1. INTRODUCTION
• Hair is a big part of our identity and appearance. It is a quotient of beauty
and confidence, and when one loses hair, they lose self-esteem and self-
confidence. Alopecia can be a traumatizing experience as it affects the self-
image of the sufferer. Many patients with alopecia end up having depression.
• Alopecia, also known as hair loss or baldness, refers to the partial or
complete absence of hair from areas of the body, especially the scalp. Some
amount of hair fall is completely normal. In women, it is about 80-100 strands
per day and in men, it is 50-70 strands per day. But if this increases or if there
is noticeable hair thinning making the scalp visible then it is termed alopecia.
2. • Alopecia can occur at any age from birth to the late decades of life. Peak
incidence appears from age 15-29 years. As many as 44% of people with
alopecia have onset at younger than 20 years. The mean age for diagnosis
of alopecia is 32 years in males and 36 years in females.
• All races are affected equally by alopecia. No increase in prevalence has
been found in a particular ethnic group. A 66%-74% lifetime prevalence of
psychiatric disorders has been reported in alopecia patients, with a 38%-
39% lifetime prevalence of depression and a 39%-62% prevalence of
generalized anxiety disorder.
3. • In Homoeopathy, the holistic approach to cure the disease is unique and is
called individualization. No knowledge is perfect unless it includes an
understanding of the origin that is the beginning and as all man’s diseases
originate in his constitution. The patient’s constitution must be known if we
wish to know his disease. In the case of alopecia, either with acute
manifestation or chronic it can be well managed with homoeopathy. It can
majority time ward off surgical interventions.
• Homoeopathic medicines can be given in various potencies. Much work to date
has been done on Centesimal Potency but somehow Hahnemann’s final
potency i.e. LM Potency is much neglected. It is also known as Q potency and
50-millesimal potency. Despite many advantages, LM Potency use never comes
to the surface as the potency of choice. So, to evaluate the efficacy of LM
potencies in alopecia this study is taken as a task.
4. REVIEW OF LITERATURE
• Definition of Alopecia:- Alopecia is the most notable example of non scarring,
non-patterned alopecia, characterized by the sudden rapid appearance of
circumscribed, circular or oval bald patches in hair-bearing areas, especially the
scalp. [1]
• General anatomy of hair:- The follicular life cycle can be divided into 3 phase:
anagen, catagen and telogen. The anagen phase is the phase active growth. The
catagen phase marks follicular regression and the telogen phase last
approximately 3-4 years. The catagen phase approximately 3 months.
Approximately 84% of scalp hairs are in the anagen phase, 1-2% are in the
catagen phase and 10-15% are in the telogen phase. [2]
5. • The hair follicle can be divided into 3 regions:
a) the lower segment(bulb and suprabulb)
b) the middle segment (isthmus)
c) the upper segment (infundibulum)
• The lower segment extend from the base of the follicle to the insertion of the
erector pili muscle. The middle segment is a short section that extends from the
insertion of the erector pili muscle to the enterace of the sebaceous gland duct.
The upper segment extends from the entranced of the sebaceous duct to the
follicular orifice. [2]
6. MICROANATOMY OF ANAGEN
PHASE HAIR
• The bulb encompasses the dermal papilla and the hair matrix. The dermal
papilla consists of an egg-shaped accumulation of mesenchymal cells
surrounded by ground substance that is rich in acid mucopolysaccharides
(AMPs). The papilla protrudes into the hair bulb and is responsible for
instigating and directing hair growth. Because of the abundance of AMPs, the
dermal papilla stains positively with Alcian blue and metachromatically with
toluidine blue. The lower part of the dermal papilla is connected to the fibrous
root sheet. The hair matrix surrounds the top and sides of the dermal papilla.
In darkly pigmented individuals, melanin can be found in abundance within
the melanophages of the dermal papilla. [3]
7. • The hair matrix is the actively growing portion of the follicle consisting of a
collection of epidermal cells that rapidly divide, move upward, and give rise to
the hair shaft and the internal root sheath.
• Inner root sheath:- The inner root sheath (IRS) is closely apposed to the hair
shaft, and, because the sheath contains no pigment, it can easily be distinguished
from the hair shaft. The IRS coats and supports the hair shaft up to the level of
the isthmus, at which it breaks down and exfoliates in the infundibular space. [3]
• Hair shaft :- The hair shaft consists of 3 layers. The outermost layer of the hair
shaft (cuticle) consists of overlapping cells that are arranged like shingles. They
point outward and upward and interlock with the IRS cuticle, which leads to a
firm attachment between the hair shaft and the IRS. As a result, they move
upward in the follicular canal as a single unit. The keratin produced is termed
hard keratin. [4]
8. • Outer root sheath:- The outer root sheath (ORS) covers the RS as it extends
upward from the matrix cells at the lower end of the hair bulb to the entrance
of the sebaceous gland duct.
• Fibrous root sheath:- The fibrous root sheath is the outermost layer of the hair
follicle and surrounds the vitreous layer. The root sheath is continuous with the
dermal papilla at its lower end and with the papillary dermis above it.
• Suprabulb region:- The suprabulb region extends from the hair bulb to the
isthmus and consists of components of the hair shaft, IRS, ORS, vitreous layer,
and fibrous root sheath.
• Infundibulum:- The infundibulum is the upper portion of the hair follicle, above
the entry of the sebaceous duct. Surface epidermis lines the infundibulum. [4]
9. MICROANATOMY OF CATAGEN PHASE
HAIR
• Although the factors are largely unknown, active hair growth (i.e., the anagen
phase) halts, and the catagen phase begins. A period of 2-3 weeks is required
for the transition to occur. [3]
10. MICROANATOMY OF TELOGEN PHASE
HAIR
• During the telogen (resting) phase, the secondary follicular germ and the
dermal papilla form the telogen germinal unit, from which the new anagen
hair develops. [3]
12. • Scarring alopecia
• Primary cutaneous disorders
• Cutaneous lupus (chronic discoid lesions)
• Lichen planus
• Central centrifugal cicatricial alopecia
• Folliculitis decalvans
• Linear scleroderma (morphea)
• Systemic diseases
• Discoid lesions in the setting of systemic lupus erythematosus
• Sarcoidosis
• Cutaneous metastases [5]
13. COMMON TYPES OF ALOPECIA
• ALOPECIA AREATA (AA)
Alopecia areata is an autoimmune condition which causes patchy hair
loss. It can result in a single bald patch or extensive patchy hair loss.
14. • ALOPECIA TOTALIS (AT)
It is more advanced form of alopecia areata which results in total loss of all hair
on the scalp.
15. • ALOPECIA UNIVERSALIS (AU)
It is the most advanced form of alopecia areata which results in total loss of hair
on the body, including eyelashes and eyebrows.
16. • ALOPECIA BARBAE (AB)
It is alopecia areata that is locaised to the beard area. It can be a single bald
patch or more extensive hair loss across the whole of the beard area.
17. • ANDEROGENETIC ALOPECIA (AGA)
It is known as male pattern or female pattern baldness. It is a thinning of the
hair to an almost transparent state, in both men and women. It is thought to be
a hereditary form of hair loss and is the most common type of progressive hair
loss.
18. • TRACTION ALOPECIA
Traction alopecia is usually due to excessive pulling or tension on hair shafts as a
result of certain hair styles. It is seen more often in women, particularly those of
East Indian and Afro-Caribbean origin. Hair loss depends on the way the hair is
being pulled. Prolonged traction alopecia can stop new hair follicles developing
and lead to permanent hair loss.
19. • ANAGEN EFFLUVIUM
This hair loss is generally caused by chemicals such as those used to treat
cancer. Initially it causes patchy hair loss, which often then becomes total hair
loss. The good news is that when you stop using these chemicals the hair
normally grows back (usually about6 months later). Other drugs also can cause
hair loss. Many medicines used to treat even common dieases can cause hair
loss.
20. • TELOGEN EFFLUVIUM
It is form of hair loss where more than normal amounts of hair fall out. There is
a general 'thinning' of the hair. Unlike some other hair and scalp conditions, it is
temporary and hair growth usually recovers. [6]
21. THE PSYCHOLOGY OF HAIR LOSS
• The research has shown that there are several common reactions to hair
loss. These include:-
a. PANIC
b. DENIAL
c. SHAME
d. DESPERATION
e. FIXATION
f. JEALOUSY
g. ISOLATION [7]
23. HOMOEOPATHIC APPROACH
• Alopecia is an autoimmune disease. Dr. H.A. Roberts says, "Similar remedy or
similar disease satisfies susceptibility and establishes immunity" Each and every
individual case has unique feature to represent the symptom and disease by
that way of individualization only homoeopathy treats the individual as a
whole.[8]
• Homoeopathy is a therapeutic system in which drug is applied to disease
according to a specific principle. In this we treat person as a whole. Health is not
merely a state of being, it is power. Health is the power of resist, power to
adopt life to condition without fear, the power to live a life in the world. The aim
of homoeopathy is to build that power. [9]
24. • The mind, body, sprit and the trinity of life, which is present in every
Organism. Harmonious low of life maintains health and deviation leads to
disease. As Robert correctly stated that, "Any disturbance of this vital energy
immediately shows itself in of harmony through the outward manifestations of
our beings. in other words, symptom, when harmonious flow is disturbed, we
get sickness as a result, and it has as its base and inception. This lack of
harmony in the low of vital energy through the body is manifest in disease as it
naturally develops because of disturbed vital force. [9]
