| Etiology |
- The major types of alopecia are alopecia areata, telogen
effluvium, drug-induced and androgenetic.
- The cycle of each follicle is independent of its neighbors
and
passes through three phases – a growth phase (anagen),
lasting for three to five years, a short conversion phase
(catagen), and a resting phase (telogen), lasting for up
to three months, after which the hair is shed. One possible
cause of alopecia areata has been suggested as premature
termination of the anagen phase.
- Alopecia areata is sudden-onset patchy hair loss in one
or more circumscribed round or oval areas, primarily on the
scalp. The condition appears to have an Immunological basis,
occurring in association with autoimmune and atopic disorders.
Although the exact pathogenesis has yet to be definitively
identified, the disease is often associated with emotional
factors and endocrine dysfunction. Alopecia areata usually
appears as patchy baldness, but occasionally causes all hair
to be lost. Although total
baldness is often permanent, regrowth is possible in cases
with limited involvement.
- Telogen effluvium is characterized by shedding of hair,
rather than hair loss. It follows an acute illness, surgery,
pregnancy, malnutrition, excessive dieting, blood loss or
severe psychological stress.
- The most common form is androgenetic which includes male
pattern baldness and diffuse female alopecia.
- Excess:
1. Excess patterns are caused by excessive intake of spicy,
hot or fried food or by a depressed mental state transforming
into Fire, thus consuming Yin and Blood and generating
Wind due to Blood-
Heat. Wind-Heat then follows Qi upward to the vertex,
preventing the hair root from being nourished by Yin and
Blood. Sudden loss of hair, yellow discoloration of the hair
or premature graying can then result.
2. Another Excess pattern is caused by Blood Stasis in the
hair orifices, depriving the hair root of nourishment by Yin and
Blood. Both patterns manifest as unexpected hair loss.
3. Overeating of sweet and fatty food tends to damage the
Spleen and Stomach, leading to internal accumulation of Damp-Heat.
If this Damp-Heat steams upward to the vertex along the channels
and attacks the hair root, the hair will thin or fall out.
4. Blood stasis in the hair orifices (follicles) obstructs
the movement of Qi in the channels, making it difficult
for new Blood to irrigate and nourish the hair root, thus
leading to rapid hair loss over a large area.
- Deficiency:
1. Qi and Blood Deficiency or Liver and Kidney Yin Deficiency
resulting in lack of transformation and generation of Qi and
Blood. The hair root is empty and the hair has no source
of growth, leading to large areas of hair loss.
2. Looseness of the pores in the scalp allows external Wind
to attack, thus making the hair root less secure and depriving
it of proper nourishment, resulting in patches of hair loss.
3. Qi and Blood Deficiency due to prolonged illness,
or debilitation of the Chong and Ren vessels
mean that the hair is no longer nourished properly, resulting
in dry hair or thinning and lusterless hair, and eventually
to hair loss.
4. Internal damage due to the emotions can injure the Heart
and Spleen, impairing the transformation and transportation
function of the Spleen leading to loss of the transforming
and generating Qi and Blood. This manifests in the
Exterior as gray hair and hair loss and in the Interior as
Deficiency-Heat due to restlessness and overstrain.
5. When Lung Qi is abundant, it promotes the diffusion and
distribution of Body Fluids and Blood to nourish the Zang-Fu organs
internally and moisten and enrich the skin, flesh, hair,
and orifices externally. Damage to the Lungs can lead to
various hair
disorders, including thinning hair, dry or gray hair, or
hair loss.
6. The Kidneys store the Jing. If the Jing is
Deficient, the Kidneys cannot transform and generate Yin and
Blood, causing depletion of the source for generating hair.
This results in hair loss or premature graying of hair.
7. Excessive sexual activity drains the Kidney Jing,
damaging the Liver and Kidneys.
8. Congenital Deficiency of Kidney Qi is also responsible
for late growth of hair, thin hair, or lusterless dry yellowing
hair.
|
Clinical Manifestations
|
- The highest incidence of alopecia occurs among the
young and middle-aged.
- The disease is characterized by the sudden appearance
of one or several clearly defined round or oval patches
of hair loss, generally 1-4 cm in size.
- In severe cases, there may be loss of eyebrow, moustache,
beard, axillary, or genital hair. A few patients lose
all the hair on the scalp (alopecia totalis); complete
baldness of the head and body is known as alopecia universalis.
- The skin is smooth and white or may have short stubs
of hair at the margins of lesions (so-called “exclamation
mark hairs”, about 4mm in length and tapering toward
the scalp). Inflammation and scaling are absent.
- Hair loss may be accompanied by fine pitting of the
nails.
- New hair growth is usually the same color and texture
as existing hair, but may be fine and white, particularly
in older patients.
- The outcome is variable. A first episode usually results
in regrowth within a few months. Further episodes often
result in more extensive patches of hair loss, with slower
regrowth.
|
Treatment Principle |
|
Herb Formulas |
- Combination Internal and External Treatment: Bao
Fa Tang + Sheng
Fa Bao
- Patent Medicines: He Shou Wu Wan
- Topical:
Alopecia
Topical #3
Zi Yun Gao
Alopecia
Topical #4
Alopecia
Topical #5
Su
Xiao Ke Tu Ling Sheng Fa Jing
Sheng Fa Ding (Generating Hair Tincture),
Gui Zhi Ban Mao Ding (Cinnamon Twig
and Mylabris Tincture)
Dong Chong Xia Cao Jiu (Cordyceps
Wine)
1.
Fresh slices of
ginger Sheng
Jiang are
rubbed onto the bald
area to produce a hot
feeling, three times
daily.
2. Powder of Zhi
Chuan
Wu is mixed with vinegar or ginger juice
and applied once a day to the bald area.
3.
Cordyceps Yan
Hu Suo tincture is applied to
the affected area 3-5 times daily.
4. Semen Sinapis Bai
Jie Zi is powdered, mixed with oil to form
an ointment, and applied to the affected area once daily.
6. Psoralea tincture Bu
Gu Zhi Ding, applied three times daily.
7. Apply 25% Zanthoxyli Chuan
Jiao Tincture
8. Mix powdered Rx. Aconiti Chuan
Wu with vinegar and apply.
9.
For hair loss with severe itching
in children: Grind any amount
of Sm. Sinapis Bai
Jie Zi into a fine powder
and mix with enough lard or oil to
form an ointment. Apply to the head
once daily.
- Topical Patent Medicines:
101 Hair Regenerating Alcohol
Su
Xiao Ke Tu Ling Sheng Fa Jing
San Xian Dan
|
Points |
- Primary points: DU-16, DU-20, Zhangfading (midway
between DU-16 and DU-20)
use for each treatment
Secondary points: DU-23, GB-20, Taiyang, Yiming, join Yuyao to SJ-23 select
three points and alternate treatments
- DU-19, DU-20, DU-23, GB-41, GB-43, KI-3, LIV-3, SP-6, ST-8, ST-36, UB-60
For severe itching: + DU-14, GB-20
For insomnia: + HT-7, Sishencong
For hair loss on the temples: + GB-8, ST-8
For poor appetite:+ REN-12, ST-36
For hair loss on the eyebrows: join Yuyao to SJ-23
- Fanglao (1 cun posterior to DU-20), Jiannao (0.5
cun inferior to GB-20)
For severe itching: + DU-14
For greasy hair: + DU-23
For hair loss on the temples:
+ ST-8
- Prick to bleed UB-40
- Ear: Lung, Kidney, Shenmen, Sympathetic,
Endocrine, Spleen
- Scalp Acupuncture: Upper three-fifths of the
Motor and Sensory areas
- Plum Blossom: Ashi points (hair loss
sites), GB-20, LU-9, PC-6 neck,
sacrum and lumbar region
For hair loss on the temples:
+ ST-8
For hair loss at the
vertex: + DU-19, DU-20, DU-21
For
severe
itching:
+ DU-16, GB-20
For
insomnia:
+ Anmian
For
Kidney
Deficiency:
+ KI-3, UB-23
- Moxibustion: Indirect with ginger on GB-34, SJ-5, ST-36, UB-13, UB-23 Treat
once every 2-3 days with five treatments being one course.
Put five days between courses.
|
