Premature Greying of Hair and its Homeopathic Management
Premature greying of hair (PHG) is becoming common in young generation. High-stress levels and pollution are reported to be among major causes in urban region. Greying of hair, scientifically termed as “canities,” is a physiological phenomenon and considered to be a part of chronological aging. Physiologically in white races it occurs at the age of 34.2 ± 9.6 years whereas in black races, the onset is slightly later at 43.9 ± 10.3 years.[1] A cut off age of 25 years was considered in India to be considered as premature ageing.[2],[3],[4] Moustache & beard are usually greying earlier than body and scalp hair. It was reported by Daulatabad et al that mean age of onset of greying of hair was 11.6 ± 3.6 years. The mean duration at the time of presentation was 39.8 ± 37.2 months. Frontal head is more prone to greying of hair in 48.1% cases and in the 75% cases positive family history with an equal prevalence on paternal and maternal sides are responsible.[5] Another cross section observational study had been done on 1400 degree college students between the age group of 18-30 years in the field practice area Karnataka, among them 26% had premature greying of hair. 53% females and 47% males are affected. Exacerbating factors included change/usage of hard water (67%) and emotional stress (22%).Anaemia was found in 11% of patients with premature canities.[6]
Cause and risk factors of Canities[7],[8]
Gene plays very important role for premature greying of hair. Apart from it some other factors like pollutions, water hardness, and deficiencies of trace elements, such as Vitamin B12, Vitamin D3, and calcium may also be associated with PHG. A case control study was conducted at a trichology clinic in India with total 37 patients of PHG and 37 age- and gender-matched controls.For various parameters such as haemoglobin, serum ferritin, zinc, copper, calcium, Vitamin B12, and Vitamin D total of 100 subjects were investigated with their consent. Chi-square test was used to compare proportions between groups. Result shows that patients with PHG had lower Serum ferritin levels and lower serum Vitamin B12 levels. Patients with PHG had significantly lower levels of high-density lipoprotein cholesterol (HDL-C) as compared to control group. Lack of exercise and irregular eating habits are also found in PHG patients.
Aetiopathogenesis of Canities
There are so many reasons that influence the PHG. The exact aetiopathogenetic mechanism causing premature greying is still unclear and largely speculative. Melanocyte activity, defective melanosomal transfers to cortical keratinocytes and melanin incontinence due to melanocyte degeneration are speculated to cause greying of hair. Tyrosinase enzyme helps the initial stages of melanin synthesis. At the mid of age, hair bulb tyrosinase activity gradually peaks and the bulbs of grey or white hairs appear to lack or are deficient in tyrosinase.[9] Recurrent oxidative stress causes death of melanocytes of the hair follicles bringing about normal hair greying but in PHG exhaustion and poor sustenance of the melanocyte stem cell is the suspected reason.[10] Incompletely melanized melanosomes normal numbers of melanocytes are found in PHG under electron microscopy. [11]In grey hair, the pigmentary unit becomes fuzzy, melanocytes are few and rounded, and lightly pigmented oligodendritic melanocytes become detectable in the proximal hair bulb below Auber’s line.Melanogenically inactivity of melanocytes causes resultant pigment loss in greying hair follicles.[12]Flawed melanosomal transfer to the cortical keratinocytes or melanin incontinence due to melanocyte degeneration is also suspected to contribute to greying.
Defective melanosomal transfer to the cortical keratinocytes or melanin incontinence due to melanocyte degeneration is also believed to contribute to graying.
Homeopathic Management[13],[14],[15],[16]
Mostly constitutional remedies are helpful for management of PHG. Small remedies cn be used as incurrent remedy for better recovery in frequent doses. Below remedies are given with individualistic indications. It would help the physician to choose a remedy considering other symptoms too. Further, selection of potency and dosage are more depending on the sensitivity, individual’s response to the remedy, how deep and chronic the condition is, etc., where the role of physician is more.
Acidumphosphoricum: Hair turns grey and falls out early in life. Ailments from grief, general debility, typhoid, loss of vital fluids, etc.Cannot collect his thoughts or find the right word.
Graphites: Hair of vertex, sides and beard turns grey early and falls out, with matted and brittle hair. Bald patches at the beard and chin. It is well suited for fat, chilly, and costive patients, with delayed menstrual history, take cold easily.
Lycopodium: Hair falls out, first on the vertex, later on the temples, especially after diseases of the abdominal viscera and parturition, with hair turning grey early. Greying of hair associated with gastric complaint. Ailment of liver.Headache especially right side. General aggravation afternoon, 4-8 p.m. Desire for sweets, hot food, etc.
Vinca minor: Hair falls out and is replaced by grey hair. Falling of the hair with great itching of the scalp.Eczema of scalp and face, matted hair and offensive odour. A crust is formed, the discharge is retained underneath and causes the hair to fall out or to mat together, forming the plica polonica.
Syphilinum: More suited to the people of syphilitic nature; usually prescribed based on miasmatic presentation of the patient. Profuse hair fall, in spots, with white scaly dandruff and dry scalp associated with greying of hair.
Sulphur: Premature hair greying with dry, cold and hard scalp, worse washing. Scalp sore to touch, itching violently, and worse in the evening, when getting warm in bed. Alopecia with dandruff.Desire for sweets.General aggravation and aversion from bath.
Sepia: Hair greying after pregnancy, chronic headache, irregular menstruation. More suitable to weak women with yellow complexion, bearing down sensation and tendency to abortion.Feeling of goneness in stomach especially 11-12 a.m.; not relieved by eating.
Natrum muriaticum: Premature greying of hair in pateintshave history of grief, grief, fright, anger, or prolonged taking of excessive salt. The hair falls out when touched, especially in nursing women. Falling of hair from lack of nutrition. Hair falls out when merely grasped, most on bregma and temples, but also on beard and genitals.
Drugs for external application
| Acidumsalicylicum 1x | Used externally as 5% solution to treat hair falling and dandruff. |
| Arnica montanaØ | It has repute for years as a means of stopping the falling of the hair. It produces an extraordinary growth of hair when used locally. |
| BerberisaquifoliumØ | Externally useful in cases of hair fall due to fungal and bacterial infection. |
| Cantharis Ø | Hair falls out in bunches, spots when combing, especially during pregnancy and lactation. Scales on scalp, enormous dandruff with stiff hair. 10% solution is used. |
| CardiospermumØ | Alopecia due to eczema and psoriasis. |
| CeonothusamericanaØ | It is used locally as hair tonic. |
| CochleariaarmoraciaØ | A useful remedy in dandruff when applied locally. |
| Jaborandi Ø | It is claimed to have a favourable influence in cases of alopecia. If continued over a prolonged period it restores the original colour of grey hair, so that helpful in premature greying. |
| Salvia officinalis Ø | Externally used for premature greying. |
References
[1] Keogh EV, Walsh RJ. Rate of greying of human hair. Nature 1965;207:877-8. PubMed
[2] Tobin DJ, PausR. (2001). Grayinggerontobiology of the hair follicle pigmentary unit. ExpGerontol, 36(1), 29-54
[3]Pasricha JS, Verma K. Diseases of the appendages. In: Treatment of Skin Diseases. 5th ed. New Delhi: Mehta Publishers; 2008. p. 289
[4]Sonthalia S, Priya A, Tobin DJ. Demographic characteristics and association of serum Vitamin B12, ferritin and thyroid function with premature canities in Indian patients from an urban skin clinic of North India: A retrospective analysis of 71 cases. Indian J Dermatol 2017;62:304-8
[5]Daulatabad D, Singal A, Grover C, Chhillar N. Profile of Indian patients with premature canities. Indian J DermatolVenereolLeprol 2016;82:169-72.
[6]Bhramaramba TS, Belagola D Sathyanarayana, MukundaRangaSwaroop, Yogesh Devaraj, Raghavendra JC, Monica Dukkipati, Priyanka Kumari. A Clinicoepidemiological Study Of Premature Canities Of Degree College Students In The Rural Area. International Journal Of Advances In Case Reports, 2016;3(14):489-493.
[7]SwagataChakrabarty, Prafulla G Krishnappa, Dinesh G Gowda, and JyothiHiremath. Factors Associated with Premature Hair Graying in a Young Indian Population. International Journal of Trichology. 2016 Jan-Mar; 8(1): 11–14.
[8]Ramesh M Bhat, Rashmi Sharma, Anita C Pinto, SukumarDandekeri, and Jacintha Martis.Epidemiological and Investigative Study of Premature Graying of Hair in Higher Secondary and Pre-University School Children.Int J Trichology. 2013 Jan-Mar; 5(1): 17–21.
[9]Commo S, Gaillard O, Bernard BA (2004) Human hair graying is linked to a specific depletion of hair follicle melanocytes affecting both the bulb and the outer root sheath. Br J Dermatol 150: 435–443.
[10]Arck PC, Overall R, Spatz K, Liezman C, Handjiski B, et al. (2006) Towards a “free radical theory of graying”: Melanocyte apoptosis in the aging human hair follicle is an indicator of oxidative stress induced tissue damage. FASEB J. 20: 1567-1569.
[11]Kukita A, Fitzpatrick TB (1955) Demonstration of tyrosinase in melanocytes of the human hair matrix by autoradiography. Science. 121:893-894.
[12]Horikawa T, Norris DA, Johnson TW, Zekman T, Dunscomb N, Bennion SD, et al. DOPA-negative melanocytes in the outer root sheath of human hair follicles express premelanosomal antigens but not a melanosomal antigen or the melanosome-associated glycoproteins tyrosinase, TRP-1, and TRP-2. J Invest Dermatol 1996;106:28-35.
[13] W. Boericke, New Manual of Homeopathic Materia Medica& Repertory [with Relationship of Remedies], Second Re-Augmented & Revised Edition Based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
[14] A. L. Blackwood, A Manual of Materia Medica, Therapeutics and Pharmacology, Reprint Edition 1995, B. Jain Publishers, New Delhi
[15] T. F. Allen, Encyclopaedia of Pure Materia Medica, B. Jain Publishers, New Delhi.
[16] HERING’S GUIDING SYMPTOMS of our Materia Medica By Calvin B. Knerr, M. D. B Jain Publishers Pvt Ltd; New Delhi