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Alternative
treatments
Once the classic treatments of dermatologists are exhausted a
number of people turn to the use of alternative treatments. Some
of these therapies are recommended by the more experimental dermatologists
or by alternative practitioners. Usually very little is known about
alternative treatments in relation to their effects on alopecia
areata hair loss. Most alternative treatments are not reported in
the medical literature. A wide range of alternative treatments are
being used by people with alopecia areata. Their rate of success,
if any, is unknown as no trials have been conducted. A list of alternative
treatments reported to me is posted below for your interest but
I make no claims to their safety or effectiveness.
1) Stress reduction. There have been anecdotal claims for success
in remission of alopecia areata by using stress relaxation, hair
massage and even monetary reward as a psychological influence
(Putt 1994), hypnotherapy (Harrison 1991) and by acupuncture (Ge
1990).
There
is even a patent held on the treatment of alopecia areata by acupuncture
(1994).
2) Aloe vera. Known for its soothing anti-inflammatory properties
topical aloe vera cream and aloe vera in solution for oral intake
has been used by some with alopecia areata in an attempt to reduce
or remove the hair follicle inflammation. A quick look in the medical
journal database for articles on aloe vera suggests that this plant
extract contains a complex set of chemicals with the ability to
suppress AND stimulate the immune system in a number of ways. There
are reports on clinical trials, of varying quality, suggesting aloe
vera may have a positive effect in wound healing, immune stimulation,
anti-cancer and anti-viral effects. There is also a recent report
on its use in psoriasis treatment. It doesn't look like we know
much on how it works but aloe vera does induce nitric oxide production,
probably from macrophages, and aloe vera contains superoxide dismutases.
Both these substances have been implicated as possible simulators
of hair growth in androgenetic alopecia. Aloe vera contains a potential
anti-inflammatory mannose-6-phosphate. It contains acemannan which
apparently stimulates macrophages to produce cytokines IL-6 and
TNF-alpha, and acts as an antiviral by stimulating T cytotoxic cells.
3) Poison ivy. Poison ivy has been tried by one or two people.
It is a potent contact sensitizing chemical. However, comments suggest
that the results were not good. The dermatological contact sensitizers
are a better bet.
4) Melatonin. Melatonin has been used by some people with alopecia
areata. Melatonin seems to be the popular cure-all of choice at
the moment but several reports suggest that melatonin could have
quite adverse effects on people with alopecia areata. Overall, research
suggests that taking melatonin may actually exacerbate alopecia
areata if it is an immune mediated condition.
Melatonin is produced naturally in the pineal gland and the pineal
gland is under serious investigation as one of the main organs involved
in the process which converts environmental light changes into an
endocrine response. In short, the neurohormone melatonin provides
day length information to our bodies. In response to daily and seasonal
light changes there is a detectable melatonin/circadian rhythm.
Melatonin, along with norepinephrine and acetylcholine are suppressed
by visible light exposure while cortisol, serotonin and dopamine
levels increase. Subsequently there is a daily rhythm of melatonin
production with build up during darkness and suppression of melatonin
production during daylight. Melatonin build up after sundown can
be dissipated by sleeping. The need for sleep after taking melatonin
pills is believed to be our body's feedback response designed to
control melatonin levels and stop the neurohormone from becoming
too concentrated in our systems.
Melatonin has immunostimulatory/immunoenhancing properties. A
high affinity receptor binding site for melatonin has been found
on T helper lymphocyte cells providing a direct link between melatonin
levels and immunosensitivity. Melatonin activates these T lymphocytes
into production of cytokines and this cascade of chemical signals
recruits other immune cells and makes them more responsive (Maestroni
2001). One of the key targets for melatonin is the thymus as the
central organ of the immune system.
Melatonin treatment is being considered for its anticancer properties
and for counteracting immunodepression that may develop during stress,
viral infection, other drug treatments and aging. Corticosteroids
have been shown to reduce the number and function of melatonin binding
sites as part of their immunosuppressive properties (Poon 1994).
5) Sunlight. Some people with alopecia areata suggest simple exposure
to sunlight can help hair regrowth. There may be some validity in
this. At its simplest, sunlight includes UV radiation. UV light
is known to reduce the numbers of immune cells in the skin. Indeed,
UV light is regularly used in the dermatology clinic for treating
psoriasis and alopecia areata. Of course UV light exposure also
increases the risk of developing melanoma skin cancer. Excessive
exposure to UV light results in sunburn. This physical damage to
the skin results in mild inflammation. Sunburn is effectively causing
an irritant effect. Sunburn may act to promote hair growth in the
same way as chemical irritants used in the dermatology clinic.
There are of course seasonal changes in daylight intensity and
time period. With the reduction of daylight exposure in winter there
is believed to be an overall increase in melatonin production and
comparative decrease during summer months. Our ancestors may have
needed this melatonin boost in winter to help protect us from the
increased stress of low temperatures and lack of food. This would
suggest a generally less responsive immune system in summer which
may in part account for the seasonal growth and loss of hair some
alopecia areata affected people experience.
We must also consider day length changes with the latitude of
where we live. The autoimmune disease multiple sclerosis is more
common in temperate latitudes - less so closer to the equator. One
hypothesis put forward for this disparity is the immunosuppressant
effects of sunlight mediated by melatonin. The overall reduced levels
of natural light and intensity in higher latitudes may lead to higher
levels of melatonin. Subsequently this may result in a more responsive
immune system and make people more susceptible to development of
autoimmune conditions (Hutter 1996). We don't know enough about
regional variations in alopecia areata expression to know if there
is a greater frequency in temperate latitudes.
6) Heat treatment. Excessive heat treatment may act much like
sunburn. The physical damage to the skin will induce inflammation
and promote hair growth in the same way as chemical irritants used
in the dermatology clinic.
7) Zinc supplements. We might describe zinc supplements as a pseudo
alternative treatment as zinc sulfate has been used in several treatment
trials for alopecia areata. However, the trials were all conducted
in Europe and mostly published in non-English language medical journals
and this means the work is not widely known in the USA. Several
analyses reports on zinc concentration in the blood serum of people
with alopecia areata suggested a zinc deficiency. Some dermatologists,
particularly in Germany and Russia, use zinc supplements in addition
to other treatments. The belief is that the zinc acts as an immunomodulator
and helps correct an imbalance in the immune system. Note that taking
too much zinc is toxic and can have serious health consequences.
8) Mustard seed/Capsicum poultice. The use of these products to
treat alopecia areata has been with us for a few thousand years.
They are a simple method of applying an irritant to induce dermatitis
and promote an inflammatory response. Despite being around for a
long time these products have never been scientifically tested for
their actual success rate in promoting hair growth.
9) Vitamin supplements/creams. Vitamins are important in hair
growth and certain vitamins such as vitamin E are known to exert
an immunomodulatory effect on the immune system. Some people have
attempted to use topical or oral applications of various vitamins
to treat alopecia areata. The actual effects on alopecia areata
are unknown. There are no published studies on diet and alopecia
areata hair loss. Note some vitamins are toxic in high concentrations.
Vitamin overdose can in itself cause diffuse hair loss.
10) Asprin poultice. Asprin has an immunomodulatory effect.
Asprin in solution has been applied to the scalp skin in an attempt
to reduce
hair follicle inflammation. The success rate has not been studied.
11) Dimethylsulfoxide (DMSO). DMSO is a hydroxyl radical scavenger
and antioxidant. In theory it has the potential to protect cells
from hydroxyl radical mediated radiation damage (Dod 1968). Neutralizing
the hydroxyl radical reduces inflammation and may be the primary
mechanism of action allowing DMSO to work in immune disorders. DMSO
reacts with the hydroxyl radical (OH) to form a methyl radical (CH3)
which is much less reactive than the hydroxyl radical.
DMSO may also be used as a carrier of drugs and other compounds
through the skin. Low molecular weight compounds when dissolved
in DMSO and applied to the skin are readily carried into the systemic
circulation. In various trials, DMSO has been used as a carrier
for antibiotics, corticosteroids, anti-inflammatory agents and essential
fatty acids. The key side effect of DMSO treatment is the characteristic
garlic-like smell of the breath. DMSO is metabolized to DMSO2 (dimethylsulphodioxide)
and DMS (dimethylsulphide) in the body. The kidney excretes DMSO2
in the urine. The lungs excrete DMS, which gives breath a characteristic
garlic-smell, that can last for up to 72 hours. Other side effects
involve erythema, itching, and urticaria. Concern has also been
expressed over the potential for DMSO to cause cataracts.
12) Homeopathic treatment. Your doctor will be able to tell
you what form of alopecia you have. The clerk at your local health
food
store should be able to give you a good description of the principles
of homeopathic remedies, and so can your local homeopathic doctor.
Alopecia areata stemming from depression and stress is apparently
typically treated with a homeopathic remedy called "Phosphoricum
acidum" available
at most local health food stores. Phosphoricum acidum in a 1x
potency
is used by taking 1 granule 3 times a day, and as soon as there
is any hair regrowth the treatment is stopped. This is not a
cure
but a treatment. Alopecia areata is generally recurrent, but when
new patches form, the treatment is restarted. Apparently it
is important
not to touch the granules. You put them in your mouth directly
from the lid of the container, otherwise their medicinal qualities
will
be annulled. Sounds bizarre to me, but that is homeopathy for
you.
13) Herbs. Chinese doctors often prescribe herbs for alopecia
areata. A treatment literally called the "alopecia areata pill"
or sometimes "Trichogen" is available from some Chinese pharmacists.
The listed contents on a bottle I obtained are 20% Radix Polygoni
Multiflori, 10% rehmannia
glutinosa, 10% radix et rhizoma rehmannia, 10% radix angelicae
sinensis, 10% radix salvia mittiorrhiza bge, 10% radix paeoniae
lactiflorae,
10% fructus schizandrae, 10% codonopsis pilosula, 5% fructus chaenomelis,
5% rhizoma notopterygii. Apparently the key ingredient here is
the
herb Radix Polygoni Multiflori. This herb may also be known as "Fo
Ti" or "Sho Wu".
14) Evening primrose oil (EPO), borage and black currant oil.
Evening primrose oil (EPO) is a source of omega-6 essential fatty
acid (EFA) as are borage and black currant oil. Black currant
oil has a considerably greater concentration of omega-6 than
EPO. There
are reports on work using EPO, borage, and black currant oil in
treating autoimmune conditions in humans or animals including,
psoriasis,
glomerulonephritis, lupus, rheumatoid arthritis, and diabetes.
Overall, there does seem to be some indication that these oils
have a mild
immunosuppressive effect although the long term benefits have
been brought into question. It seems that the active ingredients
are the essential
fatty acids. No one has truely identified what the specific product(s)
is/are and the experiments could not be described as definitive
proof in any way, although gamma-linolenic acid (GLA) is most
frequently mentioned. How it works has not been described in
much detail but
may have something to do with incorporation of fatty acids into
cell membranes and the activity of products from fatty acid breakdown
such as eicosanoids.
15) Flax seed oil, linseed oil, fish oil. Omega 3 is manufactured
in plants such as green algae. It is popularly taken in the form
of linseed oil or fish oil. Fish do not actually make these fatty
acids. The fish eat algae and consequently accumulate high concentrations
of omega 3 fatty acids. Some evidence is available about the beneficial
effects of omega 3 fatty acids in diseases such as cancer, Alzheimer's
disease, and autoimmune conditions. Omega 3 has an anti-inflammatory
effect and has been investigated for its beneficial effects in
treating
rheumatoid arthritis, systemic lupus erythematosus, and ulcerative
colitis. How omega 3 might work has not been investigated in
detail, but it may
revolve around its effects on arachidonic acid and eicosanoid synthesis.
Aromatherapy
In 1998 double-blind study published in the Archives of Dermatology
(Hay 1998) found that 44 percent of participants who massaged their
scalps with a mixture of essential oils daily for seven months showed
growth in bald patches. The tonic was composed of active essential
oils described.
2 drops thymus vulgaris (88-mg)
3 drops lavandula angustifolia (108-mg)
3 drops rosmarinus officinalis (114-mg)
2 drops cedrus atlantica (94-mg)
and used the carrier oils:
jojoba oil 3-ml
grapeseed oil 20-ml (NOT grapefruit seed oil)
While the original paper gives only limited detail about the nature
of the essential oils other scientists have given more detailed
recommendation to keratin.com. There are several different "chemotypes"
for the essential oils used in the original study. Specific recommendations
include:
For rosemary : Rosmarinus officinalis CT cineole
For thyme: " sweet thyme " such as Thymus vulgaris CT thujanol or
linalol or geraniol or terpineol (but never " red thyme " such as
Thymus vulgaris CT thymol which is pretty caustic for the skin)
For cedarwood: Cedrus atlantica (which is not Texas cedarwood. Under
this generic name, Juniperus species are safe, but never use Thuya
species)
In the published study 86 volunteers with alopecia areata massaged
oils into the scalp each evening for a minimum of 2 minutes; followed
with warm towel wrap to aid absorption of oils for about an hour.
Half of them received the complete tonic and half of them received
the carrier oils alone as a control.
The results were that 19 (44%) of 43 patients in the active group
showed improvement compared with 6 (15%) of patients in the control
group (P = .008). An alopecia scale was applied by blinded observers
on sequential photographs and was shown to be reproducible with
good interobserver agreement.
The investigators concluded that the results showed aromatherapy
to be a safe and effective treatment for alopecia areata. Treatment
with the essential oils was significantly more effective than treatment
with the carrier oil alone.
Alternative
treatments references
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GJ. The immunotherapeutic potential of melatonin. Expert Opin
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PD. Hypnosis in dermatology. Arch Dermatol. 2000 Mar;136(3):393-9.
- Hay IC,
Jamieson M, Ormerod AD. Randomized trial of aromatherapy. Successful
treatment for alopecia areata. Arch Dermatol 1998 Nov;134(11):1349-52.
- Kalish RS. Randomized trial of aromatherapy:
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- Maestroni GJ. MLT and the immune-hematopoietic
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- Camacho FM, Garcia-Hernandez MJ. Zinc aspartate,
biotin, and clobetasol propionate in the treatment of alopecia
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sunlight, diet, immunology and aetiology. Med Hypotheses. 1996
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