Abbreviations – BD- twice a day, OPD- out patient department, LMP- last menstrual period, < – Aggravation, Sac.lac- Sacrum lactis.
Abstract –Curative powers of homoeopathic medicines in psychosomatic diseases like alopecia areata [01] which are having physical symptoms, often without medical explanation [02]. Efficacy of this little pills on whole human body which eliminate all dysfunctions arising from noxious agents and restore the health as it was physically and psychologically. Different ways to understand and prescribe the similimum medicines in this case as per modern periodic table and thematic studies.
Introduction- Alopecia is called the bald spot in the scalp. This condition can appear in any hairy part of body but its more common in scalp, beard, mustaches and pubic area. This hair loss can be temporary or permanent but its different from male pattern baldness. It is an autoimmune disease in which body fail to identify own immune cells and destruct hair follicles. [03]
High risk in family history positive patients, 50 % more chances who are affected previously and low immunity can be one of the triggers for alopecia prevalence. [03]
A psychodermatological connection is noted with impairment in psychiatric comorbidities including mental wellbeing, self-esteem and mental disorders acting as pathogenic triggers for alopecia areata. [03]
Classification
Majorly, alopecia areata involves hair loss in one or more round spots on the scalp.
• Hair may also be lost more diffusely over the whole scalp, in which case the condition is called diffuse alopecia areata.
• Alopecia areata monolocularis describes baldness in only one spot. It may occur anywhere on the head.
• Alopecia areata multilocularis refers to multiple areas of hair loss.
• Ophiasis refers to hair loss in the shape of a wave at the circumference of the head.
• The disease may be limited only to the beard, in which case it is called alopecia areata barbae.
• If the person loses all the hair on the scalp, the disease is then called alopecia areata totalis.
• If all body hair, including pubic hair, is lost, the diagnosis then becomes alopecia areata universalis.
Alopecia areata totalis and universalis are rare. [03]
Patient’s information-
A 26 years old young unmarried girl by profession designer residing in a town in Gujarat, India came to OPD on 1st Feb 2022 for consultation.
Que – What is your problem?
Pt- Doctor, I have hair loss and baldness (she showed a big patch of alopecia on left side of temporal region of head). It is increases day by day. I have skin rashes on nape of neck from last one week. itching in the skin. I lost ¼ of my hairs. I feel emotional when see this hair loss. I wish it will recover soon. I have body ache too since my childhood it aggravates when I do extra physical work and it doesn’t relieve by absolute rest. I think I have medicated myself with heavy doses that’s the only reason I guess, I have taken various antibiotics and vitamins supplements as a precaution in covid phase. Now, my life is become difficult.
Que- How it was started?
Pt- Hair falling was started before 3-4 years but this bald spot is from last 10 months. I took homoeopathic medicines too. All complaints started in May 2021 after my mother’s death due to covid.
I started remaining busy after her loss, doing various activities. I dwell on past things and think about future that if my mother would have been present it would be better for us.
Que- What do you feel?
Pt- I feel guilty! I didn’t do good efforts so I couldn’t save my mother. Her covid report was positive. She was in fearful condition. She was on neurological medications. She got a lot of anxiety and fear, finally she died. I felt very much guilty from her loss.
I have an old complaint of headache, heaviness of eyes, continuous mild pain any one side of head which always appear in evening. It aggravates by over work and ameliorates by hard pressure, tight bandage and in morning.
Que- Are you sensitive to?
Pt- Yes, doctor, I am very attached with family. I lost my father in young age. I get angry when I am hurt, I shout at that point. I feel hurt. I get anger, I can’t control it. Whenever I am not allowed to do according to my wish. I forget things, particularly things and work which I have to do.
Physical generals:
Appetite– Decreased, no desire to eat, sweet taste in mouth.
Desire- Spicy food +
Aversion– Sweet +
Thirst– 2-3 lit/ day.
Stool– Unsatisfactory, has to strain
Urine– Clear, no any complaint
Menses – Menarche- at the age of 11 years. LMP- 1/02/2022
Cycle – Regular, medium flow, lasts-2 -3 days, pain in abdomen during menses.
Leucorrhoea- 1 week before and after menses. White, stain on cloth white, non-offensive.
Sleep- Needs some entertainment like watching videos or surfing internet on mobile phone before sleep. Then she feels tiered and gets sleep. Duration – 8-9 hours.
Dreams- of dead mother, as if she came back in our life.She said “I felt better she is with us. She must have come! but it’s not true I feel bad it is not possible its just a dream.”
Hobbies– I follows my mother’s work like gardening, rearranging plants, watering them.
Allergic to– dust and wheat dust / pollens, she gets itching on face and throat irritation followed by cough and hoarseness of voice.
Family history-
Father- Died in an accident 15 years ago
Mother- Hypertension and neurological issues, she died due to covid in 2021.
Brother- Skin allergy
Paternal aunty- Skin complaint.
Past h/o- Typhoid and jaundice at age of 15 years.
Past medical h/o– Preventive? medicines like antibiotics and multivitamins supplements in covid.
In homoeopathic treatment NAT. MUR 200 few doses were given to her for 3 months.
Clinical findings-
Hair loss, bald patch on frontal -temporal region of head.
Diagnostic assessment –
Diagnosis was finalized on basis of clinical examination.
Investigations-
No specific investigations were done.
Final diagnosis – Alopecia areata.[04]
Case analysis –
Analysis & Evaluation of symptoms –
| SR.NO | SYMPTOM TYPE | SYMPTOMS | INTENSITY | MIASM |
| 1 | PHYSICAL PARTICULAR | Hair falling, left side of head bald spot. | + | Psora |
| 2 | PHYSICAL PARTICULAR | Skin, eruption, rashes, nape of neck on. | + | Psora |
| 3 | PHYSICAL PARTICULAR | Body ache aggravation by extra physical work. | + | Psora |
| 4 | PHYSICAL GENERAL | Appetite decreased, no desire to eat, sweet taste in mouth. | + | Psora |
| 5 | PHYSICAL GENERAL | Desire for spicy food | ++ | Psora |
| 6 | PHYSICAL GENERAL | Aversion to sweets | ++ | Psora |
| 7 | PHYSICAL GENERAL | Leucorrhoea white, stains -before and after menses | ++ | Psora-sycosis |
| 8 | PHYSICAL GENERAL | Stool constipation, has to strain. | + | Psora |
| 9 | PHYSICAL GENERAL | Sleep late, needs some entertainment to get tired. | + | Syphilis |
| 10 | MIND | Death ailments from aggravation, parents. | ++ | Psora |
| 11 | MIND | Grief, prolonged causes anger irritability | ++ | Psora |
| 12 | MIND | Busy wants to be fruitlessly | ++ | Sycosis |
| 13 | MIND | Dreams, dead persons see, mother | ++ | Psora- sycosis |
| 14 | MIND | Forgetfulness | + | Psora-sycosis-syphilis |
[05]
Prescribing Totality –
- Death, ailments from, death of parents, mother.
- Busy fruitlessly wants to be
- Delusion, imagination, dead persons, see, mother
- Forgetfulness
- Grief, prolonged, irritability ailments from
- Food and drinks in general aversion to
- Stool constipation
- Clinical- autoimmune diseases.[06]
Therapeutic intervention –
Remedy selected was KALIUM BROMATUM 200 BD for 2 days
Sac. Lac 5 pills two times a day for 15 days.
Selection of remedy –
Remedy was selected on bases of result of non-reportorial approach and final decision was made after reading material medica,
Row 4- security, protection, health, wealth, money, shelter, rules, regulations and day to day duty.[07]
Column 1- I can’t imagine my life without. Dependent like a child. Won’t be able to cope lack of confidence. Incapable incapacity backing support. [07]
Column- 17- the structure is dissolving and crumbling. Feels starved, betrayed, disappointed and let down. Feels trapped, bound, tied down, confided by the structure and wants to break free. Alone to face it no body to depend, extreme opposite than column one. Nobody to protect, conscience, insecure. [07]
Kali Brom- Potassium bromide affects the mind and nerves. ill effects of worry, loss of business, reputation and embarrassment. Worse from emotions -anger, fright, worry. grief. better when busy mentally and physically. Brain fag, from grief and anxiety. Fidgety, busy hands, fumbles. Profound indifference and disgust for life. Sleeplessness, due to worry, grief and sexual excess. [08]
Selection of potency – as per guidelines from Organon of Medicine 6th edition, higher potency was selected on the basis of strong mental characteristics in the case.[09]
Follow up
| SR. NO | DATE | COMPLAINS | TREATMENT | REASON |
| 1 | 15/02/2022 | Better in hair falling, Itching on nape of neck < morning. | Sac.lac BD for 15 days | Significant action of medicines, no change.[09] |
| 2 | 02/03/2022 | Itching in eruptions, now size of eruption is decreased. Better in hair. | Sac.lac BD for 1 months. | no change in medicine and potency.[09] |
| 3 | 16/03/2022 | Mild increased in bald patch. | Kali Brom 200 BD for 2 days. Sac. Lac. For 1 month. | |
| 4 | 07/05/2022 | Hair regrow, headache decreased, now not bandaging head it relieves by itself. | Kali Brom 200 BD for 2days. Sac lac bd for 1 month. | |
| 5) | 18/06/2022 | Eruptions on nape of neck disappeared. Better in headache. Stool satisfactory. Menses -2-3 days, dark and flow scanty. | Kali Brom 200 BD for 2 days. Sac.lac OD for 1 month | Significant response of remedy.[09] |
| 6) | 17/07/2023 | I don’t think much, I will handle whatever will happen. Headache better, new hair growth. | Kali. Brom 200 BD for 2 days. Sac lac bd for 1 month. | |
| 7) | 17/09/2022 | Hair regrow, headache decreased, now not bandaging head it relieves by itself. | Kali Brom 200 BD for 2days. Sac lac bd for 3 months. | |
| 8) | 27/01/2023 | Stool regular, headache occasionally but intensity is less. New hairs. Mentally very much better. Doing house hold as well as office work with ease. | Sac.lac BD for 2 months | Significant response of remedy. [09] |
| 9) | 03/08/2023 | On call follow up. Latest photos. | No treatment |
Discussion:
Alopecia is autoimmune disease so no definite protocol or management is available. In this case, we can understand the utility of homoeopathic medicines in alopecia areata. To reach the similimum understanding of kingdom differentiation and understanding of rows and columns is very important in this case. Kali Brom doesn’t contains any symptom regarding hair falling according to existing materia medicas. I read but in detail mind characteristics are useful in such cases to provide permanent cure. In this case psychological factors like mother’s death caused guilt in her that somatised in a disease which has no relevant other cause in terms of alopecia.
References:
- https://www.medicaljournals.se [accessed 3rd Aug 2023]
- https://my.clevelandclinic.org [accessed 3rd Aug 2023]
- https://en.wikipedia.org/wiki/alopecia [ accessed 3rd Aug 2023]
- The web’s free 2022 ICD-10. Available from- https://www.icd10data.com [accessed 3rd Aug 2023]
- Chronic miasms in homoeopathy and the cure with classification of their rubrics/symptoms in Dr. Kent’s repertory by Dr. R.P. Patel IBPP Indian edition.
- Complete dynamics 2020 homoeopathic repertory software.
- Sankaran schema 2005.
- Materia medica of homoeopathic medicines by S.R. Phatak, 2nd revised & enlarged edition-1999.
- Organon of medicine 6th edition by Dr. S. Hahnemann
