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TITLE OF CASE

Standalone Ayurvedic Management of Alopecia areata - A case report

Dr Shanti K

ABSTRACT

A 28-year-old male engineering student presented with the complaint of patchy loss of hair on the scalp for 1 week. One day he noticed a loss of hair in a small area in the front portion of the scalp while combing his hair, which gradually increased in the area. On examination, there was two circumscribed oval-shaped patchy loss of hair on the anteromedial part of the scalp with demarcated borders. There were no signs of scaling or redness. On the basis of examination, the condition was clinically diagnosed as Alopecia areata[1] and was treated as Indralupta [2] in Ayurveda. Assessment of alopecia was done using photographs taken before and after the treatments. The treatment was carried out in three phases- shodhana cikitsa, raktamokshanam and rasayanam. In the follow-up after 1 month healthy hair growth started on the affected areas of the scalp. A follow-up conducted after 1 year revealed healthy regrowth of hair in affected areas.

KEYWORDS

Alopecia, Indraluptam, Ayurveda, Case report, Pracchanam

INTRODUCTION

Appendicitis[1] is the inflammation of the appendix, a finger-shaped pouch that projects from the colon on the lower right side of the abdomen. Although appendicitis can affect any age group, it generally prevails between the age of 10 and 30.

The symptoms of Appendicitis are pain in the lower right abdomen. Sometimes, the pain begins around the navel, and then it spreads. As the inflammation worsens, the pain becomes intense and excruciating. Associated symptoms like nausea, loss of appetite, low-grade fever, constipation or diarrhoea, and abdominal bloating, can also appear along with the pain.

Cause- An infection caused by the blockage in the lining of appendicitis. The bacteria multiply rapidly causing inflammation and swelling and this is filled with pus. At this stage, if not treated, the appendix can rupture and cause grave health issues.

PATIENT INFORMATION

The patient is a 28-year-old male patient presenting with Complaints of patchy loss of hair on the scalp for 1 week.

Medical History: The patient was suffering from complaints for 1 week. One day he noticed a loss of hair in a small area in the front portion of the scalp while combing his hair, which gradually increased in the area. It was not associated with dandruff and this was the first episode of the same. The patient did not have any autoimmune disease and was not under medication for any other disease. The patient opted for Ayurvedic management.

CLINICAL FINDINGS

Hair and Scalp examinations were done. On examination, there were two circumscribed oval-shaped patchy losses of hair on the anteromedial part of the scalp with demarcated borders. There were no signs of scaling or redness.

TIMELINE

Image 1. Timeline of events added as an attachment

DIAGNOSTIC ASSESSMENT

Modern Diagnostic parameter: The patient did not have any prior consultation. The Ayurvedic physician did the biomedical consultation based on the clinical presentation and examination.

Image 2. The image taken before the treatment 

Ayurvedic Assessment was done based on the clinical evaluation by the ayurvedic physician.

Differential Diagnosis- This does not apply as the patient came in with a definite diagnosis.

Prognosis- The outlook for most patients is good with or without treatment. However, because of poor cosmesis, some people may become withdrawn and depressed. In this case, because of this condition, he became less confident and was not interested to go to college. The patient opted for Ayurvedic treatment, which could provide supportive care for a healthy recovery and possible side effects from the standard medical care could be avoided.

THERAPEUTIC INTERVENTION

See the tab ‘Treatment details’

FOLLOW-UP AND OUTCOMES

In the follow-up after 1 month, healthy hair growth started on the affected areas of the scalp. A follow-up conducted after 1 year revealed healthy regrowth of hair in affected areas. After 48 days, except nasyam all the medicines were stopped. A follow-up done via telephone after 1 year revealed that the areas in the scalp that had patchy losses of hair, were covered with healthy hair.

Image 3. The image during treatment is added below

Image 4. The image was taken at the endpoint added below

Clinician-based assessment; After 1 month of treatment, there was regrowth of hair on the scalp in the areas where there was a loss of hair. A follow-up done after 2 months documented complete hair growth on the affected areas on the scalp.

Patient assessed- Not relevant.

Intervention adherence and tolerability – The patient adhered to the prescribed treatments and tolerated the treatments well.

Method of assessment- By monitoring the patient.

Adverse and unanticipated events; None reported.

DISCUSSION ;

The main causative factors involved in Indraluptam are tridosas along with Rakta. Snehanam by virtue of its dosa utkleshana (increasing the dosa) separates toxins accumulated in the patient’s body. It then centralizes the dosas from other parts of the body in the pakvashaya (distal part of the alimentary canal). Sodhana chikitsa to evacuate the separated morbid dosas from the body and helped to attain srotoshudhi. Prachannam helped to remove the vitiated Rakta from the body and Indralupta mashi helped in romasamjananam. Rasayana therapy was done to strengthen the new tissues on the scalp after prachannam.

PATIENT’S PERSPECTIVE

Not available.

LEARNING POINTS/TAKE-HOME MESSAGES

This case report demonstrates the successful standalone ayurvedic management of alopecia areata. The patient did not have any prior consultation, and within 1 month of starting ayurvedic treatments, symptoms started reducing. A follow-up done after 1 year revealed the affected areas in the scalp are fully covered with a dense growth of healthy hair.

INFORMED CONSENT

Written consent was obtained from the patient to publish the case report.

CONFLICT OF INTEREST

None declared.

FUNDING

None

REFERENCE

1. Zhou C, Li X, Wang C, Zhang J. Alopecia Areata: an Update on Etiopathogenesis, Diagnosis, and Management. Clin Rev Allergy Immunol. 2021 Dec;61(3):403-423.
2. Ashtanga Hrdaya. Uttara sthana. 23.25

Image 1. Timeline of events

Image 2. The image taken before the treatment 

Image 3. The image during treatment 

Image 4. The image taken at the endpoint