A Case of Alopecia Areata

Patient: Mr. xyz   ge: 30 yrs

Case Study:

A 30 year old man suffering from hair fall visited me on 13/9/2011. He has been a farmer for the last 12 years. Since then he is working with his father on his family farm. He completed his high school only and was least interested in studying. He said that his classmates use to tease him as he had effeminate gestures. Initially during the case he was sitting very erect and answered all the questions, like I was a commander and he was my junior. All the answers were limited and not much explanation was given unless I asked. His approach was mild. As the case was proceeding he was getting more comfortable and answering freely.

His complaint started five years ago. Initially the alopecia was just a small patch but gradually it progressed to more than five large and small patches. He had taken  allopathic medications and had applied a lot of medicines. Each time his hair would grow a bit, but all of a sudden the hair would fall again. This led him to try homoeopathy himself. He had applied “homoeopathic” hair oils and taken medicines for two years, but nothing was fruitful. On careful questioning about how the problem started, it came out that he was suffering from some kind of skin eruption over his right hand and forearm. He did some home medication and used weak acid to burn the eruption. The eruption went away, but the same month he saw the first patch appearing on his right temporal region. Gradually, as he tried various treatments, the number of patches went on increasing.

His appetite was good and he was physically slim.  He loved spicy and seasoned food and lemonade whenever he felt weak or tired.  He dislikes milk and milk products and fats. Occasionally he enjoyed sweets.

He perspires a lot in all seasons. Perspiration causes weakness and mild itching over the bald spots.

His bowels were regular but he was occasionally constipated.

Thirst was average, around 3 liters a day.

No urinary complaints.

Thermally he was very hot (+++) and never tolerated heat or sun. Wants cold weather and cold bathing in all seasons. As a farmer he always preferred to bathe three times a day in summer and works in wet or sheltered places.

Sexually he was very active and had amorous dreams.  He thinks about having relations with a few other women but never attempted to do so. Perspiration on sexual thoughts and feels palpitation.

Dreams were amorous. Occasionally dreams of death of his baby and also of snakes at times.

He has a habit of chewing tobacco, so much so that he always wants it in his mouth, even before falling asleep.

Emotionally he was highly irritable and used to get abusive if family members didn’t respond to him. He was anxious and in a hurry to complete the case. Though he was cooperating with case taking, his anxiety was expressed through restlessness and gestures. Being asked about anxiety, he said he also perspires whenever he is tense. Perspires on head, palms and soles.

Symptoms considered:

1. MIND – HURRY, haste – tendency
2. HEAD – HAIR – affections of – falling out, alopecia – spots in, alopecia areata
3. GENERALITIES – FOOD and drinks – lemonade – desires
4. GENERALITIES – WEAKNESS, enervation, exhaustion, prostration, infirmity – perspiration – from
5. MIND – ANXIETY – perspiration – with
6. SKIN – ERUPTIONS – General  – suppressed

After repertorisation these were the top 10 medicines:

Calc – 11/7

Bella – 12/6

Fl-ac – 10/6

Nit-ac – 10/6

Puls – 9/6

Ars – 11/5

Sulph – 11/5

Merc – 10/5

Sep – 10/5

Phos – 9/5

This showed that Calc covered all the rubrics with a score of 11. But as thermally the patient was hot, mild and disliked fats with effeminate gestures, I opted to give Pulsatilla

A single dose of Puls 30 was given on 13/9/11 with SL for 15 days. On 30/9/11 he saw no change.  I preferred to stay with my prescription and Puls 200 was given in aqua dose. SL for 15 days.

Next follow up was on 15/10/11. Patient said there was no change and just added that hair fall was less. I was not convinced, as I knew it was just for my satisfaction. But I gave SL for another 15 days.

On 2/11/11 the patient came back. This time he asked “Will it be going to heal or not, please tell me clearly?  The last homeopathic doctor said it will take time and went on charging without any result. I don’t feel concern of money but I want that things should work. I can wait, but the changes should be seen.”

To this I was taken back. I had never expected my Pulsatilla will give him courage to talk to me so directly. This time I gave him SL for another 15 days and said that if it didn’t work, I wouldn’t charge him.

On 15/11/11 he returned for follow up again with no results. He had the same expression and told me coldly that nothing changed. He said “Please try something better.”  He left my office and I was thinking about all he said and his manner. I again went to my repertorisation sheet. It showed the same medicine list. I was convinced that the remedy was somewhere in the list.

After a careful analysis I had this list of symptoms:

1. His thermals were hot
2. Sexual thoughts with amorous dreams
3. Weakness and longing for lemonade
4. Anxiety with perspiration

All these symptoms made me think of the acid group, and the only acid was Acid Flouricum.   On 15/11/11 Ac Fl 200 single dose was given in aqua followed by SL for a month.

Follow up on 19/12/11 was encouraging and there were definite small hair follicles seen in the bald patches. Weakness was not specific. Anxiety was less, along with less perspiration. No dose but SL was given for a month.

21/1/12: Patient came with remarkable changes. During this visit patient acknowledged the changes. A month of SL was given without any dose.

13/2/12: Hair growth was quite good and the spots were shrinking. But a new small spot was seen. Patient and I both were not aware of whether it was initially present or not. This visit an aqua dose of Fl Acid 200 was given. A month of SL was given.

9/3/12: Hair growth was optimum. The new spot had disappeared. This time patient had dry itching on right forearm. There was no bleeding, discharge or scaling. No dose with SL for 15 days was given.

20/3/12: Weakness was almost gone. Hairs growth was optimum. Itching was bearable but was aggravated in the morning and evening. Sleep was good. Eruption was moist with small scabs. No dose with SL for a month was given.

27/4/12: Eruption was much less. Occasional itching. No weakness and patient visited with a relative who gave feedback that patient was cheerful and more connected than before. No more fights and abusiveness at home. A month of SL was given with no dose.

5/6/12: Patient arrived with almost total recovery. No complaints of itching, weakness or anxiety and perspiration. Even the effeminate gestures were less. A month of SL was given with no dose and he was asked to discontinue medicines for six months.

19/3/13: Patient visited just to give follow up after discontinuation. There were no specific complaints. Hair growth optimum. No weakness, itching and anxiety. Medicine stopped.