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  2. Introduction  Skin and hair has got a lot of concern for interest of cosmetic purpose.  Hair length, color, and style play an important role in physical appearance and self-perception.  The term premature graying is applied, when abnormal graying will be found in young population and also in children.  The color of human hair depends on melanogenesis, through a process of synthesis of melanin and its subsequent distribution from the melanocyte to keratinocyte.
  3. Cont…  The human hair follicles contain two types of melanin-  The black-brown pigment eumelanins mainly present in black and brown hair.  The yellow or red pheomelanins in red and blonde hair. (  Ayurveda, the richest heritage of India long back highlighted this burning problem and categorized the same under the heading of Palitya.  The disease Palitya is mentioned under the heading of Kshudraroga and Shirogataroga.  The main etiology of Palitya is vitiation of Dehoshma and Ushna Guna of Pitta which circulates to Romakoopa and causes Paka of hair.
  4. Aims And Objects  Review and Critical analysis of premature graying of hair in children .  To evaluate etiopathgenesis of Palitya in children  To study treatment protocol for management of premature graying of hair (Palitya) in childhood clinical practice.
  5. Material and Methods  Information on premature graying of hair (Palitya) is collected from different -  All available Ayurvedic literature  Contemporary medical text books,  Magazines,  Journals, and  e- References
  6. Etiology Acc. To Ayurveda  According to Ayurveda the disease of Palitya, specific Nidana are not mentioned.  But on basis of Samprapti, Pitta Prakopaka Nidana, Rasadushti and Asthidushti Nidana can be considered.  Nidanas of the Kshudra Roga and Shirro Rogas can be also applied to understand Palitya.
  7. Cont…  For easy understanding Nidana of Palitya can be classified under these headings-  Dietary (Ahara),  Environmental (Vihara),  Psychological (Manasika),  Unknown causes (Adibalapravrita).
  8. Cont…  The Dietary (Ahara) Nidana –  Consumption of Ushna, Tikshna, Lavana, Amla, Vidahi, Tilataila, Kulatha, Sarshapa, Dadhi, Kanji etc Pittavardhak Aahara.  Above all causes vitiate Pitta and affect Rasa Dhatu Poshana Karma.  Rasa Dhatu and Asthi Dhatu Dushti is the Nidana of Palitya.
  9. Cont…  Environmental (Vihara) Nidana –  Like ratrijagarana, atapasevana, dhumasevana, dushitavayusevana, siroabyangaayoga, dushitajalasnana, ativyayama and upavasa are important.  Above all causes accounts for improper nourishment of scalp and hair follicles leading to premature graying of hair.
  10. Cont…  Psychological (Manasika) Nidana – like Krodha, Sokha, Adhikachinta and Manasikashrama are considered to be both Pitta and Vata Prakopa Nidanas responsible for Akalajpalitya.  Unknown causes (Adibalapravrita) Nidana - Development of premature graying of hairs in Pitta Prakriti.
  11. Etiology Acc. To Contemporary Science  Achromotrichia- The change in hair colour occurs when melanin ceases to be produced in the hair root and new hairs grow without pigment.  Stress- Stress has been considered as major cause of the induce achromotrichia.
  12. Cont…  Nutritional factor- Nutritional deficiencies like vitamin B12 deficiency, severe iron deficiency, chronic protein loss, copper deficiency, low serum ferritin, and low serum calcium and vitamin D3 levels are often found associated with premature graying of hairs.  Environmental factors- Smoking results in generation of huge amount of reactive oxygen, species leading to increase oxidative stress culminating into damage to melanin producing cells melanocyte.
  13. Cont…  Medical conditions- Albinism, Vitiligo, Pernicious anemia, Thyroid diseases and Werner’s syndrome.
  14. Symptomatology of Palitya (Roopa)  The symptomatolgy of Palitya has been attributed to Tridosha pradhanta by Ashtang Hridayam.  Vata pradhana Palitya-  Sphutitam (cracked),  Shyava (black in colour),  Karksha (rough),  Ruksha (dry),  Jwalataprabham (watery) are commonly seen.
  15. Cont…  Pitta pradhana Palitya-  Dahayukta (burning sensation),  Pita (yellow colour) will be evidenced.  Kapha pradhana Palitya-  Snigdha (smooth),  Vivradhi (growing),  Sthula (thick),  Shukla (white) will be seen.
  16. Cont…  Tridoshaja Palitya-  Sarva Dosha Lakshana Yukta (Mixed features of all the dosas) will be seen. • Acharya Yogaratnakara also mentioned the same.  Madhava Nidana explains-  Kalaj Palitya in which graying of hair occurs after certain age due to vitiation of Tridosha.  Akalaj Palitya occurring due to vitiation of Shariroushma and Pitta Dosha in an early age.
  17. Samprapti Ghataka Dosha Tridosha {Pitta (Bhrajaka pitta) pradhana } Dushya Rasa dhatu, Asthi dhatu Agni Jatharagni, Dhatwagni Srotas Rasavaha, Asthivaha Srotodusti Sanga, Vimarggamana Udbhava Sthana Aamashaya Vyadhi Adhishthana Keshabhumi Roga Marga Bahya Roga Marga Sadhya Asadhyata Ekdoshaj Sadhya, Sannipataj Asadhya
  18. Current Treatment Trends  Topical antiaging compounds.  Oral supplementation with l-cystine and l- methionine, and topical melatonin.  Large doses of P-aminobenzoic acid (PABA).  Prostaglandins (stimulators of melanocyte growth and melanogenesis)  Temporary hair colorants are used worldwide.
  19. Cont….  The basic treatment principle of Palitya -  Avoidance of causative factors like Pittavardhak Ahara and Vihara.  Purification therapies (Samshodhana Chikitsa)  Nasal medication (Nasya Karma)  Anointing the face and head (Vaktra-siro Abhyanga)  Application of pastes (Lepa) and  Oral medications.
  20. Nasya Karma  In Akalaj-Palitya the Navana and Pratimarsha Nasya is mentioned.  Yogas for Nasya Karma- These Yogas for Nasya karma mentioned in different classics have been given below.  Bhringaraja Taila  Bhringaraja Ghrita  Chandanadya Taila  Prapoudarikadi Taila  Nimba beejadi Taila  Yashtimadhuka Taila
  21. Shiroabhyanga  Nilikadi Taila  Bhringaraja Taila  Maha neela Taila  Sarayakadi Taila
  22. Shiro Lepa 1. Lohachurna + Bhringaraja + Haritaki + Vibhitaki + Amalaki + black soil are taken in equal quantity powdered and mixed with sugar cane juice. This mixture is kept for 1month and that juice is applied over hair. 2. Two Amalaki fruits, two Haritaki and two Vibhitaki, 5 karsha Amra majja; 1 karsha lohachurna are mixed well and kept in Iron jar. This is kept for whole night and applied. 3. Triphala + Loha churna + Bhringaraja swaras - Kept in matured coconut for month. This is applied over scalp. 4. Kashmaryadi Taila.
  23. Oral medication  Amalaki rasayana  Bhringaraja rasayana  Saptamrita loha  Loha churna  Bhringaraja churna  Guduchi churna
  24. Discussion  Palitya is a disease which does not have satisfactory treatment till date. The reason behind that may be improper execution of treatment.  In Ayurveda the first line of treatment seems Shodhana.  Shodhana expels vitiated Doshas from body.  Basic pathogenesis of Palitya is based on either Margavarodha or Dhatu Kshaya/Dushti or sometimes both.
  25. Cont…  After proper Shodhana any treatment works better as clean cloth can be coloured better than a dirty cloth.  Amongst Shodhana, though Vamana and Virechana are best but Nasya seems treatment of choice in Palitya because of its action on Uttamanga and it can act as both Shodhana and Shaman.
  26. Cont…  If we go through the mechanism of Nasya the drug absorbed by three process in nasal mucosa. 1. The olfactory neurons 2. second by supporting cells and surrounding capillaries. 3. The third way by cerebro-spinal fluid (CSF).
  27. Cont…  Shiroabhyanga, Sirodhara, Sirolepa are other external treatments which can be used simultaneously.  Many oils and Lepas are only Krishnikarna in nature act as a stimulant or nutrient for the hair follicles like-  Nimba Beeja Taila  Bhringaraja  Nirgundi  Lepa of Karveer Moola Swarasa and Dugdhika Swaras
  28. Conclusion  After reviewing the literature we can conclude that Palitya is a disease which has Srotorodha along with Dosha Prakopa.  From the above discussion we can say that the Panchkarma plays important role in Chikitsa of Palitya.  Acharya Charaka and Vagbhatta mentioned Samshodhana therapy causes expulsion of vitiated Dosha and thus breaks the Samprapti of Palitya.
  29. Cont…  Vamana expels Apakva Pitta and Kapha Dosha from Urdhavamarga.  Virechana expels Pitta Dosha from Adhomarga.  After the Samshodhana karma, if we use Samana Chikitsa with yukti Praman, we can find better results in premature graying of hair.