Alopecia Areata
Overview
Alopecia areata is an immune-related, non-scarring form of hair loss producing sudden, well-defined round or oval smooth bald patches on the scalp, sometimes triggered by stress, illness, or pregnancy; most cases regrow, but the course is unpredictable and may recur or become extensive. Chinese medicine names it 'you feng' (oily wind), relating acute patches to blood deficiency generating wind with failure to nourish hair, and prolonged or extensive loss to liver-kidney insufficiency. Recovery takes months and should be followed with dermatology.
TCM disease & pathogenesis
TCM calls this you feng ('oily wind'), colloquially 'ghost-licked head', marked by sudden smooth patchy hair loss. Since 'hair is the surplus of blood', the condition concerns blood and the liver-kidney. Mental strain or constrained emotions generating fire, together with blood deficiency generating wind, opens the hair pores; prevailing wind and blood dryness leave the hair root unnourished so hair sheds abruptly. Alternatively, prolonged illness, childbirth, or overtaxation causes liver-kidney insufficiency with depleted essence-blood, so hair withers and falls. Acute patches with dizziness, insomnia, and occasional scalp itch belong to blood deficiency with wind-dryness; long-standing brittle hair progressing to large or total loss belongs to liver-kidney insufficiency. Treatment nourishes blood to promote hair growth and supplements liver-kidney, with qi-moving, blood-quickening, and wind-extinguishing. Recovery takes months under dermatological follow-up.
Pattern differentiation (clinical patterns)
Blood Deficiency Generating Wind
Sudden patchy hair loss with smooth shiny scalp and occasional itching, dizziness, insomnia, pallor, pale tongue with thin coating, fine pulse.
Nourish blood and extinguish wind; moisten dryness and promote hair growth.
Liver-Kidney Insufficiency
Prolonged course with dry brittle hair and progressive or total hair loss, sore weak lower back and knees, dizziness and tinnitus, pale tongue with scant coating, deep fine pulse.
Tonify liver and kidney; nourish blood and promote hair growth.
Connections
Daily care & prevention
Avoid panic and maintain regular sleep and balanced nutrition; avoid tight hairstyles and harsh chemicals, protect the scalp from sun, and keep a record of regrowth and triggers. Press Baihui (GV20), Yintang (EX-HN3), Fengchi (GB20), Ganshu (BL18), Shenshu (BL23), and Zusanli (ST36). Rapid total scalp or body hair loss, scalp redness or scaling, or eyebrow loss warrants specialist care.
When to seek medical care
Seek care for rapid progression to total scalp or body hair loss, an inflamed, red, scaly or painful scalp, loss of eyebrows or eyelashes, nail changes, or association with other autoimmune symptoms; children with sudden hair loss should also be assessed.