Hair fall/ khalitya
Sushruta states that Pitta Dosha along with Vata by involving the roots of the hair (Romakoopa) causes the fall of hairs and thereafter Kapha along with Rakta obstructs the channel of Romakoopa leading to the stoppage of the regeneration of the hair and this condition is known as Indralupta, Khalityaor Ruhya.
Acharya Charak mentions that Tejas involving Vatadi Dosha when scorches up the scalp result in Khalatiya. According to Chakrapani word Tejas here denotes Dehoshma as well as Pitta Dosha (Chakrapani – Ch. Chi. 26/132-133).
Madhava Nidana: Based on the foregoing, it may be said that gradual loss of hair from the scalp is known as Khalitya,
Kartika further differentiated Khalitya, Ruhya, and Indralupta. Indralupta is a hair loss from beard and mustaches, Khalitya is a condition in which hair loss occurs only in the scalp and Ruhya is the entity in which hair loss occurs all over the body (Kartika in Madhukosha commentary on Madhava Nidana 55/28-29).
SYNONYMS OF KHALITYA
Genesis Of Hair/Kesh
- In Ayurveda before the development of placental circulation garbh poshan is done by Lomakoopa. In modern science, there is a small Hair developed in a fetus. It’s called ‘lanugo’. As per modern science, there is no relation between lanugo in fetal circulation.
- According to Charak the Kesho Patti Kal in a fetus is at the seventh month of gestational age. (Ch. Sa. 8/32). While according to Vagbhatta it is six months (A.S. Sa. 2/24).
- The Mala of Asthi Dhatu is Kesha & Loma, which are related to Swedavaha. The Asthi Dhatu has emerged from Meda Dhatu. The Prasada portion and the Kitta portion are differentiated and the Kitta portion of it is Kesha or hair. (Su. su. 16/36, Ch. Chi. 15/19, A.H. Sa. 6/63-64).
KESHA IN RELATION TO PRAKRUTI
The nature of Kesha has been related to different types of Prakruti of persons which are described hereunder in each major Prakruti & Sara.
- Vata Prakruti:- According to Charak, Vata Prakruti persons have rough hair on the head, face & body. Acharya Sushruta states that person of Vata Prakruti has often rough and gristly bread, mustache, fingernails, and hair. Other classiscs statsthat Vata Prakruti person have Sphutit, Dhusara (grey/ dusty) colored hair and in small number.
- Pitta Prakruti:- According to Charak, Sushruta & Sharangdhara Pitta Prakruti people have early wrinkles, grey hair, and baldness and they have possessed generally scanty, soft & tiny hair on the head, face & body. Vagbhatta mentioned that the color of the Kesha is Pingala and in a small number of Roma in Pitta Prakruti.
- Kapha Prakriti – Sushruta, Vagbhatta & Sharangdhara mentioned that the person of Kaph Prakruti has trim, fleshy, curly, Snigdha and dark black color of Hair.
IMPORTANCE OF THE HAIR
Protective aspect –
- Hair is to protect against heat loss.
- It traps air adjacent to the skin and thus it provides an invisible insulating layer.
- Hair such as eyebrows and eyelashes protects that particular organ and related system from foreign particles, bacteria, etc.
- Its fiber may also increase the surface area for faster evaporation of sweat from neighboring apocrine glands.
- Some Hair follicles have a highly developed nerve network around them, which plays a pivotal role in providing sensory and tactile information about the environment.
- The Hair also does the tactile receptor functions. Hair serves a sexual function in promoting the evaporation of the apocrine sweet and the accompanying characteristic odor that goes along with it provides a sexual attraction for the lower animal.
- In some animals, the air within the medulla plays a role in the regulation of body temperature
Cosmetic aspect –
- To make the human personality attractive – is now in focus.
- Hair styles are used to make a statement, to identify the individual with a particular function of society.
NIDANA PANCHAKA OF KHALITYA
The examination of a disease, a person should be done by Darshana, Sparshana, and Prashan, whereas that of the disease by Nidan (etiological factors) Purva Rupa (premonitory signs and symptoms), Rupa (Signs and symptoms), Upashaya, and Samprapati (pathogenesis). Thus, to understand the disease Khalitya above five factors would be described.
Hetu (Etiological Factors):
Nowadays, Women also go outside & work. Working women have fast schedules so they eat fast food. This results in malnutrition, low Hb levels, low Calcium levels, & low Protein level causes many problems it directly reflects in the loss of hair. Uses of synthetic shampoos & other chemicals that damage the luster of the hair. Due to all these reasons, one out of two women suffer from hair problems. They take Junk food & Miscombination of food intake Akalabhojan, overeating –Adhayashana, Spicy and Oily food –Ushana, Tikshna Ahara, etc.
All the above factors and malnutrition, Poor Hygiene imbalance of Sleep, Stress & Pollution play a major role in Rakta Dusti Which leads to especially Keshashatan (Hair falling).
Any substance or factor which is responsible for the disease it’s known as a causative factor. In Ayurveda various factors imbalance the state of equilibrium of Doshas. This ultimately leads to creating a suitable situation for various diseases. These factors are considered Nidan/Hetu (Etiological factors).
There is no clear description regarding the causative factors of Khalitya, but by analyzing the explanation of the pathogenesis of the disease and by collecting the scattered reference from Ayurvedic texts, an indirect knowledge of etiological factors may be acquired.
Khalitya is put on under the Khudra Roga. Acharya Vagbhatta described them in Shiro Roga and these are further subdivided into nine Kapala Vyadhi, Khalitya being one of them. There is no separate mention of the specific causative factor of Khalitya but the general etiological factors of Shiroroga can be considered as a cause of Khalitya.
In addition to this, Acharya Charak has mentioned various factors which vitiate Vatadi humor by which Shirogata Rakta also gets vitiated and gives rise to different Shiroroga. According to Vagbhatta, Khalitya comes under the roof of Shiroroga. So, the etiological factors mentioned by Acharya Charak can be understood as that of the disease Khalitya. (Ch. Su. 17/8-14; A. H. Ut. 23/1-2)
In Vimanasthana, Charak has described the disorders occurring due to the over intake of Kshara, Lavana, and Viruddha Ahara. This mentions the occurrence of Khalitya as a consequence of it.
It has been mentioned that the Viruddha Ahara-like, simultaneous intake of Lavana (salt) with milk in the diet induces Khalitya 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 Aahara in routine is prone to have Khalitya. (Ch. Vi. 17- 19)
Causative factor of Khalitya as per Ayurvedic text described as below:
|Ahara Janya Nidana||Vihar Janya Nidana||Manas Janya|
|Atilavan Sevan||Ati vyayam||Atichintan (thinking)|
|• Atikshara Sevan||• Raja||• Chinta (tension)|
|• Guru Bhojana||• Dhoom||• Krodha (anger)|
|• Shit Bhojana||• Atap||• Bhaya|
|• Atisnigdha Bhojana||• Tushar (hima)||• Shoka|
|• Atti matra Bhojana||• Ambukriya|
|• Atti Madhya pan||• Atiswapana|
|• Vatik ahar Sevan||• Atijagaran|
|• Adhik japan||• Atisweda|
|• Ama||• Baspa Nigraha|
Purvarupa is the premonitory symptoms of the disease, which are observed before the complete manifestation of the disease.
The vitiated Doshas getting Sthanasamshraya in their respective Dhatus presents some of the symptoms which are known as Purvarupa.
In the case of Khalitya, no specific Purvarupa has been described. According to Ayurvedic literature, in such cases appearance of the symptoms in a very mild form may be considered Purvarupa. In this way, occasional loss of some hairs may be considered Purvarupa of Khalitya.
Hetu, Linga and Aushadha are the Trisutra of Ayurveda. Linga is the synonym of Rupa. In medical science, it’s very necessary to know about the Symptomatology of the disease. The prognosis of the disease is depending upon the severity of the symptom.
Vitiated Dosha creates various signs and symptoms according to their constitution according to the Prakruti of disease which is called Rupa. So far as Rupa of Khalitya is concerned very little explanation is found in Ayurveda classics. Thus the cardinal symptom of Khalitya is gradual loss of hair. Ashtanga Samgrahakara has classified Khalitya into four types’ viz. Vataja, Pittaja, Kaphaja and Sannipataja Khalitya. Though Khalitya is a Tridoshajavyadhi its type depends on the dominancy of individual Dosha. Rupa of Khalitya according to its type are as follows:
Types of Khalitya
- Vataj– Aganidagdhasaman(Appear like burned skin), Shyava- Aruna varna(blackish)
- Pittaj – Pitta-Neela-Harita varna, Siravyapta(surrounded by veins), Swedukta(sweat all over the scalp)
- Kaphaj Khalitya Ghana(thicked), Swetabha(whitish), Snigdha(oily)
- Tridoshaj– Tridosha laxana, Nakhaprabha(scalp looks like bears nail), Daha(burning sensation), Kesharahita
Upasaya means Aaushadha (Medicine), Ahara (Diet article), and Vihara (Physical Habitats) which help in the removal of disease and which is also Satmya for Purusha. (Good for person) and just opposite it is Anupasaya.
Upashaya is the fourth factor of Nidan Panchak which is also required for knowledge of the disease. It is also useful in the differential diagnosis of the disease.
In the case of Khalitya, no specific homologation or unhomologatory diet or drugs have been mentioned. According to Acharya Charak (Ch. Ni. 1) the diet, drug, or behavior, which are opposite to the etiological factor of the disease and which do not deteriorate the latter can be considered Upashaya. Thus, the diet, drugs, and behavior, which are antagonists to Vata Dosha, Pitta Dosha, and etiological factors can be considered as Upashaya in Khalitya.
There is no clear-cut description of Pathyapathya of Khalitya in Samhitas, but as the disease, Khalitya is related to Shiroroga, Twakavikar, Rakta Vikara, and Dhatukshayajanya or due to Mansik nidanjanya (psychological disturbance). Rasayana, Rakta Dosha Prashamana, Vayasthapana, Twachya, and Madhya dravaya help prevent the Khalitya.
Dravyas in Pathya, are as follows:
Ahara ( Diet)
|Dhanya (Millets)||Godhuma, Yava, Shali, Mudga||Bajari, Adad (masa), Kodaraka, Nispav,|
|Shaka Varga||Jivanti, Kushmanda, Patol, Kakadi, Karavellaka, Tomato, Onion, Lauki and Patrashaka, Dhanyak, Krishmanda, Metika, Palak, Galaka (Dhamargava), Karvellaka, Turiya (Krutavedhan).||Chilly, Potato, Vrintak (brinjal)|
|Taila Varga||Tila Taila, Sarashapa Tail, and Coconut Oil For external and internal Use.||Ground Nut Oil, Vegetable Ghee|
|Fruit||Amalaki, Dadima, Matulunga, Amraphala, Narikel, Kadaliphala, Draksha, Kashmari, Chiku, Sitafala, Singoda, Apple.||–|
|Others||Milk, Sugar, Honey, Jirak, Haridra.||Kshar, Prickle, Lavan, Madhyapan, Egg, coffee, Dahi, bakery item|
|Sarvangasana||Excessive exercise||Cold drinks|
|Karna Purana||Ahankara||Ratri Jagarana|
|Padatal Abhyanga||Lobha||Nidra Viparyaya|
The Samprapti of a disease refers to the process by which the vitiated Doshas react with Dushyas and produces Kriyatmaka and Rachanatmaka changes in the target organ leading to the manifestation of a disease. Otherwise, the process of manifestation of the disease is known as Samprapti. In Samprapti – Nidana is the efficient cause, Dosha is the material cause, and Dosha – Dushya Sammurchana is the essential cause.
- Charak:-Teja with help of Vatadi humor scorches the scalp and produces Khalati in a person (Ch. Chi. 26/132). According to Acharya Charak, Vata and Pitta are the main Dosha for causes of Samprapti.
- Sushruta – The Pitta, provocative by its factors penetrates the Romakoopa and there it unites with the Vata and disturbed the hair growing process. Then the Shleshma along with the Shonita obstructs inthe Romakoopa, to prevent the growth of new hair from that place. (Su. Ni. 13/32-33)Thus, Acharya Sushruta has considered the involvement of all the three Doshas viz. Vata, Pitta, and Kapha along with Shonita in the occurrence of Khalitya.
CHIKITSA SIDDHANTA( Treatment Protocol)
A specific line of treatment has been adopted for all diseases in ancient Ayurvedic texts, especially in Charak Samhita. Such a line of treatment for a disease is also called Chikitsa Siddhanta.
The line of treatment of Khalitya mentioned by different Acharya is as under:
Acharya Charak says that after adequate Samshodhana patients of Khalitya should be subjected to Nasya, massage of oil, and Shirolepa.
The therapeutic measure adopted by Ashtanga Samgrahakara coincides with that of Charak and Sushruta. He advises adopting regimens of Indralupta and Palitya in Khalitya along with the administration of Samshodhana as per Dosha. He suggests another method for the Raktamokshana by scratching the scalp either by Suchi, Kurchika, or by rough leaves before application of Lepa. After Snehana, Swedana and Asravana, Acharya Vagbhatta advises to give Nasya.
The common management can be divided as follows:
- Rasayan and Keshya Dravya
HAIRCARE IN AYURVEDA
- Moordha Taila: Oil is regularly applied on the head (scalp); it is called Moordha Taila. Adoption of this procedure in routine makes the scalp revitalized, keeps hair healthy, black and firm rooted, induces sleep, and keeps away Khalitya and Palitya (Ch. Su. 5/
- Nasya:- It has been described in Charak Samhita that the administration of Nasya at the proper time with the proper method keeps the eyes, ears, and nose of the person healthy. The hair of that person does not turn gray and he does not suffer from Hair falling. His hair growth is also accelerated. (Ch. Su. 5/57-58). Nasya In Ayurveda it is said that Nose is the gateway of the Cranial cavity and it is also said that all diseases of the Supraclavicular region can be treated by Nasya karma (A.H.SU.20/1) In Ayurveda classic, we can say that Nasya is the best therapy for Keshashatan.
- Snana:- According to Acharya Charak, Snana is a pious, vitalizer, aphrodisiac, and expeller of fatigue, sweat, harmful things, etc. from the body and an enhancer of life. (Ch. Su. 5/25) Acharya Sushruta has given some additional information about Snana in the context of hair fall that the head and Hair should not be washed with hot water or with very cold water. He adds that bathing should be done according to season and geographical distribution, but the overhead bath with hot water should be avoided always. (Su. Chi. 24/57-61) Acharya Vagbhatta adds that pouring warm water over the body increases the strength but the same over the head makes for a loss of strength in the Hair and eyes. (A. H. Su. 2/17)
- Dhoomapana:- In Charak Samhita, on the topic of Dinacharya, the benefits of Dhumapana are described. Along with other benefits, it is said to cure the Khalitya and Palitya, further, it also improves the health of the head and senses. (Ch. Su. 5/30-31). According to Acharya Sushruta inhalation of medicated firms improves the firmness of hair on the head, beard, and teeth. (Su. Chi. 40/15)
- Kshaurkarma: According to Acharya Charak, Hair cutting (Kalpana) and proper tying (Samprasadhana) of hair of scalp and beard should be done regularly. (Ch. Su. 5/99) Acharya Sushruta says that the management of hair (Kesha Prasadhana) should be done with Keshaprasadhani (combs and brushes). It is also said that it is Kesha and aborter of Raja, Mala, and Jantu, etc., and increases the beauty of Hair. Acharya adds that by regular cutting of hair a person may achieve vigor, happiness, lightness, good look, etc. (Su. Chi. 24/73) According to Acharya Vagbhatta, one should not allow the Hair, nails, and mustaches to grow long. (A. H. Su. 2/31)
- Ushnisha:- The wearing of Ushnish (turban) on the head protects the Hair from wind, heat, dust, etc. (Su. Chi. 24/75)
Though, modern medical science has been developing advanced technologies and therapeutics for the diagnosis and management of different disorders. Earlier, Hair and its disorders were described under the heading of skin diseases. Hair, nails, and sudoriferous and sebaceous glands in particular situation grow in the skin in its process of development and as such, they are taken to be the integrated part of the skin and are usually described as appendages of the skin. Recently modern science has developed a branch that deals with pathophysiology, care, and preservation of Hair, known as Trichology. Skin is the largest organ of the body. Hair is known as appendage of skin