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Friday, May 18, 2012

ALOPECIA (Hair Loss)

Western medical concept:
Researchers have determined that this form of hair loss is related to hormones called androgens, particularly an androgen called dihydrotestosterone. Androgens are important for normal male sexual development before birth and during puberty. Androgens also have other important functions in both males and females, such as regulating hair growth and sex drive.

There are various types of alopecia. A common pattern of male hair loss is that it begins above both temples or at the vertex, and may progress to complete baldness (Figure 6.8). In women, the hair usually becomes thin all
over the head, and the hairline does not recede.

Our head hair is nourished by Kidney yin and Liver Blood. Thinning or loss of hair occurs when overworked or stressed, when there is blood loss or anaemia or when the climate is very dry. Dryness makes the hair brittle and causes split ends. Blood deficiency (also due to stress and overwork, because stress consumes Liver Blood) makes the roots weak, and the individual strands of hair thin and dull. The mechanical strain of washing, combing or even moving the head on the pillow is enough to cause the loss of large handfuls of hair. When treating hair loss, it is necessary to nourish and moisten the hair, and it will flourish again in growth. It is important to initiate treatment as soon as symptoms develop as, once complete baldness sets in, it will be very difficult to make a difference.

I have addressed general hair loss and partial hair loss in certain areas of the head as the two types that give good results with acupuncture. Both energy treatment and local treatment is given. The patient should take some vitamin–amino acid combinations such as Panthovigar N®, which contains thiamine, calcium pantothenate, cystine and keratin, and some local care.

Explaining the treatment:
In hair loss of any type, the Kidney yin must first be tonified, ideally on point K 7. The patient should also drink water more regularly and rest more. Where possible, a midday rest would be excellent, as midday is the worst time energetically for those who have Kidney yin deficiency. If Kidney yin is deficient, this would generate uncontrolled Kidney yang, which rises to the head.

If Liver Blood deficiency can be established, then Blood should be tonified with points Ren 14, UB 15, UB 17, Sp 10, GB 39 and an iron supplement.

The next thing to do would be the local treatment. This is done (a) in the area with hair loss and (b) on the organs associated with the areas of the hair loss.

Local treatment on the area of hair loss:
This area should be examined well. If there is some hair and the scalp has normal roughness, then electrical stimulation should be used. This will cool the scalp in the area.

The technique – electrical stimulation on area of hair loss:
The area with thinning hair is treated with four subcutaneous needles, two on each side, and these are connected to two outlets of an electrical  stimulator (taking care to connect the two needles on the same side of the body to one outlet). The needles are then stimulated at continuous frequency, around 10 Hz, for 20 minutes.

This needling is relatively painful, and is therefore difficult to repeat more than twice weekly for 2 weeks, and then has to be done once weekly for a further four to eight sessions (Figure 6.9).

When there is no hair at all in the affected area, this area can be treated locally with plum-blossom tapping to bleed. The tapping therapy has to be done daily for up to 14 days. It would be more convenient and  practical for the patient to take a plum-blossom hammer home and get a family member to do it for them (Figure 6.10).

The technique – plum-blossom tapping on bald area:
Clean the area well with surgical spirit and allow it to dry. Holding the plum-blossom hammer, tap hard vertically on the bald area with no particular direction. When finished, this area should be covered with droplets of blood, which should be wiped off.

This treatment is very effective in small areas of baldness, or in alopecia areata. It is not as successful in large areas or if the entire head is bald. Within 14 days of treatment, one can see and feel fluff-like hair growing in this area. The initial growth is grey coloured, and is not the colour of the rest of the hair. But within 1–3 months the hair will become thicker and more coloured. Once the ‘fluff’ starts to appear, the bleeding tapping should be stopped. Local treatment is no longer necessary. If needed, electrostimulation could be given (Figure 6.9).

Treatment on the organs associated with hair loss:
The common areas for hair loss are the temples and vertex. In alopecia areata, it can be anywhere in the head. There is empirical knowledge that different parts of the head are related to different organs of the body, and that imbalances of these particular organs will manifest as pain, hair loss, greying or skin problems in these parts of the head.

According to the table on TRADITIONAL CHINESE MEDICINE VIEW the frontal head (including both temples) is associated with the Stomach and Large Intestine, the bright yang organs. Headache that is due to hunger or low blood sugar will occur in this area. A headache that accompanies gastritis will also manifest in this area. Hair loss in this area is due to excessive heat in the Stomach or Large Intestine (more often the Stomach). Just as hair grows more in areas which are cold, to insulate and protect these areas, so the body will lose hair in areas which are hot, in an attempt to keep cool.

Thus, hair loss only in the area of the Stomach or Large Intestine needs to be treated by balancing the energy there – tonifying the yin and sedating the yang (the yin needs to be tonified, because this is a long-term imbalance and there should be some deficiencies too. As there is heat, the deficiency must be with the yin aspect).

Energy-balancing points for vertex hair loss:

"Balance Liver yin deficiency and yang excess"

■ Liv 5 and GB 40 sedation – Luo-connecting point of yin organ and sedate yuan-source point of yang organ.

■ Avoid sour foods, alcohol and stress, all of which will increase Liver yang aspect.

In the case of both hair loss and premature greying of head hair (the second is a symptom of Kidney yang deficiency), patients seem to express concern only when it is too late. In traditional Chinese medicine, we worry about tendencies of the body rather than extreme symptoms, predominantly because the more chronic and far gone an imbalance, the more difficult it becomes to correct. When imbalances are detected early, however, they are easier to correct and prevent from going into a chronic state.

It is normal to lose hair during climate changes and when the weather is dry, during at least two cycles of the year. But then the hair grows again and returns to the earlier state. If one notices hair loss in large quantities – covering the pillow or the shower base – it is alarmingly high and needs treatment. Because, even if hair grows again, it will be less and thinner than before, and will gradually lead to serious proportions. If we notice hair loss when we are overworked, when we have long periods of poor sleep and when we are generally run down, then we need to treat the hair loss. 

Hair loss – dos and don’ts:
■ Gently massage the scalp with coconut, olive or sesame oil, leave it on for 30 minutes or overnight, and then wash. This will cool and nourish the hair roots and is much better than any conditioner; this can be done once a week.
■ Take a multivitamin product.
■ Take a herbal iron supplement if there is Blood deficiency.
■ Go to bed before midnight.
■ Post-menopausal women, or men of the same age, should have an afternoon rest when ever possible (the heat tends to rise up because of the Kidney yin deficiency).
■ Drink plenty of water regularly. Eat watery foods and greens.
■ Keep head cool (not cold!). If one has a hot head and cold feet, then a warm foot bath will change this order.
■ Don’t wash hair too often – twice weekly is fine. If hair is too greasy, there is a fault with the diet. This can be caused by excessive milk products, cheese, processed meats such as sausage, fatty meats and oily preparations and excessive refined sugars.
■ Avoid close caps and hats when possible: they increase the damp–heat in the head.
■ The hairdryer is not a plumping machine for a head with less hair! It dries and scorches the roots. Do not use a hairdryer regularly unless it is necessary to go out soon after washing the hair – and then keep it at a reasonable distance. Ask your hairdresser (who uses it too close to the scalp) to do the same.
■ Avoid direct sunlight on the head for long. Carry an umbrella if you need to stand in the sun.
■ Avoid coffee and alcohol.

COSMETIC ACUPUNCTURE, by Radhah Thambirajah