Abstract: Female Pattern Hair Loss (FPHL), also referred to as Female androgenic alopecia, is a prevalent and progressive condition affecting women, characterized by gradual thinning at the crown and front of the scalp while the hairline remains intact. Its occurrence rises with age and is frequently linked to considerable psychological distress. While androgen involvement has been observed, numerous cases do not present clinical or biochemical signs of hyperandrogenism, indicating a complex underlying cause that includes genetic factors and hormonal receptor polymorphisms. . It is crucial to differentiate this condition from chronic telogen effluvium through thorough history-taking, clinical assessment, and, when necessary, hormonal and metabolic evaluations. Timely intervention is vital to prevent further progression. Customized homeopathic treatment, informed by a comprehensive patient evaluation, may provide supportive advantages by targeting underlying constitutional issues and improving overall treatment outcomes. Ongoing management is often necessary to achieve lasting results.
Keywords : Androgenic alopecia, female pattern hair loss (FPHL), hair thinning, homeopathy, holistic treatment, psychological effects, hormonal evaluation, early intervention, constitutional treatment, and long-term management are all covered.
Introduction:
Previously known as androgenetic alopecia in women, Female Pattern Hair Loss (FPHL) is currently the preferred nomenclature because of its ambiguous and frequently contradictory relationship to androgen levels. The most common type of hair loss in women is FPHL, which may start in adolescence and worsen with age. It is a widespread, nonscarring alopecia that mostly affects the central, frontal, and parietal areas of the scalp and is defined by the gradual shrinking of hair follicles that results in a noticeable decrease in hair density.
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Epidemiology-
Prevalence: One prevalent kind of alopecia is alopecia areata.
- Gender: effects are equally felt by men and women
Age: any age can be begin
Pathophysiology: The underlying aetiologies of male androgenetic alopecia (AGA) and female pattern hair loss (FPHL) seem to be different, despite the fact that they both share a final common pathway of follicular shrinking and regression. The involvement of androgens in FPHL is still unclear, despite their well-established role in male AGA. A complex aetiology and androgen-independent pathways may be involved, as many women with FPHL have normal testosterone levels. A genetic
In certain situations, follicular shrinkage may happen without any hormonal stimulus, while in other situations, predisposition may use intracellular androgen receptors to sensitize hair follicles to normal androgen levels.
More than 60 gene loci linked to AGA have been found in recent genomic research, confirming the polygenic character of hair loss in both sexes. Miniaturization causes terminal hairs in FPHL to change into vellus-like hairs with a shorter anagen phase, which results in shorter, thinner hair shafts. This process is usually less severe and more widespread in women than in males, and it seldom results in total baldness. Furthermore, the shrinkage process may be accompanied by mild perifollicular inflammation, often known as “microinflammation,” which sets it apart from the more severe inflammation observed in scarring alopecias.
Diagnosis of FPHL:
Assess the onset, pattern, and related symptoms during the history and physical examination.
Look for symptoms of hyperandrogenism, such as irregular menstruation, acne, or hirsutism.
Examine the whole scalp for widespread thinning, paying particular attention to the occipital area.
• Pull Test:
Gently pull on 50–60 hairs.
Six hairs removed indicates active shedding, a positive test result.
• Standardized Wash Test: Wash over gauze after five days without shampoo → count hairs.
To distinguish between TE and FPHL, separate the hairs according to length.
AGA/TE Wash Test(Modified Wash Test):
Long (more than 5 cm)
In the middle (3–5 cm)
Vellus/short (<3 cm)
Total telogen hairs and vellus hair percentage should be counted.
Trichogram:
Select 60–80 hairs from two different scalp locations.
Examine the distribution of the hair cycle phases under a
microscope.
Shown as the percentage of telogen versus anagen hairs.
The use of homeopathy in treating female pattern hair loss (FPHL)
When treating FPHL, homeopathy takes a comprehensive, customized approach that considers the patient’s entire physical, mental, and constitutional health in addition to the hair loss.
• Individualization: A thorough case history that includes the patient’s psychological condition, family history, lifestyle, stresses, hormone profile, and any related symptoms, such as irregular menstruation or acne, is used to determine the best course of action.
• Constitutional Remedies: Following an assessment of the patient’s temperament, general health, and inclinations (such as anxiety, sadness, or hormone imbalance), they are recommended.
• Root Cause Treatment: To treat potential underlying reasons including hormonal imbalances, homeopathic medications are used.
Emotional triggers such as shock or grief.
The malfunctions of metabolism.
Typical Treatments (chosen according to each patient’s presentation):
• Natrum muriaticum, Lycopodium clavatum, Sepia officinalis, phosphoric acid,and fluoric acidum
Case Summary Identification of Patient
Miss ABC 19-year-old,of Vidisha visit to Gautam Nagar POPD of Govt Homoeopathic Medical College and Hospital Bhopal.
Presenting Complaint – A case of a 19 years old female presented in OPD with chief complaints of a discoid patch on the scalp which shows no scaling which led to a single bald spot.
Location- vertex Sensation- mild itching
Modalities- worse during washing, combing the hair.
History of Presenting Complaints
Patient was apparently well 1 years back when she gradually developed hair fall along with roots in the discoid patch initially, it was a small patch which gradually increased in size.
Physical Generals
- General modalities– Most of the complaint aggravated by sun exposure.
- Thermal Reaction- Hot
- Appetite – increased.
- Thirst – 2-3 Liter a day
- Bowel – constipated.
- Tongue –white patches.
- Sleep- Sound
- Dreams – Not specific
- Menstrual History – Menses’ is regular.
Mental General
- She is nervous, introverted and overthinker.
- Forgetful and melancholic.
- the patient exhibited marked introversion, emotional suppression, and a strong aversion to consolation. She reported past emotional trauma related to unresolved grief following
a close relationship breakup, which she had never openly expressed. She often dwelled on past emotional wounds, cried in solitude, and showed sensitivity to criticism.
General Examination
- Built – Healthy
- Pulse – 88/min
- Pallor – not seen
- Respiratory rate – 18/min
Analysis and Evaluation of Symptoms
Mental General:
- Introverted, melancholic.
- Suppressed emotions
- Aversion to company desire to be alone, fear of rejection, depression and hopelessness, quiet.
Physical Generals –
- Desire – salty food.
- Thermal reaction – Hot
Totality of Symptoms –
- introvert, melancholic.
- depressed in her life
- fear of rejection.
- Consolation aggravation.
- Craves salty food.
- Hair falling out in bunches
- White patches on tongue.
- Rubrics–
- MIND- CONSOLATION-agg
- MIND- EMOTIONS-suppressed.
- MIND- FEAR – rejection; of
- MIND- GRIEF- silent
- MIND –INTROVERTED people
- MIND – RESERVED
- HEAD-HAIR-falling
- STOMACH-APPETITE-increased
- RECTUM-CONSTIPATION-ineffectual urging and straining.
Repertorisation
Working method – computed method Software used – synthesis
Repertorisation method – synthesis repertory used
Repertorial Analysis
- Natrum mur – 08/22
- Ignatia – 08/18
- Staph-08/15
- Lycopodium -07/13
- Phos-06/14
Remedy Selection
As Natrum muriaticum cover maximum number of rubrics and scored maximum point therefore Natrum muriaticum was selected on the basis of repertory and Materia medica.
Prescription
Natrum mur. 1M single dose, placebo 200/1 dram BD for 30 days Follow up: placebo
After taking the medicine: hair growth reappears, as well and felt much better physically and mentally.
BEFORE TREATMENT:
AFTER TREATMENT:
Discussion
In this case, the patient who received homeopathic treatment did considerably better than the previous time. Homeopathic treatment was given according to an individualistic approach. Remedy was selected on the basis of symptoms similarity after analysing the repertorial totality and on the basis of Materia medica. Homoeopathic treatment is more cost effective having no further associated symptoms. Here in this case 1M potency were selected according to the patient’s susceptibility. Only single dose of selected potency was required here which worked beneficially. We the homoeopathic physician should always consider the potential of a single remedy and minimum dose in a case.
Conclusion
Alopecia areata is a complex condition that requires a comprehensive approach. Homoeopathy offers a safe, effective and holistic solution by addressing the underlying causes and promoting overall well- being.
Conflict of Interest Not available
Financial Support Not available
Reference
| 1 | https://ijdvl.com/female-pattern-hair-loss/ | |
2 | Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S. Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. Int J Womens Dermatol. 2018 Jun 19;4(4):203-211. doi: 10.1016/j.ijwd.2018.05.001. PMID: 30627618; PMCID: PMC6322157. | |
| 3 | Boericke W. New Manual of Homoeopathic Materia Medica and Repertory. Boericke W, SivaramanP, editors. New Delhi, India: B Jain; 2002. | |
| 4 | Wadia SR. Homoeopathy in skin diseases. New Delhi, India: B Jain; 2023. | |
Author
Dr. Mukesh kumar sonwani – (Md Scholar) Dept. of Homoeopathic Pharmacy, Govt. Hom. Medical College, Bhopal.
Co – Author
Dr. Chetna Pandey – (M.D.Hom.) H.O.D. (Dept. of Homoeopathic pharmacy) Govt. Hom. Medical College, Bhopal.
