Introduction
Hair is often considered a reflection of health, beauty, and vitality. In Ayurveda, healthy hair is regarded as a byproduct (upadhatu) of asthi dhatu (bone tissue) and is closely connected with overall well-being. When hair begins to thin, fall excessively, or bald patches appear, it is not merely a cosmetic concern but a sign of deeper imbalances.
In Ayurvedic texts, hair fall is broadly described as Khalitya (gradual hair loss) and Indralupta (alopecia areata). In modern medicine, it can correspond to conditions such as androgenetic alopecia (pattern baldness), telogen effluvium, alopecia areata, and hair loss due to systemic factors.
For students and doctors of Ayurveda, understanding the pathology, modern insights, and integrative treatment options is essential for addressing one of today’s most common health concerns.
Pathology
Ayurvedic Samprapti (Pathogenesis)
According to Charaka, Sushruta, and Vagbhata:
Dosha involvement: Predominantly Pitta and Vata dosha vitiation.
Dhatudushti: Weakness of asthi dhatu (bone tissue) and rasa dhatu (plasma), leading to poor nourishment of hair.
Agni disturbance: Impaired digestion (agnimandya) produces ama, which blocks proper tissue metabolism.
Samprapti ghatakas:
Vitiated Pitta burns the hair roots (romakupa).
Vata accelerates hair fall and dryness.
Kapha, when aggravated, clogs follicles and prevents regrowth.
Types in Ayurveda:
Khalitya – diffuse hair thinning and loss.
Indralupta – patchy baldness (similar to alopecia areata).
Modern Pathogenesis of Hair Fall
Androgenetic Alopecia: Genetic predisposition + sensitivity of follicles to dihydrotestosterone (DHT).
Telogen Effluvium: Hair shifts prematurely into shedding phase due to stress, illness, or nutritional deficiency.
Alopecia Areata: Autoimmune attack on hair follicles.
Other causes: Thyroid dysfunction, iron deficiency, polycystic ovarian syndrome (PCOS), infections, drug-induced hair loss, chemotherapy.
Modern Aspect
Diagnosis in Modern Medicine
Clinical Examination: Pattern and severity of hair loss.
Trichoscopy / Dermoscopy: Magnified follicle visualization.
Laboratory Tests:
Thyroid function tests
Serum ferritin (iron levels)
Vitamin D, Vitamin B12
Hormonal profile (testosterone, DHEA-S in females)
Scalp biopsy in unclear cases.
Modern Treatment
Pharmacological:
Minoxidil topical solution
Finasteride (for men, with caution due to side effects)
Corticosteroid injections (for alopecia areata)
Procedures: PRP (Platelet-rich plasma), microneedling, hair transplant surgery.
Nutritional Support: Iron, protein, vitamin D, biotin.
Lifestyle: Stress reduction, adequate sleep, balanced diet.
Though modern treatments may improve hair density temporarily, they often require lifelong use, have relapse after discontinuation, or carry side effects.
Ayurvedic Treatment
Ayurveda treats hair fall by addressing root causes—dosha imbalance, dhatu weakness, and impaired agni.
- Nidana Parivarjana (Avoiding Causes)
Excessive spicy, salty, sour foods (pitta aggravating).
Junk food, irregular eating, late nights.
Stress, anger, and excessive alcohol.
Harsh chemical-based hair products.
- Shodhana (Purification Therapies)
Virechana (Purgation): To expel excess Pitta from the system.
Nasya (Nasal therapy): Use of medicated oils like Anu taila, Bhringaraja taila to nourish scalp and follicles.
Raktamokshana: In Indralupta (alopecia areata), Jalaukavacharana (leech therapy) is classically recommended to purify blood around patches.
- Shamana (Palliative Therapy)
Medicated Oils & Application:
Bhringaraja taila (considered the king of hair herbs).
Neelibhringadi taila, Keshya tailas.
Application of fresh aloe vera or amla paste.
Internal Medications:
Triphala churna for digestion and detox.
Amalaki rasayana for rejuvenation.
Bhringaraj churna for hair growth.
Narasimha rasayana to strengthen hair and improve ojas.
- Ahara & Vihara (Diet & Lifestyle)
Include: milk, ghee, sesame seeds, black gram, green leafy vegetables, amla, curry leaves.
Avoid: spicy, fried, excessively hot foods, smoking, alcohol.
Yoga & Meditation: Reduces stress-induced hair fall.
Dinacharya: Regular scalp massage with warm oils enhances circulation.
- Rasayana Therapy (Rejuvenation)
Ashwagandha – reduces stress (cortisol) and strengthens tissues.
Guduchi – immunity booster.
Amalaki – antioxidant, rich in vitamin C.
Bhringaraja – hair regrowth and scalp nourishment.
Integration of Ayurveda and Modern Medicine
Diagnosis: Modern lab tests help detect deficiencies or autoimmune conditions, while Ayurveda identifies dosha imbalance and agni dysfunction.
Treatment: Ayurvedic internal medicines, Panchakarma, and lifestyle corrections complement modern therapies like nutritional supplements and PRP.
Research Evidence: Studies show Bhringaraja and Amalaki improve hair follicle activity and antioxidant status. Nasya therapy has been reported beneficial in chronic hair fall.
Patient Education: Ayurveda emphasizes prevention through daily scalp care, balanced diet, and seasonal regimens—something often overlooked in modern dermatology.
Conclusion
Hair fall (Khalitya / Indralupta) is not just a superficial issue; it is a window into systemic imbalances. Ayurveda highlights digestion, nutrition, and dosha equilibrium as the foundation of healthy hair, while modern science adds diagnostic precision and targeted interventions.
The best outcomes arise when both systems are integrated—using Ayurvedic therapies like Nasya, Rasayana, and herbal formulations alongside modern diagnostics and nutritional correction. For Ayurveda students and doctors, hair fall offers a perfect example of how classical principles can be applied effectively in today’s clinical practice.
Contributor – Dr. Manoj Tiwari
