Clinical Cases

A Relapsing Case of Alopecia Areata

April 17, 2017
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by Muhammad Afzal
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Written by Muhammad Afzal

Dr. Muhammad Afzal Sandhu presents a case of Alopecia Areata in a girl of 6.

Abstract:

The patient was a 6 year old girl who suffered from falling of hair in a patchy pattern. Internal and external allopathic treatments were tried for four years by three different dermatologists, but symptoms returned. This patient improved well after homeopathic treatment, not only at the local level but constitutionally as well, within one and half years. Treatment continued for about 2 years with more than one year follow up.

CASE PRESENTATION

Miss T. K. , age 6 years, was a diagnosed case of alopecia areata at the age of 2 years. On April 24, 2014, she was consulted for the homeopathic treatment of her relapsing complaint of hair falling in patches. She presented the following chief complaints at the time of examination.

Observations and Presenting Complaints

  • Falling of hairs from scalp in patchy pattern.
  • Patchy area presented with dark color.
  • Falling of eye lashes and hairs of eye brows.
  • Pale face, remaining hairs thin, lusterless and unhealthy.
  • Scaly dandruff in head with mild itching.
  • Body growth was not proper in height and weight.
  • Thin chest.
  • White spots on nails.
  • She had poor appetite.
  • Burning heat in soles.
  • Desire salted and spicy food, cold drinks, ice cream.
  • Aversion to sweets.

History of presenting illness

Patient was alright 4 years before, then she experienced itchy areas on scalp with falling of hair from these areas. Her elder sister also had h/o alopecia areata and responded well with allopathic treatment with no relapse. So, her parents confidently sought a dermatologist’s opinion and treatment was begun. First treatment was of 6 months with recovery and then relapses after 3 months. Second treatment was given for 3 years, including internal medication and external injection therapy. Within a few weeks of stopping treatment, hair fall continued.  Another course of treatment was given for 9 months but without any positive result.

Past Personal History

H/o Chicken pox

Family History

H/o tuberculosis in Mother

PHYSICAL GENERALS

Appetite               : Diminished

Thirst                             : Excessive for cold water

Desires                 : Salted, spicy foods, cold drinks

Aversion              : Sweets

Bowel Habits       : Normal

Urination              : Normal

Perspiration                   : Normal

Sleep                    : Normal

Thermal reaction  : Hot patient

AN INNOCENT WISH

She had strong wish to wear a hair catcher but not enough hairs to hold the hair catcher.

REMEDIES SELECTION

  • Constitutional: Phosphorus
  • Intercurrent: Sulfur, Acid Fluor
  • Acute episode: Sulph, Hepar Sulf,
  • Family History: Tuberculinum
  • Supportive: Calc phos, Nat Mur

RESULTS & DISCUSSION

Constitutionally and symptomatically this patient was a phosphorus, and one dose in 200 was advised and three doses were given with intervals during 2 months as needed. According to W.A. Dewey, phosphorus is the most important remedy in alopecia areata that presents with bald spots on the head which are dry and scaly72.

Hair started growing out, but after 2 months of starting treatment the patient developed itching on affected area of head. I consider it a positive response of the body as the same symptom was experienced by the patient at startup of the problem (which was suppressed by local steroid creams and injection). I decided to wait for some time to observe any change in symptoms. Meanwhile due to itching, the patient badly scratched the area and got secondary infection with pustular, scaly eruptions. A few doses of Sulfur 30 and Hepar sulph 30 were needed here according to symptoms, which cleared the problem.

Echinacea MT 10 drops thrice a day was prescribed for 3 weeks to enhance general immunity. Afterward a dose of Sulfur 200 was administered as an antipsoric and intercurrent remedy73. It was observed that the growing hairs were not healthy and looked thin, dry and lusterless. Patient was not taking appropriate foods, so a balanced diet was advised. Alder Smith says alopecia areata “is due to a state of perverted nutrition and not to any vegetable parasite,”74. Cowperthwaite A. C. described Flouric acid as a valuable remedy in disorders resulting from perverted nutrition and in unhealthy, broken down constitutions75. Flouric acid is mentioned in the literature as an intercurrent remedy in alopecia areata76. Two doses of acid fluor 200 were prescribed with intervals of 20 days.

Hairs were continually grown out but with no shine. A dose of Tuberculinum in 1M was administered due to H/o TB in her mother and followed by Calc Phos 6x and Nat Mur 6x alternately twice a day and continued until recovery. It gave a new vitality not only to the hair, but the patient. Now she has good complexion, dark and thick hairs and good height. In my daily practice these two salts are very effective in children with malnutrition and weak health and Silicea is a third one. In the homeopathic literature, biochemic salts including Kali phos77, Nat Mur78-79 and Calc phos80-81 are mentioned for the treatment of alopecia areata.

 

 

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About the author

Muhammad Afzal

Dr. Muhammad Afzal Sandhu received his BHMS from Islamia University Bahawalpur and a DHMS from Anwarul Islam Homeopathic Medical College Kasur. He’s been in homeopathic practice for fourteen years. He is also trained in microbiology (Univ of Lahore- Pakistan) and advanced acupuncture (Beijing China). He’s worked five years teaching anatomy, physiology, microbiology and materia medica. He is currently working with the Fauji Foundation- Lahore, as a homeopathic medical officer.

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