Alopecia Areata is a systemic autoimmune disorder where autoantibodies are driven against anagen hair follicle.

PATHOHENESIS AND GENETICS OF ALOPECIA AREATA

Its thought to be systemic autoimmune disorder affecting anagen hairfollicle.Its T-cell mediated inflamatory non scarring condition. T-cell mediates inflamatory response around hair follicle which damages hair follicle.

Endogenous retinoids metabolic  disorder plays a major role in its pathogenesis.

Atleast 129 various SNP  are associated with this disease in genome.

Atleast 4 regions in genome are found to have these genes

Genes associated with this disease have functions of controlling the activation and proliferation of regulatory T cells, cytotoxic T-Lymphocyte-Associated Antigen 4, InterLeukin-2, InterLeukin-2 receptor A, and Eos, and HLA.

PRDX5 and STX17 genes expressed in the hair follicle are associated with Alopecia Areata.

It shares genetic risk with autoimmune conditions like Diabetes Mellitus Type 1, Rheumatoid Arthritis and may accompany each other.It may be the only manifestation of Celiac disease.

Cases with congenital Alopecia Areata are also noted.It has strong hereditary association.Its a non contagious disease.

SYMPTOMS AND CLASSIFICATION OF ALOPECIA AREATA

It presents itself with small well demarcated bald patches with seemingly healthy skin below, with no scarring on skin. It can affect any region that has hair but it usually involves , scalp and beard. The patches are usually circular but it can present in any shape and extent. The hairs on the border of bald patches are very easy to pluck off compared to other regions.

CLASSIFICATION OF ALOPECIA AREATA

• Diffuse Alopecia Areata

  the baldness is diffused over whole scalp rather than in patches.

• Alopecia Monolocularis

  bald patch is located only in one spot

• Alopecia Areata Multilocularis

  many bald spots

• Ophiasis

  hairloss at margins of hairline in waveforms

• Alopecia Areata Barbae

  disease is limited only in beard region

• Alopecia Areata Totalis

  complete hairloss of scalp

• Alopecia Areata Universalis

  all hair of each and every region are lost.

DIAGNOSIS OF ALOPECIA AREATA

Trichoscopy shows evenly distributed hyperkeratotic plugs called yellow plugs, small shoots of hairs like exclamation marks, and destroyed hair follicles in follicular openings called black dots.

Biopsy

HOMEOPATHIC MEDICINES FOR ALOPECIA AREATA

SULPHUR

Sulphur is a general antisporic remedy. It is usually suited to lean, stoop shouldered patients. Sulphur is very well indicated remedy in case of Alopecia areata. Acting upon the external head, the itching is indescribable, constant itching worse from warmth of bed. Erruptions in general on the scalp. Severe loss of hair in patches. Dandruff with itense itching. Humid offensive erruptions with thick pus, yellow crust dry up into honey like scabs. Hair become dry, lustureless and fall off. Sulphur is a widely used remedy for almost every kind of itch.

LYCOPODIUM CLAVATUM

Lycopodium has a very deep and broad sphere of action. It is a remedy prepared from club moss. Lycopodium is useful in case of alopecia areata. Frequently used remedy in case of hair loss, premature greying of hair, premature baldness. Patient usually presents with patchy hair loss. Itching in the scalp due to dandruff or erruptions which are thick indurated. Complaints are usually worse from warmth and better by cold applications. Extremely sensitive patient with deep furrows on forehead.

KALIUM BICHROMICUM

Kali bichromicum is prepared by the potentisation of salt potassium bicarbonate. Kali bichromicum is a wonerful deep acting remedy having effects on multiple system of body. Patient usually presents with hairfall in spots. Dandruff with severe itching. Dandruff is yellowish in colour with formation of scabs. Scalp is infected with severe itching. Kali bichromicum helps in regeneration of hair growth.

PHOSPHOROUS

Phosphorous is well suited to young people who grow rapidly and are inclined to stoop. Phosporous indication in alopecia areata is very valuable. Phosphoorous works well in cases where falling of hair occurs in large bunches, leaving marked patches. Dandruff with sevre itching of scalp. Dry scalp and scaliness of scalp. Dry painful heat of scalp compellinh one to uncover head. Clammy perspiration on head only. Phosphorous helps in case of traction alopecia. There is receding hair line. Hairfall from forehead is prominent. Hence Phosphorous is very well indicated in frontal baldness too.

THUJA OCCIDENTALIS

Thuja is one of the indicated remedy in case of Alopecia areata. Patient usually complains of diffuse hair loss along with dandruff on scalp. Dandruff is generally thick and whitish in color with intolerable itching. Patchy hair loss. Handfull of hair come out while combing or washing hair. Single bald spots progress to form multiple spots. Hence thuja is very good remedy in such cases.

CALCAREA CARBONICUM

Calcarea carbonicum is the chief representative of calcium compounds. Great Hahnemanian antiporic. Chief action is centered in vegetative sphere. Calcarea carbonicum is one of the frequently used remedy for hairloss. Usually associated with intense itching of scalp. Marked feature is excessive perspiration of scalp or head which is so intense even wets the pillow. Head feels hot. Scratches head on waking. Hair falls in bunches. Scabs on the scalp. Painful sensitive roots of hair. Dandruff with milky crusts causes intense itching. Boils on scalp which tend to suppurate.

PULSATILLA NIGRICANS

Pulsatilla is pre eminently a female remedy especially suited to mild, gentle, yielding disposition. Very useful remedy in case of Alopecia areata. Hairfall in patches on combing hair. Purulent pustules on scalp with pain in the scalp. Itching on scalp mostly on temples and bwhind the ears. Dandruff white scaly with severe itching. Fetid and frequently cold perspiration on scalp with intense itching.

ARSENIC ALBUM

Arsenic album is a profoundly acting remedy on every organ and tissue. Arsennic album is one of the frequently indicated remedy for alopecia areata which usually appears as circular bald patches along with itching and burning of scalp. Sensitive scalp which it hes intolerably. The scalp is so sensitive that the patient cannot brush hair, seems as kfthe touch of comb or brush when rubbing over scalpwent into the brain. Circular patches of bald spots, rough, dirty, sensitive covered with dry scales. Hair greying at an early age, with severe hairfall.