Holistic management of Alopecia areata (~Indralupta) using Pracchana karma with derma-roller and Ayurveda intervention: A case report

Alopecia Areata (AA) is a prevalent non-scarring alopecia affecting the scalp and other body parts, with an incidence of 0.7% in northern India. Conventional treatments such as corticosteroids can lead to adverse effects such as skin atrophy, pigmentation changes, etc. A 21-year-old male with a history of patchy hair loss and a Severity of Alopecia Tool (SALT-2) score of 66% presented at the Outpatient department. The patient was given a holistic treatment protocol including Pracchana karma (~blood-letting by multiple incisions) with 0.5 mm derma-roller, along with external application of Gunja-Kalihari lepa (~anointment) and internal medications including Brihat manjishthadi kwatha , Kaishora guggulu , etc. The treatment plan was implemented over 100 days, with weekly derma-rolling and daily Lepa application. This case study emphasizes the effectiveness of Ayurveda management in treating Indralupta (~patchy hair loss) or AA, by addressing its underlying pathogenesis. The use of Pracchana karma combined with the Lepa promotes blood circulation and enhances nutrient absorption. Meanwhile, the Ayurveda formulations offer anti-inflammatory and nourishing properties. This integrated approach led to significant improvement in the condition of the patient, resulting in complete hair re-growth and a reduction of the SALT-2 score to 0%. These findings indicate that a holistic approach, including Ayurveda interventions, can be a viable option for managing AA effectively.