Alopecia of Nutrition and Metabolic Origin

Hair is affected early in protein deficiency, since protein is conserved for more essential purposes. Malnutrition influences the structure of the hair shaft and, sometimes, the color of the hair. Short-term experimental protein deprivation causes atrophy of the bulb and loss of internal and external roots sheaths but no changes in the anagen: telogen ratio, although these would probably develop if the protein deprivation were continued. Following are some of the Nutritional Conditions with homeopathic remedies for their treatment.

Marasmus

Marasmus is the result of protein-calorie deficiency, usually in the first year of life. The hair is fine and dry; the diameter of the hair bulbs is reduced to a third of normal and almost all follicles are in telogen. Kwashiorkor occurs during the second year of life in children suddenly weaned to a diet very low in protein and high in carbohydrate. The hair changes are grossly similar to those in marasmus, but there are more anagen follicles although most are atrophic. The differences between the findings in these two states of malnutrition may be related to .the degree and rapidity of protein deprivation. In both states the hair is brittle and easily shed, and partial or complete alopecia may occur; the hair is lusterless and if normally black, may assume a reddish tinge. Many hair shafts may show constrictions, which increase their vulnerability to trauma. Hair cuticle changes that are observed in the electron microscope appear not to contribute usefully to nutritional assessment.

Surveys of hair-root morphology may provide a simple and inexpensive way of assessing the nutritional status of a community, but root changes reflect only relatively gross differences.

Homoeopathic Remedies: Abrotanum, Nat Mur, Cal Carb, Iodine, Phosphorous, Sulphur

Iron Deficiency

Iron deficiency is occasionally associated with diffuse alopecia, even in the absence of anaemia. The association is often difficult to prove because it is not always easy to evaluate other possible factors, but in some cases the apparent response to the administration of iron is convincing.

Homoeopathic Remedies: Ferrum Met, China, Ferrum Phos, Nat Mur

Zinc Deficiency

Zinc deficiency resulting from a failure in absorption gives rise to alopecia and cutaneous changes in acro­dermatitis enteropathia. Zinc deficiency may result from prolonged parenteral alimentation with erythema, scal­ing, bullae and hair loss. Parenteral alimentation may also cause deficiency of essential fatty acids. This results in erythema, scaling of the scalp and eyebrows and diffuse alopecia. The remaining hair is dry and unruly, but this may be reversed by the topical appli­cation of safflower oil.

Homoeopathic Remedies: Zinc Met

Metabolic Disorders

Defects of hair growth occur in certain metabolic disorders but the alleged finding of arginosuccinic acid in the urine of patients with monilethrix has been proved to be due to technical error, and a similar finding claimed in other defects of the hair shaft requires confirmation. Changes resembling trichorrhexis nodosa have been more reliably related to arginosuccinic aciduria.

In homocysteinuria, which is an inborn error in the metabolic pathways of methionine, the hair is sparse, fine and fair. It appears normal on microscopy but shows an orange-red fluorescence when stained with acridine orange and examined under ultraviolet light. Affected children are mentally retarded, have a shuffling duck-like gait, a malar flush and a wide variety of skeletal defects.

In hereditary orotic aciduria, which is a rare inborn error of pyrimidine metabolism characterized by re­tarded physical and mental development and macrocytic anaemia, the hair is fine, short and sparse.

A genetically determined defect in the iricorporation of histidine, tyrosine and arginine into hair keratin has been found in a syndrome in which dry, lusterless, tightly curled hair is associated with flat, fragile dys­trophic nails and enamel hypoplasia of the teeth.

Homoeopathic Remedies: Tuberculinum, Sulphur, Cal Carb, Lycopodium, Carcinosin

01 Feb 2010