E-ISSN:2456-3110

Case Report

Alopecia areata

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 2 FEBRUARY
Publisherwww.maharshicharaka.in

Management of Indralupta (Alopecia areata) through Ayurveda - A Case Report

Borase R1*, Raut D2
DOI:10.21760/jaims.10.2.44

1* Rushikesh Borase, Post Graduate Scholar, Department of Kaumarbhritya, Government Ayurved College and Hospital, Nanded, Maharashtra, India.

2 Deokumar Raut, Assistant Professor, Department of Kaumarbhritya, Government Ayurved College and Hospital, Nanded, Maharashtra, India.

Introduction: Alopecia areata (AA), an autoimmune disease characterized by the appearance of non-scarring bald patches affecting the hair bearing areas of the body. Scalp is the most common site of involvement. It can be compared with Indralupta in Ayurveda. The pathophysiology of Indralupta is the vitiated Tridoshas and Rakta, affecting the scalp and also blockage of hair follicles with aggravation of Rakta and Kapha which further prevents regrowth of hairs. It is described as Kapalgata Roga by Acharya Vagbhata and as a Kshudra Roga by Acharya Sushruta and Madhava Nidana.

Methods: This is a case study of 11 years male child brought by his parents to Balroga OPD having complaints of bald patches over scalp region for 6 months. Patient was diagnosed with Indralupta and managed by classical treatment of Raktamoskhan by Jalauka along with some internal and external drugs. Treatment for 4 months along with the diet regimen mentioned in Ayurvedic text was followed.

Result: The patient got speedy recovery with remarkable regrowth of scalp hair after 4 months of treatment.

Discussion: Classical Indralupta Chikitsa mentioned in Ayurvedic classics is effective in the management of Alopecia areata.

Keywords: Alopecia areata, Autoimmune, Ayurveda, Indralupta, Leech therapy, Autoimmune disorder, Hair loss, Patchy baldness

Corresponding Author How to Cite this Article To Browse
Rushikesh Borase, Post Graduate Scholar, Department of Kaumarbhritya, Government Ayurved College and Hospital, Nanded, Maharashtra, India.
Email: 		Borase R, Raut D, Management of Indralupta (Alopecia areata) through Ayurveda - A Case Report. J Ayu Int Med Sci. 2025;10(2):305-311.
Available From
https://jaims.in/jaims/article/view/4018/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-01-16 2025-01-17 2025-01-27 2025-02-07 2025-01-27
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
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© 2025by Borase R, Raut D and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Download PDFBack To ArticleIntroductionAim and ObjectiveCase ReportMaterials and MethodsObservation and ResultDiscussionConclusionReferences
Rushikesh B et al. Management of Indralupta (Alopecia areata) through Ayurveda

Introduction

Alopecia areata is a condition characterized by localized, non-scarring hair loss. It commonly appears as patches on scalp without any scaling or inflammation. The condition has a reported prevalence of 0.1-0.2% in general population, with a lifetime risk of 1.7%.[1] Male was reported to be more affected with disease in comparison to children and women and causes more emotional problems in woman and children due to cosmetic purposes.[2] There are fewer cases in children than in adults, but it has been found to be associated with emotional stress, family history, Down syndrome, and autoimmune disorders.[3]Contemporary treatment primarily involves corticosteroids, which are associated with significant side effects and are unsuitable for long-term use.[4] Given lack of definitive management in allopathic medicine, so alternative approaches are necessary.

In Ayurveda, it can be compared to similar disease called Indralupta. It is described as Kshudra Roga by Acharya Sushruta, Madhava Nidana & as Kapalgata Roga by Acharya Vagbhata. Acharya Sushruta has mentioned Indralupta as Raktapradoshaja Vikara. Acharya Charaka mentioned that Vitiated Pitta with Vatadi Dosha when reaches scalp, it results in Khalitya (Indralupta).[5] According to Acharya Sushruta, Pitta along with Vata localize at roots of hair (Romakoopa) causes fall of hair & thereafter Kapha along with Rakta obstructs channel of Romakoopa leading to stoppage of regeneration of hair & such condition is known as Indralupta or Khalitya.[6] Thus Vata, Pitta & Kapha Dosha & Rakta Dushya are main internal causative factors of Indralupta.

Ayurveda plays a major role in treating this type of autoimmune disorder.[7] Ayurveda provides Shodhana (cleansing procedures) and Shamana (specific internal medications) Chikitsa for managing Indralupta effectively. This case reports effectiv of Ayurvedic management of Alopecia areata by using Shaman & Shodhan (Jalaukavacharan) Chiktsa along with Nidanparivarjan.

Aim and Objective

To study the role of Jalaukavcharan along with some internal and external medications in Indralupta with special reference to Alopecia areata.

Case Report

A 11-year-old patient came to Balroga OPD in Government Ayurveda College and Hospital, Nanded with the following complaints since 6 moths.

  • Bald patches over scalp
  • Dandruff
  • Itching over scalp
  • Loss of appetite

History of present illness:

After taking a detailed medical history of the patient, it was found that he suffered from Acute Febrile Illness, for which he received complete allopathic treatment in a private hospital and was completely cured. After that, he started losing hairs in multiple patches with dandruff. He was treated with corticosteroids and topical serum for 3 to 5 months in private hospital but didn’t got relief, so he approached Balrog OPD at GACH Nanded and was diagnosed with Indralupta (Alopecia areata), and treatment was started on an OPD basis.

Past medical history:

H/O of Acute febrile illness 8 months ago treated by hospital admission and IV antibiotics.
No H/O of any major illness, any drug allergy and any previous surgery.

Family history:

No H/O any significant family history of autoimmune disorder and Alopecia areata.

Personal history:

1.DietMixed
2.AppetitePoor
3.Bowel habitConstipation on and off
4.Micturition5 times a day/1 time at night
5.SleepNormal

Ashtavidha Pariksha:

1.Nadi102/Min
2.MalaMalavshtambha
3.MutraNiyamit
4.JivhaSaam
5.ShabdaSpashta
6.SparshaSamsheetoshna
7.DrukaPrakruta
8.AkrutiKrusha

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General examination:

1.Pulse rate92/min
2.Respiratory rate24/min
3.Height139 cm
4.Weight31 kg
5.Blood pressure100/70 mmhg
6.Temperature97.8°F

Systemic examination:

1.RSAEBE, clear
2.CVSS1, S2 normal
3.CNSConscious, well oriented

Disease Specific Examinations:

Site of involvementTemporal and Back of Scalp
PatternIrregular patches
Number6 patches (2 - Back of scalp, 1 - Right temporal region, 1 - Left temporal region)
Skin colourSlight reddish
DischargeAbsent
SensationPresent

Laboratory Investigations:

Haematological investigations carried out to exclude any other disease. CBC, B.T., C.T. was carried out to perform Jalaukavacharan.

Hb%11gm/dl
Total R.B.C5.14mil/c.mm
Total W.B.C8000/cu.mm
Neutrophil54.8%
Lymphocytes33.1%
Eosinophils4.3%
Basophil1%
Monocytes3.5%
Bleeding time1min 24sec
Clotting time3min 04sec

Samprapti Ghataka:

  • Dosha - Vata, Pitta, Kapha
  • Dushya - Rasa, Rakta, Asthi
  • Srotas - Anna, Rasa, Rakta, Asthivaha Srotas
  • Sroto Dushti - Sanga
  • Agni - Mandagni
  • Adhisthana - Shirah and Shirah Kapala
  • Sadhyasadhyata - Kriccha Sadhya

Materials and Methods

The treatment was planned according to the basic principles narrated in the context of Indralupta disease. Primary management of Indralupta (Alopecia areata) is Shodhana therapy (Detoxification). As per Ayurvedic literature application of Jalauka (Leech) on the lesions is a type of Raktamokshan (blood-letting) under Panchakarma Chikitsa. Vitiated Rakta by Pitta Dosha should be removed from the body (Diseased part) by using Jalauka. Leech Therapy (Jalauka) was done once a fortnight along with internal medications up to 4 months.

Table 1: Leech Therapy (Jalauka).

RaktamokshanaFrequencyDuration
Application of Jalauka (Leech) 1 at a time.Once a fortnightUp to 4 Months

Table 2: Following medicines were prescribed during the course of treatment.

SNMedicationsDose and durationMode of Action
1.Aampachak Vati1 tablet twice a day for 15 daysAampachana and Agnideepana
2.Asthiposhak Vati1 tablet twice a day for 4 monthsAsthidhatu Poshana and Keshya Guna
3.Mahamanjishthadi Kwath7 ml twice a day for 4 monthsRaktadhatu Shodhana

Table 3: Pathya and Apathya.

PathyaApathya
Ahara
  • Laghu, Snigdha Ahara
  • Fresh fruits
  • green leafy vegetables
  • Sprouts
Ahara
  • Atiushna, Tikshna, Amla, Lavan Ahara
  • Viruddha Ahara
  • Street Food
Vihara
  • Meditation
  • Yoga
  • Pranayam
  • Regular exercise
Vihara
  • Chinta, Bhaya, Krodha.
  • Vegavrodh
  • Divaswap
  • Ratrojagaran

Criteria for assessment[8]

1. Number of bald patches
2. Gradation of hair falling
3. Amount of hair growth


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SymptomsGradation
Hair falls absent0
Mild-hair falls on wash1
Moderate-hair falls on combing2
Severe-hair fall3

Observation and Result

  • Before Treatment: There was patchy hair loss, no hair roots, slight dryness at the site was present.
  • After 2 months of treatment: No new bald patches seen, Hair fall was significantly reduced and new hair growth was seen over bald patches.
  • After Treatment: After 4 months treatment, length and density increased. Black hairs easily observed over most of the affected site.

SNSymptomsBefore treatment (0th day)After 2 months of treatmentAfter 4 months of treatment
1.Bald patches6No new patches seen2
2.Hair fall++++No hair fall
3.Hair growth0Mild hair growthBlackish hair growth over most of the patches

jaims_4018_01.jpg
Before treatment

jaims_4018_02.jpg
After 2 months of treatment

jaims_4018_03.jpg
After 4 months of treatment

jaims_4018_04.jpg
Before treatment


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jaims_4018_05.jpg
After treatment

jaims_4018_06.jpg
Before treatment

jaims_4018_07.jpg
After treatment

Discussion

Vata, Pitta and Kapha Dosha and Rakta Dushya are the main internal causative factors of Indralupta. Charaka in Vimanasthana, while describing the disorders occurring due to over indulgence in Kshara, Lavana and Viruddha Ahara has mentioned the occurrence of Hair Loss as a consequence.

It has been mentioned that the Viruddha Ahara like, simultaneous intake of Lavana (salt) with milk in the diet induces Indralupta, as observed in the people of Saurashtra and Bahlika. Thus, it can be said that a person habituated to excessive Lavana or Kshara intake and taking Viruddha Ahara in routine is prone to have Indralupta.[9]

So Nidana Pariwarjana is advised here. As, Vata, Pitta and Kapha Dosha and Rakta Dushya are the main internal causative factors of Indralupta. So, the medications that balance out Vata, Pitta, Kapha, and Rakta and having action of Keshaya (conducive to the growth of hair) and Rasayana help promote the regrowth of hairs.[10]

In Ayurveda, both Shodhana (Internal and external cleansing procedures) and Shamana treatment (Disease specific internal medications) are prescribed for Indralupta.

Aampachan Vati:

It contains Katu drugs like Chitrak, Pipalimula, Ajvain, Shudhjavakhar, Sunth, Chavya, Saijikhar (Shudhnavsagar), Kalimirch, Pipali, Saudra Namak, Hing and Saindhav in which Bhavna was given by Nimbu Swarasa which is best drug for Deepan and Pachan. Hence Aampachan Vati helps to restore healthy digestion, assimilation and metabolism of essential food elements.[11]

Mahamanjisthadi Kashaya:

It pacifies vitiation of Kapha and Pitta. However, it is formulated such a way that it can be effective in all types of diseases cause by all three Dosha. It is mainly blood purifier. It Detoxifies blood and aids to eliminate toxins accumulated in the body. It increases skin glow.

Asthiposhak Vati:

It contains a powder formulation of the following ingredients: Kukkutandatvak Bhasma (processed hen eggshell),


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Shodhit Laksha (processedLacciferlacca), Shodhit Guggul(processedCommiphora wightii), Choorna of Asthisamhruta (Cissus quadrangularis), Arjuna (Terminalia arjuna), Amalaki (Emblica officinalis), Ashvagandha (Withania somnifera), Guduchi (Tinospora cordifolia) and Bala (Sida cordifolia). These ingredients undergo processing in a decoction of Babboola (Acacia arabica) in the required quantity. According to Aacharya Charaka Kesh is a Mala of Asthi Dhatu, Asthi Poshana causes nourishment of Kesh and Asthi. Amalaki ingredient of Asthiposhak Vati is Keshya, Khalitya-Palityahar, Tridoshhar, Deepan, Pachan, Rasayan which help in rejuvenation process. Guduchi ingredient of Asthiposhak Vati is Tridosh Shamak and Rasayana.[12] In this way Shamana Chikitsa acts and prevents further hair fall.

Raktamokashana in this case performed with Jalaukavacharan (blood-letting in which leech is used) as, it is described as best method to pacify the vitiated Pitta and Rakta.[13] Leech sucks the blood and improves local blood circulation mainly by injecting histamine like substances that causes vasodilatation. After the evacuation of vitiated blood from the affected site, re-channelization of blood flow is stabilized. Many studies have confirmed that leeches have more than hundred bioactive substances in its saliva, which mainly have analgesic, anticoagulant and anti-inflammatory effects.[14] This is the reason for selecting the combination of systemic medications and leech therapy for treating this particular case.

The available treatment in modern medicine mainly based on steroid and minoxidil etc. which have their own side effects. Leech therapy works similar to minoxidil as it improves the local blood circulation along with its anti- inflammatory action.

Conclusion

Hair disorders cause negative impact towards the individual and his or her quality of life. Ayurvedic management with Mahamanjasthadi Kwath, Ampachak Vati, and Asthiposhak Vati internally and externally use of Jaloukavacharna (leech therapy) was found very effective in the management of case Indralupta. During case study no any side effects was found. Observed benefits may be attributed to Raktashodhak, Antioxidant, immunomodulatory properties. Nidanaparivarjana was also a necessary part of the treatment.

in this case, we observed a significant result within 4 months. This treatment protocol should be clinically evaluated on large number of patients to confirm the efficacy.

References

1. Tan E, Tay YK, Goh CL, Chin Giam Y. The pattern of alopecia areata in Singapore: A study of 219 Asians. International Journal of Dermatology. 2002;41(11):748–753. [Crossref][PubMed][Google Scholar]

2. Al-Mutairi N, Eldin ON. Clinical profile and impact on quality of life: Seven years’ experience with patients of alopecia areata. Indian Journal of Dermatology, Venereology, and Leprology. 2011;77(4):489–493. [Crossref][PubMed][Google Scholar]

3. Khopkar U. Skin Diseases and Sexually Transmitted Infections. 7th Edition. Reprint 2019. Chapter 16, p.187 [Crossref][PubMed][Google Scholar]

4. Seetharam KA. Alopecia areata: An update. Indian Journal of Dermatology, Venereology, and Leprology. 2013;79(5):563–575. [Crossref][PubMed][Google Scholar]

5. Trikamji AY. Sthana CSC. Chaukhambha Orientalia, Varanasi. Reprint edition, 2004. [Crossref][PubMed][Google Scholar]

6. Trikamji AY. Sthana SSN. Chaukhambha Krishnadas Academy, Varanasi. Reprint edition, 2004. [Crossref][PubMed][Google Scholar]

7. Shingadiya RK, Sapkota YR, Bedarkar PB, Patgiri BJ, Prajapati PK. Efficacy of Ayurvedic Classical and Modified Formulations on Skin Disorders. Rasamruta. 2017:1–17. [Crossref][PubMed][Google Scholar]

8. King BA. Defining severity in alopecia areata: Current perspectives and a multidimensional framework. [Internet]. 2022 Mar 31. Available from: [Article][Crossref][PubMed][Google Scholar]

9. Trikamji AY. Sthana CSV. Chaukhambha Orientalia, Varanasi. Reprint edition, 2004; p. 672 [Crossref][PubMed][Google Scholar]

10. Sharma RK, Bhagwan D, Caraka S. Caraka Samhita. Chaukhambha, Varanasi. Reprint edition, 2018. [Crossref][PubMed][Google Scholar]


J Ayu Int Med Sci 2025;10(2)310
Rushikesh B et al. Management of Indralupta (Alopecia areata) through Ayurveda

11. Motwani M. Ayurvedic management of Indralupta (alopecia areata) with Raktamokshana (Pracchana Vidhi) and Shirolepa. International Journal of AYUSH Case Reports. April–June 2023;7(2). [Crossref][PubMed][Google Scholar]

12. Tripathi B. Ashtanga Hridaya Uttara Tantra. 39/159. Choukhambha Surbharati Prakashan, Varanasi: 2017; p. 1202 [Crossref][PubMed][Google Scholar]

13. Srikantha Murthy KR. Astanga Hrdayam of Vagbhata. Chaukhambha, Varanasi. Reprint edition, 2005. [Crossref][PubMed][Google Scholar]

14. Kirti K. A conceptual study of Jalaukavacharana. World Journal of Pharmaceutical and Medical Research. 2022;8(5):123–125. [Crossref][PubMed][Google Scholar]

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