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    Old 08-21-2003, 10:23 AM   #1
    1btg
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    Question Alopecia Areata.

    Hi everyone, I have this Alopecia problem since I was a kid. First it atacked my hair in which it created bald spots the size of a quarter and they would be there for several weeks til they disappear. Then it started attacking my beard and the same thing happened 'til a coupla years ago when the bald spots on it no longer heal and on some that have, the hairs are very thin.
    My question is, does anyone know if there's anything available like a cream or anything that would help this problem?
    Thanx for any replies.
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    Old 08-21-2003, 10:40 AM   #2
    zuzu8
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    Hi 1btg-

    Have you tried posting this on the Skin, Hair and Nail Disorders Board? I've seen posts there about alopecia areata.

    Good luck,

    zuzu xxxx

     
    Old 08-21-2003, 10:11 PM   #3
    imthatguy
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    My 17 yr. ols sister has this. She is almost completely bald. I feel so bad for her....She has tried just about everything there is to try. I keep trying to get her to go the natural route, but with not much success. There's a chinese pill caled alopecia areata pills. They can be found at a chinese herb store, or other herbal stores. There are many other natural remedies if you search around the web a little bit. That would be the first route I would try. Here is the info I have on it. It's really long, but hopefully something in it will help you or someone else. Hope you got some time on your hands......lol

    TREATMENT OF ALOPECIA
    WITH CHINESE HERBS
    by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
    Alopecia may arise from numerous causes, including stress reactions, hypothyroidism, exposure of the hair follicles to topically-applied chemicals, therapies used for cancer, and genetic male-pattern balding. The disorder is often classified by its specific manifestation, such as patchy balding (alopecia areata), total loss of head hair (alopecia totalis), or total loss of body hair (alopecia universalis). Alopecia areata and alopecia totalis frequently affect women, and the disorder may persist for several months to about a year, sometimes longer.
    Generally, alopecia is interpreted by Chinese doctors as the result of a deficiency syndrome, specifically involving blood deficiency, with generation of internal wind or invasion of external wind that affects the head; the situation is sometimes complicated by blood stasis and/or blood heat. The belief that there is an influence of wind in the etiology of the hair loss is reflected in the Chinese name for the disease, which is youfeng, literally oil-wind. The reference to oil, which can also mean glossy, is an expression characterizing the smooth, shiny scalp appearance where the hair has been lost. The Chinese name has led to some humorous translations; in the package insert for Alopecia Areata Pills, the primary indication is for "grease hair dropping."
    The underlying pathological processes cause the hair follicles to be undernourished. Blood deficiency can arise from poor diet, excessive use of drugs, the aging process, stress reaction (worry, anxiety, depression, which impairs spleen function and thereby reduces nurturing of blood), and debilitating diseases. Sudden hair loss, like other sudden health changes, is interpreted as a consequence of "wind;" in this case it is invading the channels that traverse the scalp.
    A typical description of the cause of alopecia is presented in Practical Traditional Chinese Dermatology (1):
    The hairs are the extension of blood, and the normal growth and development of long, pliable, and tough hairs depends on the sufficient supply of nourishment from ying and blood. If the supply of nutrients is reduced, the wind may be produced in the body to cause loss of hairs. Nervousness, depression, and mental instability may cause production of internal heat, and the excessive heat in the blood may produce wind and cause loss of hairs due to reduced nutrition supply, and such patients may show clinical manifestation of wind syndrome due to blood heat. In patients with chronic diseases and exhaustion of essence and blood, the deficiency of blood may also produce wind to cause loss of hairs, and such patients may show the clinical manifestation of wind syndrome due to deficiency of blood. In patients with their diseases wrongly treated or refractory to any treatment, the fresh blood can not be produced to nourish the hairs because of the stagnation of blood and obstruction of meridians, and such patients may show clinical manifestations of wind syndrome owing to blood stagnation.
    According to the English-Chinese Encyclopedia of Practical Traditional Chinese Medicine (2),
    Alopecia is mostly caused by deficiency of liver and kidney with subsequent failure of [blood to go up and nourish] the hair. The hair pores are open when the hair is poorly nourished, and wind invades the pores on the occasion. Therefore, deficient blood with wind [invasion] leads to hair loss. However, stagnation of liver qi and impaired qi mechanism will also result in hair loss because of the malnutrition of hair due to stagnation of qi and stasis of blood.
    The same encyclopedia has an elaboration of the etiology of alopecia in the volume of dermatology (16):
    This disease is often caused by deficiency of blood, which fails to cooperate with qi in nourishing the skin. The striae of skin and muscles in turn become loose, and the opening of the sweat glands is loose, hence, pathogenic wind intrudes from outside, causing blood-dryness and malnutrition of the hair. Besides, the mood of depression, stagnation of liver qi, and overwork may impair the heart qi and cause stagnation of qi and blood stasis so that qi and blood cannot nourish the hair, hence the occurrence of the disease; deficiency of the liver qi and kidney qi may also cause this disease, because the liver stores the blood whose state can be manifested by the hair, while the kidneys produce bone marrow which is also responsible for the growth of hair.
    RECOMMENDED PRESCRIPTIONS
    In Practical Traditional Chinese Dermatology, three basic formulas are recommended:
    Wind Due to Blood Heat Wind Due to Blood Deficiency Wind Due to Blood Stagnation
    Rehmannia, raw Rehmannia, cooked Tang-kuei, tails
    Moutan Tang-kuei Red peony
    Scrophularia Peony Cnidium
    Biota leaf Cnidium Persica
    Morus leaf Lycium Carthamus
    Anemarrhena Ligustrum Biota leaf
    Vitex Cuscuta Angelica
    Tang-kuei Eclipta Green onion
    Morus fruit Ho-shou-wu Ginger, fresh
    Dictamnus Astragalus Jujube
    Citrus
    A slightly different presentation of patterns and formulas is offered in the book Manual of Dermatology in Chinese Medicine (3)
    Blood Heat Giving Rise
    to Wind Deficiency of Yin and Blood (Decoction) Deficiency of Yin and Blood (Pill) Deficiency of Qi and Blood (Decoction) Deficiency of Qi and Blood (Powder) Blood Stasis
    Rehmannia, raw Tang-kuei Ho-shou-wu Tang-kuei Tang-kuei Red peony
    Ligustrum Red peony Hoelen Rehmannia Peony Cnidium
    Morus fruit Peony Achyranthes Peony Citrus Persica
    Moutan Cnidium Tang-kuei Codonopsis Astragalus Carthamus
    Red peony Rehmannia Lycium Atractylodes Cinnamon bark Bakeri
    Cornus Salvia Cuscuta Astragalus Ginseng Jujube
    Scrophularia Ho-shou-wu Psoralea Hoelen Atractylodes Ginger, fresh
    Sesame, black Morinda Ligustrum Licorice, baked Musk
    Cuscuta Cistanche Ho-shou-wu Rehmannia
    Hematite Ligustrum Soja Schizandra
    Fu-shen Morus fruit Cnidium Hoelen
    Tang-kuei Chiang-huo Typhonium Polygala
    Schizonepeta Licorice, baked
    Again, the English-Chinese Encyclopedia of Practical Traditional Chinese Medicine offers yet another group of formulas, the first three for "blood-deficiency and wind-dryness" and the latter two for "activating blood flow to remove blood stasis:"
    Shenying Yangzheng Dan, Modified Yangxue Shengfa Wan Qibao Meiran Dan Tongqiao Huoxue Tang, Modified Huoxue Quyu Pian
    Tang-kuei Tang-kuei Ho-shou-wu Tang-kuei Tang-kuei
    Peony Peony Hoelen Red peony Red peony
    Cnidium Cnidium Achyranthes Cnidium Persica
    Rehmannia Rehmannia, raw Tang-kuei Persica Carthamus
    Ho-shou-wu Ho-shou-wu Lycium Carthamus Pangolin
    Carthamus Carthamus Cuscuta Sparganium Artemisia (liujinu)
    Ligustrum Ligustrum Psoralea Zedoaria Gleditsia
    Cuscuta Cuscuta Bupleurum Pyrolusite (zhiwu)
    Chiang-huo Eclipta Curcuma Saussurea
    Gastrodia Salvia Turmeric Clove
    Soja Ginger, fresh Rhubarb
    Green onion Eupolyphaga
    In this last group, Qibao Meiran Dan is the same as the Pill for Deficiency of Yin and Blood mentioned above. This Chinese name of this formula is translated in Formulas and Strategies (17) as "Seven-Treasure Special Pill for Beautiful Whiskers." The prescription is attributed to a master herbalist of the Ming Dynasty, Shao Yingjie, but it was recorded by Wang An, in his book Yifang Jijie during the early Qing Dynasty (1682 A.D.). By that time, the formula had become quite popular.
    One can see that in virtually all formulations (the exception being the last two presented above), tonification therapy is important, but there are distinctly different groups of ingredients that are relied upon for different syndromes and by different authorities. Ginseng Nutritive Combination (Renshen Yang Rong Tang), similar to the decoction for qi and blood deficiency related above, is a well-known traditional prescription given for general weakness and nutritional deficiency; that formula has been recommended by Japanese doctors for treating alopecia (4).
    While there are no individual herbs that stand out as being essential to the treatment of alopecia, there is obvious reliance on the ingredients of Siwu Tang (Tang-kuei Four Combination, comprised of tang-kuei, peony, cnidium, and rehmannia), as well as herbs that are characteristically recommended for preventing graying of hair (a condition also thought to be due to blood deficiency syndrome), notably ho-shou-wu, ligustrum, morus fruit, and biota leaf. Although mentioned only once among the ingredients for the above formulas, eclipta is also used for preventing greying of hair and is included in some of the formulas used in clinical trials, as described below. For blood stasis, red peony, cnidium, persica, and carthamus are the most frequently used. Wind-dispelling herbs are broadly selected from the range of available items, with dictamnus, chiang-huo, morus leaf, schizonepeta, vitex, typhonium, and green onion (congbai; Chinese chive) mentioned in the above formulas. Some herbs that have black color (the color of Chinese hair) are used: black sesame seeds, black soy beans (soja), and psoralea are examples. Cuscuta is mainly used for tonifying the kidney, a principle of therapy not much relied upon other than through inclusion of cooked rehmannia as part of the blood nourishing strategy.
    An examination of the herb formulas reveals very few ingredients in each formula for dispelling wind (sometimes none) and no ingredients specific to calming internal wind other than the single mention each of gastrodia and hematite (this may have been included mainly as a blood nourishing agent). The emphasis on wind in the etiology of alopecia as described in modern texts appears to be more of an academic nod to the ancient name of the disease than to a persisting belief that wind is an important factor in the disease. As with the formulas recommended above, those prescriptions subjected to clinical trials rarely include wind-dispelling or wind-settling ingredients.
    CLINICAL EVALUATIONS OF INTERNAL THERAPIES
    Alopecia areata, the condition that is the subject of the clinical evaluations, can spontaneously resolve. Therefore, it is difficult to know the effectiveness of treatment in the absence of a carefully controlled study. The reports in the medical literature generally involve uncontrolled studies, which means that one can not separate out cases of improvements due to herb therapy from spontaneous remission. According to the reported results (summarized briefly below), with a treatment time of 1-3 months duration (though sometimes longer), the majority of cases treated are resolved or, at least, improved. An examination of formula ingredients reveals that tonic therapies, especially herbs that nourish the blood, are relied upon.
    Shengfa Wan (literally, pill to generate hair), is a modification of Qibao Meiran Dan, made by adding Erzhi Wan (a formula comprised of just ligustrum plus eclipta). According to Formulas and Strategies:
    This formula [Erzhi Wan] is widely used in China, both by itself and as an additive to other formulas when the liver and kidney yin need to be tonified. It is considered safe and relatively mild. It is often compared to Liuwei Dihuang Wan [Rehmannia Six Formula]....Erzhi Wan is considered by some to be superior in treating premature graying or loss of hair.
    The complete formula, containing ho-shou-wu, ligustrum, eclipta, lycium, cuscuta, tang-kuei, achyranthes, psoralea, and hoelen, was made as large honey pills, 10 grams each, and *****istered three times daily (5). The pills, which provided about 20 grams of herbs in powder form and 10 grams of honey as binder, were *****istered before meals, unless digestive disturbance occurred, in which case the pill was given after meals instead. Treatment time was 1-3 months. It was stated that of 21 cases treated, 2 cases were cured, 8 markedly improved, and 3 significantly improved (with 8 cases not improved).
    A similar formula, Shengfa Yin, a decoction comprised of ho-shou-wu, rehmannia, tang-kuei, schizandra, morus fruit, biota seed, ligustrum, and eclipta, was reported to cure 30 of 36 persons affected by alopecia areata, with 4 others improved (6). The obviously better results, compared to the report on Shengfa Wan, may have been due to use of a higher dosage form of *****istration and longer therapy (duration not specified in the report).
    According to another report, all of 50 cases of alopecia areata treated could be cured within 9 weeks with daily ingestion of a decoction of ho-shou-wu, black sesame, soja, astragalus, gelatin, atractylodes, longan, and jujube, taken along with cystine (100 mg, three times daily), and topically applying concentrated decoction of morus bark (7). Specifically, 6 cases were resolved after three weeks, another 32 cases after 6 weeks, and the remaining 12 by 9 weeks. Cystine is important to protein structure and was given to promote good hair formation; it is an oxidized form of the common amino acid cysteine. The high rate of success might have been due to the combination of using a decoction plus applying a topical preparation; the role of cystine is questionable, and it is not included in the other trials.
    In a large-scale study (8), the internal treatment for alopecia, Tuofa Zaisheng San, included ligustrum, ho-shou-wu, rehmannia, biota twig, salvia, schizandra, peony, tang-kuei, carthamus, cnidium, and chiang-huo, was given along with topical application of the drug minoxidil. According to the report, treatment time was 2-12 months, with 117 of 146 cases cured, and 11 cases improved. A follow-up after one year showed that there was relapse in only 10 cases. This formula is very similar to the patent remedy called Alopecia Areata Pills (Trichogen), which was developed during the 1970's and has been marketed worldwide since the 1980's. According to the package labeling, the formula is:
    Ho-shou-wu 20%
    Rehmannia (raw and cooked) 20%
    Tang-kuei 10%
    Salvia 10%
    Peony 10%
    Schizandra 10%
    Codonopsis 10%
    Chaenomeles 5%
    Chiang-huo 5%
    The herbs are extracted, formed into small pills (250 mg each), and recommended to be taken 6 pills each time, three times daily (daily dose of the extract is 4.5 grams), for a course of treatment of 600 pills (if taken continuously, 6 bottles of the product, over a period of 33 days). Since the body weight of the Chinese, at the time this package insert was written, was quite a bit lower than most Westerners, the dosage should probably be increased by as much as 50%. The package insert proclaims "satisfactory results" were attained with over 1,000 trial cases and that:
    After treatment for a period of time, light color, newly grown, soft hair gradually becomes darker and black. But in a few occasions the patients have recurrence of baldness. In order to reduce the recurrence, one or two [additional] courses of treatment is necessary to ensure efficacy.
    Alopecia that occurs in the elderly is responsive to treatment, according to one report (9). A double-blind placebo-controlled study of an anti-aging mixture named Huolisu, including astragalus, salvia, and ho-shou-wu, was conducted with 507 subjects, 287 receiving the herbs. The power of the placebo and the rate of spontaneous remission was here demonstrated, with nearly 35% of the control group showing some improvements in both subjective and objective measures. However, the herb treatment group had nearly 77% of patients showing improvements, including a reduction in alopecia during a 3 month trial.
    TOPICAL TREATMENTS
    Alopecia often occurs in individuals who are relatively healthy; they may suffer from substantial emotional stress and poor nutrition, but the most evident symptom-or the symptom of greatest immediate concern to them-is the alopecia. In such cases, topical treatments are deemed especially appropriate, because of the localization of the symptom. Also, since the hair follicles are just below the skin surface, topical treatment is deemed a means of rectifying the problem even if an internal therapy is also needed to improve the function of the internal organs, nourish the blood, and overcome disorders such as blood stasis.
    There are three major approaches to topical treatment with herbs:
    1. Use strong circulatory stimulants, such as hot pepper or ginger, to try and restore the scalp circulation.
    2. Use blood-vitalizing herbs, such as those used in internal therapies, to promote microcirculation.
    3. Employ herbs with a reputation for benefiting the hair, such as ho-shou-wu, morus fruit, or ligustrum.
    The diversity of recommended topical treatments, which includes some that are not easy to explain by the usual interpretations of herb actions, makes it difficult to select one that would be workable, and most Westerners are not well disposed to making these unusual preparations and using them regularly, so only brief mention will be made here. In Practical Traditional Chinese Dermatology, three topical treatments are described:
    A mixture of dictamnus, biota leaf, ginger, crataegus, and angelica is made as a tincture and applied once or twice a day.
    Fresh slices of ginger are rubbed onto the bald area to produce a hot feeling, three times daily.
    Powder of chuanwu (a type of aconite) is mixed with vinegar or ginger juice and applied once a day to the bald area.
    In Manual of Dermatology in Chinese Medicine, these topicals are mentioned:
    A mixture of biota leaf, zanthoxylum, and pinellia is made as a decoction and mixed with fresh ginger root juice, and applied to the affected area twice daily.
    A mixture of artemisia, chrysanthemum, mentha, siler, kao-pen, vitex, schizonepeta, and musk; make a decoction (musk is added separately) and wash the head with it; let it set in the head for 5 minutes, and repeat; then rinse with warm water.
    Cordyceps tincture is applied to the affected area 3-5 times daily.
    Brassica is powdered, mixed with oil to form an ointment, and applied to the affected area once daily.
    In the English-Chinese Encyclopedia of Practical Traditional Chinese Medicine, vol. 16: Dermatology, these are suggested:
    Psoralea tincture (Bugu Zhiding), applied three times daily.
    Fresh ginger roots slice: rub the affected part rapidly.
    According to the book Oriental Materia Medica (10), the herb swertia is "80% effective in treating all cases of hair loss." Research in Japan has shown that an extract of swertia (a relative of gentiana that is used frequently in the treatment of hepatitis) dramatically enhances the circulation to the skin when applied topically. This herb has been extracted in an essential oil base (geraniol) in the hair tonic product Gentax that is produced and widely used in Japan and is now available in the U.S. (via Kenshin Trading Company, in Torrance, California). The crude herb swertia is rarely exported from the Orient, so is difficult to obtain other than in this prepared form.
    A popular Chinese "hair growth" tincture-Lily Brand Hair Tonic-is made with extract of capsicum (and other undisclosed ingredients); this is similar to the home remedy made by the Chinese with red chilies soaked in wine. The action of capsicum, like that of ginger and zanthoxylum, is to promote local circulation via "counterirritant" action (spicy components cause the vessels to dilate).
    The largest clinical evaluation of a topical treatment for alopecia involved over 8,300 patients (11). The liquid, known as "101 Hair Regenerating Alcohol" (which has been made available in Chinese shops in the U.S.) contains ginger, ginseng, astragalus, tang-kuei, cnidium, persica, carthamus, salvia, and some undisclosed ingredients. The liquid was applied 2-3 times per day, for 2-3 months. It was claimed in the report that the "cure" rates for alopecia areata, alopecia totalis, and alopecia universalis were 91.7%, 83.4%, and 62.1% respectively. Less than 6% of those treated in each category failed to respond to the treatment.
    In another large-scale clinical evaluation, 822 patients suffering from alopecia areata or alopecia totalis were treated with the topical formula, Suxiao Ketuling Shengfa Jing (12). The ingredients, extracted in alcohol, include capsicum, eclipta, ho-shou-wu, biota twig, drynaria, ginseng, carthamus, and cnidium. According to the report, 630 patients were cured and others had partial regrowth of hair; only 48 patients (less than 6%) showed no response.
    Yet another topical treatment that was evaluated is Jumei Renshen Shengfalu (13). The liquid extract of biota twig, drynaria, ginseng leaf, and melia was applied topically for 88 cases of alopecia areata resulting in improvement in 71 of those cases, and 74 cases of alopecia seborrheica, with improvement in 52 cases. A control group was treated with a "Western" style topical liquid containing salicylic acid, resorcinol, glycerin, and carbolic acid. The effective rate for that treatment was only 48%. Both the herb and drug liquids were applied twice daily for 2-3 months.
    HAIR LOSS ASSOCIATED WITH CHEMOTHERAPY
    Chemotherapy for cancer and certain other drug treatments may cause alopecia, which is difficult to prevent while the drug is being used. In books about treating side effects of cancer therapy (e.g., Cancer Treatment with Fu Zheng Pei Ben Principle (14) and Treatment of Toxic Side Effects Resulting from Radiation and Chemotherapy (15)) there is no mention of alopecia. Nonetheless, ITM received reports of some cases of patients undergoing chemotherapy that did not result in hair loss or resulted in less hair loss than was expected (these cases were unexplained by Western doctors in the U.S.); the patients were using Chinese herb tonic formulas to help prevent leukopenia. One of the proposed mechanisms involved in overcoming leukopenia is promoting microcirculation in the bone marrow; the herbs that accomplish this, such as millettia, hu-chang, and salvia (see: Millettia (Jixueteng)) may also promote microcirculation in the skin and, thereby, help alleviate alopecia. So, there is some preliminary and circumstantial evidence, as well as theoretical basis, to expect that this type of alopecia might be prevented by early intervention with Chinese herbs. When the drug therapy or radiation is stopped, the combination of tonic herbs and topical application of circulation-promoting agents may help to more quickly restore hair growth in those who begin the herb treatment after hair loss has already occurred.


    Alternative treatments
    Once the classic treatments of dermatologists are exhausted a number of people turn to the use of alternative treatments. Some of these therapies are recommended by the more experimental dermatologists or by alternative practitioners. Usually very little is known about alternative treatments in relation to their effects on alopecia areata hair loss. Most alternative treatments are not reported in the medical literature. A wide range of alternative treatments are being used by people with alopecia areata. Their rate of success, if any, is unknown as no trials have been conducted. A list of alternative treatments reported to me is posted below for your interest but I make no claims to their safety or effectiveness.
    1) Stress reduction. There have been anecdotal claims for success in remission of alopecia areata by using stress relaxation, hair massage & monetary reward as a psychological influence (Putt 1994), hypnotherapy (Harrison 1991) and by acupuncture (Ge 1990). There is even a patent held on the treatment of alopecia areata by acupuncture (1994).
    2) Aloe vera. Known for its soothing anti-inflammatory properties topical aloe vera cream and aloe vera in solution for oral intake has been used by some with alopecia areata in an attempt to reduce or remove the hair follicle inflammation. A quick look in the medical journal database for articles on aloe vera suggests that this plant extract contains a complex set of chemicals with the ability to suppress AND stimulate the immune system in a number of ways. There are reports on clinical trials, of varying quality, suggesting aloe vera may have a positive effect in wound healing, immune stimulation, anti-cancer and anti-viral effects. There is also a recent report on its use in psoriasis treatment. It doesn't look like we know much on how it works but aloe vera does induce nitric oxide production, probably from macrophages, and aloe vera contains superoxide dismutases. Both these substances have been implicated as possible simulators of hair growth in androgenetic alopecia. Aloe vera contains a potential anti-inflammatory mannose-6-phosphate. It contains acemannan which apparently stimulates macrophages to produce cytokines IL-6 and TNF-alpha, and acts as an antiviral by stimulating T cytotoxic cells.
    3) Poison ivy. Poison ivy has been tried by one or two people. It is a potent contact sensitizing chemical. However, comments suggest that the results were not good. The dermatological contact sensitizers are a better bet.
    4) Melatonin. Melatonin has been used by some people with alopecia areata. Melatonin seems to be the popular cure-all of choice at the moment but several reports suggest that melatonin could have quite adverse effects on people with alopecia areata. Overall, research suggests that taking melatonin may actually exacerbate alopecia areata if it is an immune mediated condition.
    Melatonin is produced naturally in the pineal gland and the pineal gland is under serious investigation as one of the main organs involved in the process which converts environmental light changes into an endocrine response. In short, the neurohormone melatonin provides day length information to our bodies. In response to daily and seasonal light changes there is a detectable melatonin/circadian rhythm. Melatonin, along with norepinephrine and acetylcholine are suppressed by visible light exposure while cortisol, serotonin and dopamine levels increase. Subsequently there is a daily rhythm of melatonin production with build up during darkness and suppression of melatonin production during daylight. Melatonin build up after sundown can be dissipated by sleeping. The need for sleep after taking melatonin pills is believed to be our body's feedback response designed to control melatonin levels and stop the neurohormone from becoming too concentrated in our systems.
    Melatonin has immunostimulatory/immunoenhancing properties. A high affinity receptor binding site for melatonin has been found on T helper lymphocyte cells providing a direct link between melatonin levels and immunosensitivity. Melatonin activates these T lymphocytes into production of cytokines and this cascade of chemical signals recruits other immune cells and makes them more responsive (Maestroni 2001). One of the key targets for melatonin is the thymus as the central organ of the immune system.
    Melatonin treatment is being considered for its anticancer properties and for counteracting immunodepression that may develop during stress, viral infection, other drug treatments and aging. Corticosteroids have been shown to reduce the number and function of melatonin binding sites as part of their immunosuppressive properties (Poon 1994).
    5) Sunlight. Some people with alopecia areata suggest simple exposure to sunlight can help hair regrowth. There may be some validity in this. At its simplest, sunlight includes UV radiation. UV light is known to reduce the numbers of immune cells in the skin. Indeed, UV light is regularly used in the dermatology clinic for treating psoriasis and alopecia areata. Of course UV light exposure also increases the risk of developing melanoma skin cancer. Excessive exposure to UV light results in sunburn. This physical damage to the skin results in mild inflammation. Sunburn is effectively causing an irritant effect. Sunburn may act to promote hair growth in the same way as chemical irritants used in the dermatology clinic.
    There are of course seasonal changes in daylight intensity and time period. With the reduction of daylight exposure in winter there is believed to be an overall increase in melatonin production and comparative decrease during summer months. Our ancestors may have needed this melatonin boost in winter to help protect us from the increased stress of low temperatures and lack of food. This would suggest a generally less responsive immune system in summer which may in part account for the seasonal growth and loss of hair some alopecia areata affected people experience.
    We must also consider day length changes with the latitude of where we live. The autoimmune disease multiple sclerosis is more common in temperate latitudes - less so closer to the equator. One hypothesis put forward for this disparity is the immunosuppressant effects of sunlight mediated by melatonin. The overall reduced levels of natural light and intensity in higher latitudes may lead to higher levels of melatonin. Subsequently this may result in a more responsive immune system and make people more susceptible to development of autoimmune conditions (Hutter 1996). We don't know enough about regional variations in alopecia areata expression to know if there is a greater frequency in temperate latitudes.
    6) Heat treatment. Excessive heat treatment may act much like sunburn. The physical damage to the skin will induce inflammation and promote hair growth in the same way as chemical irritants used in the dermatology clinic.
    7) Zinc supplements. We might describe zinc supplements as a pseudo alternative treatment as zinc sulfate has been used in several treatment trials for alopecia areata. However, the trials were all conducted in Europe and mostly published in non-English language medical journals and this means the work is not widely known in the USA. Several analyses reports on zinc concentration in the blood serum of people with alopecia areata suggested a zinc deficiency. Some dermatologists, particularly in Germany and Russia, use zinc supplements in addition to other treatments. The belief is that the zinc acts as an immunomodulator and helps correct an imbalance in the immune system. Note that taking too much zinc is toxic and can have serious health consequences.
    8) Mustard seed/Capsicum poultice. The use of these products to treat alopecia areata has been with us for a few thousand years. They are a simple method of applying an irritant to induce dermatitis and promote an inflammatory response. Despite being around for a long time these products have never been scientifically tested for their actual success rate in promoting hair growth.
    9) Vitamin supplements/creams. Vitamins are important in hair growth and certain vitamins such as vitamin E are known to exert an immunomodulatory effect on the immune system. Some people have attempted to use topical or oral applications of various vitamins to treat alopecia areata. The actual effects on alopecia areata are unknown. There are no published studies on diet and alopecia areata hair loss. Note some vitamins are toxic in high concentrations. Vitamin overdose can in itself cause diffuse hair loss.
    10) Asprin poultice. Asprin has an immunomodulatory effect. Asprin in solution has been applied to the scalp in an attempt to reduce hair follicle inflammation.
    11) Dimethylsulfoxide (DMSO). DMSO is a hydroxyl radical scavenger and antioxidant. In theory it has the potential to protect cells from hydroxyl radical mediated radiation damage (Dod 1968). Neutralizing the hydroxyl radical reduces inflammation and may be the primary mechanism of action allowing DMSO to work in immune disorders. DMSO reacts with the hydroxyl radical (OH) to form a methyl radical (CH3) which is much less reactive than the hydroxyl radical.
    DMSO may also be used as a carrier of drugs and other compounds through the skin. Low molecular weight compounds when dissolved in DMSO and applied to the skin are readily carried into the systemic circulation. In various trials, DMSO has been used as a carrier for antibiotics, corticosteroids, anti-inflammatory agents and essential fatty acids. The key side effect of DMSO treatment is the characteristic garlic-like smell of the breath. DMSO is metabolized to DMSO2 (dimethylsulphodioxide) and DMS (dimethylsulphide) in the body. The kidney excretes DMSO2 in the urine. The lungs excrete DMS, which gives breath a characteristic garlic-smell, that can last for up to 72 hours. Other side effects involve erythema, itching, and urticaria. Concern has also been expressed over the potential for DMSO to cause cataracts.
    12) Homeopathic treatment. Your doctor will be able to tell you what form of Alopecia you have. The clerk at your local health food store should be able to give you a good description of the principles of homeopathic remedies, and so can your local Homeopathic doctor. Alopecia areata stemming from depression and stress is apparently treated with a homeopathic remedy called "Phosphoricum acidum" available at most local health food stores. Phosphoricum acidum in a 1x potency is used by taking 1 granule 3 times a day, and as soon as there is any hair regrowth the treatment is stopped. This is not a cure but a treatment. Alopecia areata is generally recurrent, but when new patches form, the treatment is restarted. Apparently it is important not to touch the granules. You put them in your mouth directly from the lid of the container, otherwise their medicinal qualities will be annulled. Sounds bizarre to me, but that is homeopathy for you.
    13) Herbs. Chinese doctors often prescribe herbs for alopecia areata. A treatment literally called the "alopecia areata pill" or sometimes "Trichogen" is available from Chinese pharmacists. The listed contents are 20% Radix Polygoni Multiflori, 10% rehmannia glutinosa, 10% radix et rhizoma rehmannia, 10% radix angelicae sinensis, 10% radix salvia mittiorrhiza bge, 10% radix paeoniae lactiflorae, 10% fructus schizandrae, 10% codonopsis pilosula, 5% fructus chaenomelis, 5% rhizoma notopterygii. Apparently the key ingredient here is the herb Radix Polygoni Multiflori. This herb may also be known as "Fo Ti" or "Sho Wu". How the herbs are supposed to work is unknown.
    14) Evening primrose oil (EPO), borage and black currant oil. Evening primrose oil (EPO) is a source of omega-6 essential fatty acid (EFA) as are borage and black currant oil. Black currant oil has a considerably greater concentration of omega-6 than EPO. There are reports on work using EPO, borage, and black currant oil in treating autoimmune conditions in humans or animals including, psoriasis, glomerulonephritis, lupus, rheumatoid arthritis, and diabetes. Overall, there does seem to be some indication that these oils have a mild immunosuppressive effect although the long term benefits were brought into question. It seems that the active ingredients are the essential fatty acids. No one has truely identified what the specific product(s) is/are and the experiments could not be described as definitive proof in any way, although gamma-linolenic acid (GLA) was most frequently mentioned. How it works has not been described in much detail but may have something to do with incorporation of fatty acids into cell membranes and the activity of products from fatty acid breakdown such as eicosanoids.
    15) Flax seed oil, linseed oil, fish oil. Omega 3 is manufactured in plants such as green algae. It is popularly taken in the form of linseed oil or fish oil. Fish do not actually make these fatty acids. The fish eat algae and consequently accumulate high concentrations of omega 3 fatty acids. Some evidence is available about the beneficial effects of omega 3 fatty acids in diseases such as cancer, Alzheimer's disease, and autoimmune conditions. Omega 3 has an anti-inflammatory effect and has been investigated for its beneficial effects in treating rheumatoid arthritis, systemic lupus erythematosus, and ulcerative colitis. How omega 3 might work has not been investigated but may revolve around its effects on arachidonic acid and eicosanoid synthesis.

    Aromatherapy
    In 1998 double-blind study published in the Archives of Dermatology (Hay 1998) found that 44 percent of participants who massaged their scalps with a mixture of essential oils daily for seven months showed growth in bald patches. The tonic was composed of active essential oils described.

    2 drops thymus vulgaris (88-mg)
    3 drops lavandula angustifolia (108-mg)
    3 drops rosmarinus officinalis (114-mg)
    2 drops cedrus atlantica (94-mg)

    and used the carrier oils:

    jojoba oil 3-ml
    grapeseed oil 20-ml (NOT grapefruit seed oil)
    While the original paper gives only limited detail about the nature of the essential oils other scientists have given more detailed recommendation to keratin.com. There are several different "chemotypes" for the essential oils used in the original study. Specific recommendations include:
    For rosemary : Rosmarinus officinalis CT cineole
    For thyme: " sweet thyme " such as Thymus vulgaris CT thujanol or linalol or geraniol or terpineol (but never " red thyme " such as Thymus vulgaris CT thymol which is pretty caustic for the skin)
    For cedarwood: Cedrus atlantica (which is not Texas cedarwood. Under this generic name, Juniperus species are safe, but never use Thuya species)
    In the published study 86 volunteers with alopecia areata massaged oils into the scalp each evening for a minimum of 2 minutes; followed with warm towel wrap to aid absorption of oils for about an hour. Half of them received the complete tonic and half of them received the carrier oils alone as a control.
    The results were that 19 (44%) of 43 patients in the active group showed improvement compared with 6 (15%) of patients in the control group (P = .008). An alopecia scale was applied by blinded observers on sequential photographs and was shown to be reproducible with good interobserver agreement.
    The investigators concluded that the results showed aromatherapy to be a safe and effective treatment for alopecia areata. Treatment with the essential oils was significantly more effective than treatment with the carrier oil alone


    would suggest it is a diet, environmental, stress or circulation problem.

    For diet, make sure she is eating whole foods, eat organic, eliminate refined or processed foods, eat lots of vegetables, drink lots of water. Start taking a good multivitamin like Rainbow Light brand. EAT amla fruit, it was traditionally used to strengthen hair, connective tissue and muscle. Get Horsetail and other super green food sources in diet to increase hair strength.

    For environmental, stay away from chemicals, insecticides, herbicides, cosmetics and aerosol sprays. She should stay natural and clear of man made pollutants or chemicals.

    For stress reduce it, or have her learn to release it. Learn stress reduction techniques. Use adaptogen herbs which help the body deal with stress. These include the Ginsengs, I would probably start with Siberian Ginseng for her.

    For children use Chamomile and Catnip to calm them down, these two herbs are good for nervousness which is shown as stomach or GI upset.

    For circulation use Ginkgo, Hawthorn, Rosemary.

    Use a Rosemary rinse on the scalp, it has been traditionally used to prevent hair loss.

    It has also been suggested that this is an Autimmune disease, if so Immune Amphoteric Herbs are appropriate, such as Medicinal Mushrooms (Reishi (The Gano dermas), Shiitake, Maitake, Chaga), and or the other Immune Amphoteric herbs Astragalus, Shisandra and Licorice, which are also Adaptogens.

    Principal Proposed Natural Treatments
    Essential Oils
    One study suggests that a combination of essential oils applied topically may stimulate hair growth in people with alopecia areata. In this double-blind placebo-controlled trial, 84 individuals massaged either essential oils or a non-treatment oil into their scalps each night for 7 months.3 The results showed that 44% of those in the treatment group experienced new hair growth compared to only 15% of the control group. The treatment oil contained essential oils of thyme, rosemary, lavender, and cedarwood, in a base of grape seed and jojoba oils.
    Although there are no reported side effects associated with using thyme, rosemary, lavender, and cedarwood oils topically, essential oils can be toxic if taken internally. They can also cause allergic reactions, which may be severe, when applied topically. For more information, see the full essential oil article.

    Other Proposed Natural Treatments
    Very preliminary evidence suggests that topical khellin, an extract of the fruit of the Mediterranean plant khella (Ammi visnaga), may promote new hair growth when combined with ultraviolet light (UVA) therapy. Khellin selectively sensitizes the skin to UVA and is related to drugs used to treat psoriasis.4
    The supplements zinc aspartate and biotin, taken together in high (and possibly dangerous) doses, have been tried for alopecia areata in children.5
    Hypnotherapy has also been proposed as a treatment for alopecia areata, but a very small study found it had no effect.6


    Alternative/Natural Treatments
    Despite claims to the contrary, no alternative therapies can reverse normal balding, although some may encourage reversal of temporary hair loss and improve damaged hair. Certain relaxation techniques are helpful in calming stressful people.
    Chinese Medicine - In Chinese medicine, hair is thought to be nourished by the blood, which is influenced by the liver and kidneys. Chinese medicines for the hair are intended to help and nourish these organs and promote new hair growth; they include such herbs as polygonum (Polygonum multiflorum), lycium fruit (Lycium barbarum), Chinese foxglove root (Rehmannia glutinosa), Chinese yam (Dioscorea opposita), and cornus (Cornus officinalis). In Chinese medicine, hair is thought to be nourished by the blood, which is influenced by the liver and kidneys. Chinese medicines for the hair are intended to help and nourish these organs and promote new hair growth; they include such herbs as polygonum (Polygonum multiflorum), lycium fruit (Lycium barbarum), Chinese foxglove root (Rehmannia glutinosa), Chinese yam (Dioscorea opposita), and cornus (Cornus officinalis).
    Herbal Therapies - For temporary or partial hair loss from a known cause, herbalists recommend stimulating hair follicles and improving blood circulation in the scalp to encourage new hair growth. Try massaging your scalp with essential oil of rosemary (Rosmarinus officinalis) or rinsing your hair with tea made from sage (Salvia officinalis) or nettle tea. For temporary or partial hair loss from a known cause, herbalists recommend stimulating hair follicles and improving blood circulation in the scalp to encourage new hair growth. Try massaging your scalp with essential oil of rosemary (Rosmarinus officinalis) or rinsing your hair with tea made from sage (Salvia officinalis) or nettle tea.
    Homoeopathy - Many homoeopathic remedies are thought to be effective for hair loss, particularly thinning caused by pregnancy, stress, or emotional trauma. Consult a homoeopathic professional for more advice. Many homoeopathic remedies are thought to be effective for hair loss, particularly thinning caused by pregnancy, stress, or emotional trauma. Consult a homoeopathic professional for more advice.
    Massage- Massage improves circulation and helps supply more blood to the scalp, which in turn improves the health of your hair and scalp. Massage improves circulation and helps supply more blood to the scalp, which in turn improves the health of your hair and scalp.
    A few drops of vitamin E oil massaged into the scalp is recommended to strengthen fragile hair and help prevent dry, flaky skin. Or use the oils mentioned above.
    (Emotional or physical stress may be a factor in some cases of hair loss. Yoga and meditation may help in these cases).
    Dietary Considerations
    Hair loss can result from a poor diet. It is advisable that you start back on a balanced diet and consult your doctor about supplemental vitamins A, B complex, and C, as well as iron and zinc. (Go to our Vitamins page).
    Prevention
    Be careful with your hair and do not over wash or treat it. If your hair is very oily, you may want to wash it every day, but shampooing too often can strip your hair of its natural oil.


    [This message has been edited by imthatguy (edited 08-22-2003).]

     
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