
plaint of multiple patches of hair loss of scalp and beard ically. No clinical abnormality was detected on per ab-
since 1 year. domen examination.
History of present illness: - A 25 year’s old male patient Blood investigation: - Blood investigations of the patient
experienced dandruff and itching of scalp 2 year back. reveals Hb-9.6g/dl. TLC, DLC values were within normal
After few months, he suffered from hair fall. Gradually he limits.
developed patchy hair loss of scalp and beard. He also
had redness of scalp. He was under mental stress due to

Treatment Planned
Table 1: Ayurvedic treatment plan
Panchakarma Treatment Drugs Days
Guduchi Choorna 3gm TDS, 03 days
Deepana-Pachana
Nagarmotha Choorna 3gm TDS
Snehapana Tiktaka ghritam 06 days
Abhyanga Chinchadi taila 04 days
Swedana Dashmoola kwatha 04 days
Virechana trivruta avaleha, eranda taila 01 days
3 times every
Bloodletting (Pracchāna)
fortnight

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 Jitender & Prasanth : A case study on Ayurvedic management of Alopecia areata (Khalitya)

After Virechana karma, Samsarjana karma was advised
for 5 days. After Samsarjana karma some internal medi-
cations [Table-4] were prescribed for 15 days. Rasāyana
drugs [Table-5] were advised for next one month. Blood-
letting (Pracchāna) was done after (Pracchāna) during
that period every fortnight for three times on OPD basis
with follow up of 2 months. The duration of treatment was
63 days and follow up was done on every 15 days for
2 months. The study was conducted at All India Institute
of Ayurveda New Delhi. The patient was informed about
the treatment and the study was carried out ethically in
accordance with International Conference on Harmoni-
zation-Good Clinical Practices guidelines.

Table 2: Snehapana

Intake
Dose Onset of hunger Symptoms
time
30 ml 6.30 am 12pm Passing of flatus
50 ml 6.45 am 12:30pm Passing of flatus,
80 ml 6.30 am 2 pm Passing of flatus, increase in appetite, hard stool
110 6.40 am 3 pm Passing of flatus, increase in appetite, soft stool, lightness of body parts
ml
140 6.30 am 6 pm Passing of flatus, increase in appetite, soft and unctuous stool, softness of
ml body parts, lightness of body parts
160 6.30 am 8 pm Passing of flatus, increase in appetite, soft and unctuous stool, softness of
ml body parts, lightness of body parts

Table 3: Virechana

Complica-
Virechana No. of
Dose Anupana Symptoms tions if
drug Vega
any
Triphalakwatha 60 ml
Clarity of channels, lightness , increase in
Trivruta ava- 120 Followed by ushnoda-
19 appetite, weakness, decrease in disease None
leha, gm kapana at every 15 to
symptoms and feeling of well-being
20 minutes

Blood Letting (Pracchāna) Table 5: Rasāyana Drugs

Poorvakarama- Shiro-prakshalan(head wash) with luke-
Medicine name Dose Days
warm triphla kwath.
Saptamrita lauha 500 mg TDS 1month
Pradhana karma- bloodletting (pracchāna) is done on
diseased area using lancet needle. Narsinha
1 tsf TDS 1 month
Paschata karma- Shiro-prakshalan(head wash) with luke- Rasāyana
worm triphla kwath. Local application of paste of
Madhuyashti choorna mixed with Shatdhouta ghruta on Assessment of Result
diseased area. Assessment is done on the basis of improvement in clini-
cal symptom and SALT score
Table 4: Internal medicines Scalp is divided into 4 areas namely,
 Vertex- 40%(0.4) of scalp surface area;
Medicine name Dose Days  Right profile of scalp- 18%(0.18)of scalp surface
Trichup cap. 1 cap. TDS 45 days area;
Brihatmanjishthadi kwa- 15 ml TDS with 15 ml 15 days  Left profile of scalp- 18%(0.18) of scalp surface
tha water
area;
Kaishore Guggulu 2 Tab TDS 15 days
 Posterior aspect of scalp- 24%(0.24) of scalp surface
Sarivadhyasava 15 ml TDS 15 days
area;
Triphla Choorna 5 gm HS 15 days
Percentage of hair loss in any of these areas is percent-
age hair loss multiplied by percent surface area of scalp

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 Jitender & Prasanth : A case study on Ayurvedic management of Alopecia areata (Khalitya)

in that area. SALT score is sum of percentage of hair loss is localized Rakta Dushti as in this case[x]. Internal Medi-
in all above mentioned areas. cations are chose on the basis of their Raktashodhaka
property. Rasāyana drugs which were given also had
Table 6: SALT scale Kesya property.

Area
SALT (Before SALT (After treat- CONCLUSION
treatment) ment)
Vertex 4 1 This case study shows the successful management of a
Right scalp 2.4 1.4 case of Alopecia areata (Khālitya). Whilst there is enor-
Occiput 3.2 1 mous scope for further research but still it proves that with
Total Score 6.o 3.4 proper diagnosis and proper treatment protocol Ayur-
veda can be extremely beneficial in the management of
DISCUSSION Alopecia areata (Khālitya). By Panchakarma therapy
along with internal medicines relief can be obtained on
Alopecia areata (Khālitya) is described as one of the Kṣu- SALT scale. The recovery in the present case was prom-
dra roga in Samhitas. Vāta, Pitta, Kapha and Rakta are ising and worth documenting.
involved in Khālitya as mentioned in the texts. There was
redness of scalp in diseased region which indicates to-
wards involvement of Pitta. Virechana is the best treat-
ment for Pittaja and Raktaja Vikara. That’s why ΛΛΛΛ
Virechana was done. Pracchāna is indicated when there

Before Treatment After Treatment

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 Jitender & Prasanth : A case study on Ayurvedic management of Alopecia areata (Khalitya)
REFERENCES
i. National Alopecia Areata Foundation Available from
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AAMJ / Vol. 3 / Issue 2 / March – April 2017
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Source of Support: Nil.
Conflict of Interest: None declared
How to cite this article: Jitender & Prasanth : A case study
on Ayurvedic management of Alopecia areata (Khalitya).
AAMJ 2017; 2:1293 – 1297.
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