KHALLI (ALOPECIA AREATA / SCALP BALDNESS)

CASE STUDY: KHALLI (ALOPECIA AREATA / SCALP BALDNESS)

NIDANA (ETIOLOGICAL FACTORS)

• Pitta-vata prakopaka ahara like amla, katu, ushna, ruksha dravya
• Psychological stress (manasika nidana)
• Raktadushti hetu like intake of viruddha ahara
• Use of synthetic chemicals or excessive hair treatments
• Hormonal disturbances or auto-immune factors in modern view
  

(Ref: Sushruta Samhita Uttara Tantra 24/5; Ashtanga Hridaya Uttara Tantra 23)

POORVARUPA (PRODROMAL SYMPTOMS)

• Keshabhoomi rukshata (dryness of scalp)
• Kesha patana (hair fall)
• Kesha paridaha (burning sensation)
• Daruna sparsha (roughness of skin)
  

(Ref: Sushruta Samhita Uttara Tantra 24/6)

LAKSHANA (SYMPTOMS)

• Patches of baldness on the scalp (circular/oval)
• No visible inflammation or scaling in most cases
• Shiny or smooth surface of exposed skin
• May be associated with psychological distress
  

(Ref: Ashtanga Hridaya Uttara Tantra 23/4)

SYSTEMIC EXAMINATION TESTS (MODERN CLINICAL ASPECT)

1. Local Examination of Scalp:
• Patchy, non-scarring alopecia
• Exclamation mark hairs at periphery
• Hair pull test may be positive
2. General Examination:
• Signs of anemia, nutritional deficiencies
• Skin, nails, and thyroid evaluation

Expected Findings:

• Well-defined bald patches
• No erythema or oozing
• Possible associated nail pitting

LABORATORY INVESTIGATIONS (MODERN ASPECT)

1. CBC:
• Rule out anemia (iron-deficiency)
2. Thyroid Function Test:
• To check for hypothyroidism or autoimmune thyroiditis
3. ANA Test:
• If autoimmune alopecia is suspected
4. Scalp Biopsy (rarely needed):
• Peribulbar lymphocytic infiltration in alopecia areata

Expected Results:

• Normal labs in most simple cases
• Possible hypothyroidism, anemia, or autoimmune markers

DIFFERENTIAL DIAGNOSIS (MODERN CLINICAL ASPECT)

• Tinea capitis (fungal infection)
• Trichotillomania
• Cicatricial alopecia (scarring type)
• Telogen effluvium
• Androgenetic alopecia (pattern hair loss)

SAMPRAPTI (PATHOGENESIS)

• Vata and pitta dosha prakopa due to nidana
• Rakta and tvak dushti at keshabhoomi
• Romakupa srotorodha or maruta shoshana
• Leads to interruption in hair nutrition and hair fall
  

(Ref: Sushruta Samhita Uttara Tantra 24/5; Ashtanga Hridaya Uttara Tantra 23/5)

UPASAYA AND ANUPASAYA (PALLIATIVE & AGGRAVATING FACTORS)

Upasaya:

• Sheeta, snigdha, tikta and madhura rasa
• Nasya, taila mardana
• Rasayana and dhatu-poshaka ahara

Anupasaya:

• Ruksha, ushna ahara
• Stress, hair styling agents
• Diwaswapa and night waking
  

(Ref: Ashtanga Hridaya Uttara Tantra 23; Sushruta Uttara Tantra 24)

SAMANYA CHIKITSA (GENERAL LINE OF TREATMENT)

• Shiro abhyanga with keshya taila (bhringaraja, amalaki)
• Nasya with anu taila or keshya nasya
• Rasayana like amalaki, bhringaraja, yashtimadhu
• Nidana parivarjana (avoid ruksha, ushna ahara, stress)
  

(Ref: Ashtanga Hridaya Uttara Tantra 23)

VISHESHA CHIKITSA (SPECIFIC TREATMENT)

1. Local Application:
• Bhringaraja taila, neelibhringadi taila
• Rubbing freshly extracted onion juice or garlic paste (modern supportive)
2. Nasya Karma:
• Shadbindu taila / Anu taila nasya – 6 drops each nostril daily
3. Oral Medications:
• Bhringarajasava
• Amalaki rasayana
• Ashwagandhadi churna + madhu
• Narasimha churna
4. Leech Therapy (Jalaukavacharana):
• Indicated in dushta rakta cases
• Applied to bald patch area weekly
5. Rasayana Therapy (for chronic cases):
• Brahma rasayana
• Chyavanaprasha
• Ashwagandha lehya
6. Lifestyle Advice:
• Avoid stress, chemical products
• Maintain scalp hygiene
• Follow vata-pitta shamana diet

(Ref: Ashtanga Hridaya Uttara Tantra 23; Sushruta Samhita Uttara Tantra 24; Sahasrayoga Taila Prakarana)