Definition and cause
Alopecia is one of the most common conditions seen by veterinarians. It is often a result of multiple underlying causes with the secondary ramification of loss of hair. The broad categories of alopecia are (1) genetic predisposition, and (2) acquired, such as inflammatory, infectious (bacterial, fungal), immune-mediated, hormonal imbalances, parasitic, and secondary to other diseases such as hypothyroidism, Cushing’s, etc..
Medical therapy rationale, drug(s) of choice, and nutritional recommendations
Therapy for alopecia relies upon the proper and accurate diagnosis, because the underlying cause dictates the course of therapy. Please refer to other sections in this book for underlying causes and their appropriate therapies.
Because alopecia is most often secondary to multiple underlying causes, the prognosis varies with the primary cause.
Integrative veterinary therapies
An integrative approach to alopecia starts with a determination of the underlying cause. If the cause can be identified and addressed, the alopecia usually resolves.
The use of nutrients, nutraceuticals, medicinal herbs, and combination homeopathics that help balance gland function, reduce inflammation, and prevent cellular degeneration should be part of the therapeutic approach to alopecia.
General considerations / rationale
When searching for the underlying cause and proper diagnosis, a medical and physiological blood evaluation should be included as part of the clinician’s diagnostic protocol. This nutrition-based information gives clinicians the ability to formulate therapeutic nutritional protocols that address the local lesions as well as underlying organ conditions that may be ultimately responsible for the surface condition. For example, identifying early thyroid and pituitary weakness and supporting their function with appropriate nutrients, antioxidants, and gland support can help re-establish a normal coat. (See site, Nutritional Blood Testing for more information.)
Nutritional / gland therapy: Glandular hypothalamus, pituitary, and lymph provide intrinsic nutrients that nourish and help neutralize cellular immune inflammation and help improve organ function (see Gland Therapy, site, for a more detailed explanation).
Zinc: Zinc is a mineral that particularly benefits metabolism and skin health. Zinc-responsive dermatosis is a common deficiency disease in animals; it is found often in huskies, malamutes, and large-breed puppies.
Essential fatty acids: Research has been conducted on the importance of essential fatty acids in the daily diet, and on the clinical management of various degenerative diseases. The importance of the ratio between omega-6 and omega-3 fatty acids has been substantiated. Research on polyun-saturated fatty acids has shown their beneficial and antipruritic affects on skin.
Chinese herbal medicine
General considerations / rationale
According to traditional Chinese medicine theory, alopecia is a result of Yin and Blood deficiency in the Liver and Kidney, accompanied by blockage of the meridians. The Liver and Kidney control the Blood. The fur is the end of the Blood, according to traditional Chinese medicine (traditional Chinese medicine). Without Blood and fluids (Yin), there is no fluid to nourish the skin. Similarly, if the meridians are blocked, nourishment cannot get to the skin to allow the fur to grow. Without nourishment, the follicles become inactive.
The etiology of the Yin and Blood deficiency must be corrected to heal the patient. In Western practice this means that not only is the hair loss treated, but the cause of the alopecia must also be addressed. To modern practitioners, this means any immune dysfunction, pathogen infection, or hormonal imbalance must be corrected.
Appropriate Chinese herbs
Actractylodes (Cang zhu): Has antiinflammatory effects. Experimentally, it has been shown to ameliorate swelling caused by treatment with xylene, carrageenin, and acetic acid. It also inhibits Staphylococcus aureus and some dermatophytes.
Angelica (Bai zhi): Has demonstrated antiinflammatory properties in mice, which suggests efficacy in any inflammatory type of alopecia.
Angelica root (Dang gui): Was used in 40 patients with alopecia areata, an immune-mediated skin disease in which the follicles are attacked, leading to baldness or hair loss on the entire body. In this trial, all 40 patients had improvement in their symptoms.
Buffalo horn shavings (Shui niu jiao): Has antiinflammatory effects. It has been shown to decrease experimentally induced edema in the ears and feet of mice. It may help promote cellular immunity. It increases the leukocyte count, which may help in cases of infectious alopecia.
Bupleurum (Chai hu): Stimulates both humoral and cellular immunity in mice, which may help in cases of alopecia of infectious etiology. In addition it has been shown to inhibit various bacteria. Bupleurum has antiinflammatory effects, as was demonstrated in a mouse model using dimethyl-benzene-induced ear swelling.
Cnidium (Chuan xiong): Stimulates the cellular immunity. It increases phagocytic function of macrophages. It also stimulates the humoral immune system. It can also promote the formation of sheep red blood cells (SRBC) antibody in mice.
Dandelion (Pu gong ying): Has demonstrated antibacterial efficacy against many bacteria, including Staph aureus and beta-hemolytic streptococci.
Earthworm (Di long): Has immunostimulant properties. It improves macrophage function. It also promotes wound healing. Earthworm was shown to enhance the production of fibroblasts and capillaries in experimentally induced wounds in rabbits. It also increased the healing rate of the skin.
Fleece flower root (He shou wu): Increases thyroid hormone secretion. This may be beneficial in cases of hypothyroid-induced alopecia. Furthermore, it has been shown to inhibit a variety of bacteria including Staphylococcus aureus. It may prove efficacious in cases of bacterial pyoderma.
Honeysuckle (Jin yin hua): Has demonstrated antibacterial properties. This is due in large part to the action of chlorogenic acid and isochlorogenic acid. Among the bacteria these compounds inhibit are Staphylococcus aureus, beta-hemolytic streptococci, and E coli.
Kochia (Di fu pi): Has been shown to inhibit some dermatophytes.
Licorice (Gan cao): Has demonstrated a complex effect on the immune system. It has shown the ability to both stimulate and inhibit the phagocytic activity of macrophages. It also contains glycyrrhizin and glycyrrhetinic acid, which have approximately 10% of the corticosteroid activity of cortisone and decrease the permeability of blood vessels and interfere with histamine action. These actions suggest that licorice may be useful in allergic, immune-mediated, and infectious alopecia. In addition it has antibiotic effects on different bacteria including Staphylococcus aureus.
Mint (Bo he): Has demonstrated antiinflammatory properties. This may make it useful in inflammation-mediated alopecic condition.
Mouton (Mu dan pi): Reduces inflammation. In mice it was shown to decrease dimethylbenzene-induced inflammation in the ear. It also may treat bacterial dermatitis. It has a direct inhibitory effect on multiple strains of bacteria including Staphylococcus aureus and beta-hemolytic streptococci. It has been shown to enhance phagocytosis of peripheral neutrophils on Staphylococcus aureus.
Platycodon (Jie geng): Prevents allergic reactions and decreases capillary permeability. It has been shown to promote the secretion of corticosterone in rats, which suggests that it is indicated in cases of allergic pyoderma.
Poria (Fu ling): Inhibits Staphylococcus aureus, among other bacteria (Nanjing College of Pharmacy).
Rehmannia (Sheng di huang): Increases the level of estradiol in females and testosterone in male rats. This may be applicable in cases of hormone-responsive alopecia. It also has antiinflammatory properties. It reduces swelling and inflammation.
Schizonepeta (Jing jie): Decreases the signs in cases of pruritic rashes and itching.
Scutellaria (Huang qin): Contains biacalin, which has antibiotic activity against Stapylococcus aureus, b-hemolytic streptococcus, as well as other bacteria and some dermatophytes. Biacilin can have synergistic effects with ampicillin, amoxicillin, methacillin, and cefotaxime. It can help overcome B lactam resistance. Biacalein has an added benefit of suppressing inflammation. It has been shown experimentally to decrease swelling induced by dimethyl-benzene and formaldehyde. While decreasing inflammation, it also enhances cellular immunity. It enhances production of IL2, which stimulates the cellular immune system.
Siegesbeckia (Xi xian cao): Possesses antiinflammatory properties. It has been shown to decrease swelling in rats. It decreases both humoral and cellular immunity in mice, which suggests that it may be of use in immune-mediated cases of alopecia. Furthermore, it has antibiotic actions and may be of benefit in bacterial etiologies.
Siler (Fang feng): Has been shown to inhibit various bacteria, including Staphylococcus aureus.
Silkworm (Jiang can): Has antibiotic effects. It has been shown to affect Stapylococcus aureus and other bacteria.
White peony (Bai shao): Has antibiotic properties against a variety of bacterian including both Staphylococcus aureus and beta-hemolytic streptococci. It also inhibits some dermatophytes. It contains Paeoniflorin, which is a strong antiinflammatory. These capabilities may make it useful for bacterial, fungal, allergic, and immune-mediated alopecia.
Xanthium (Cang er zi): Decreases histamine-mediated increases in capillary permeability. This indicates that it may be of use in allergy-mediated alopecic conditions.
General considerations / rationale
Alopecia can occur as a consequence of Inflammation, Deposition, Impregnation, Degeneration, or Dedifferen-tiation phase disorders. Proper diagnosis is needed to select therapy. In Inflammation Phase disorders, simply treating the primary cause usually results in regrowth of hair. In deeper homotoxicoses, hair growth may be delayed or may not occur.
Appropriate homotoxicology formulas
(Also see other protocols such as Cushing’s, hypothyroidism, pancreatic insufficiency, etc).
Cutis compositum: Stimulates healing and detoxification of the skin.
Aesculus homaccord: Supports vascular repair.
BHI-Hair and -Skin: Used for alopecia, dandruff, acne, poor toenails, dry hair coat, postvaccinal hair loss, and hair loss after severely debilitating disease.
BHI-Skin: Treats eczema, rashes and redness, blisters, and cold sores.
Cerebrum compositum: Supports cerebral tissues.
Coenzytne compositum: Provides metabolic support.
Galium-Heel: Used for cellular and matrix drainage and detoxification, and after vaccination reactions.
Hepar compositum: Supports hepatic tissue.
Lymphomyosot: Provides lymph drainage and support.
Ovarium compositum: Treats endocrine alopecia in females.
Placenta compositum: Used to improve vascularization of extremities.
Psorinoheel: Phase remedy in Excretion and Impregnation phase disorders, intense pruritus of elbows and legs, warts, and excretion of malodorous material.
Pulsatilla compositum: Used for type two regulation rigidity.
Selenium homaccord: Used in conjunction with Psorinoheel.
Solidago compositum: Provides support of renal tissues.
Sulfur Heel: Provides general support of mesenchymal structures.
Testis compositum: Supports endocrine alopecias in males.
Thuja homaccord: Used in post vaccinal alopecia.
Thyroidea compositum: Provides endocrine support and deep detoxification and matrix drainage.
Tonsilla compositum: Supports endocrine and central controls.
Traumeel S: Used for type one regulation rigidity and after inflammatory skin issues such as allergies or vaccination reactions.
Ubichinon compositum: Provides metabolic support.
Ypsiloheel: Used for central regulation.
Authors’ suggested protocols
Pituitary / hypothalamus / pineal and skin support formula: 1 tablet for every 25 pounds of body weight BID. When indicated, lymph and thyroid support formulas may be added.
Zinc: 15 mg for every 25 pounds of body weight SID.
Eskimo fish oil: One-half to 1 teaspoon per meal for cats. 1 teaspoon for every 35 pounds of body weight for dogs.
Omega-3,-6,-9: 1 capsule for every 25 pounds of body weight with food.
Chinese herbal medicine
The authors recommend a full diagnostic work-up to determine the cause of alopecia because it is a symptom, not a diagnosis. For most causes of alopecia the authors recommend a combination of DermGuard and Immuno-Derm at a dose of 1 capsule of each herbal supplement per 10 to 20 pounds twice daily.
DermGuard contains angelica (Bai zhi), angelica root (Dang gui), aurantium fruit (Zhi qiao), bupleurum (Chai hu), cicada (Chan tui), cnidium (Chuan xiong), honeysuckle (Jin yin hua), licorice (Gan cao), mint (Bo he), moutan (Mu dan pi), platycodon (Jie geng), poria (Fu ling), schizonepeta (Jing jie), scutellaria (Huang qin), siegesbeckia (Xi xian cao), siler (Fang feng), silkworm (Jiang can), and xanthium fruit (Cang er zi).
ImmunoDerm contains atractylodes (Cang zhu), angelica root (Dang gui), buffalo horn shavings (Shui niu jiao), bupleurum (Chai hu), dandelion (Pu gong ying), earthworm (Di long), fleece flower root (He shou wu), honeysuckle (Jin yin hua), kochia (Di fu zi), licorice (Gan cao), moutan (Mu dan pi), oldenlandia (Bai hua she cao), poria (Fu ling), rehmannia — raw (Sheng di huang), scutellaria (Huang qin), siegesbeckia (Xi xian cao), tokoro (Bi xie), white peony (Bai shao), and xanthium fruit (Cang er zi).
Homotoxicology (Dose: 10 drops PO for 50-pound dog; 5 drops PO small dog or cat)
Symptom formula: Psorinoheel, Selenium homaccord, Galium-Heel, BHI-Hair and Skin, and Sulfur-Heel mixed together and given BID PO. In acute cases, Traumeel or BHI-Hair and Skin as single agents may suffice.
Deep detoxification formula: Thyroidea compositum, Solidago compositum, and Hepar compositum given every three days. Cutis compositum given every seven days.
Pituitary / hypothalamus / pineal, skin, lymph and thyroid support formulas: Animal Nutrition Technologies. Alternatives: Derma Strength — Vetri Science Laboratories; Canine Dermal and Thyroid Support — Standard Process Veterinary Formulas.
Omega-3,-6,-9: Vetri Science. Alternatives: Eskimo fish oil — Tyler Encapsulations; flax oil — Barlean’s Organic Oils; hemp oil — Nature’s Perfect Oil; Ultra EFA — Rx Vitamins for Pets.
Chinese herbal medicine
Derm Guard and ImmunoDerm: Natural Solutions, Inc.
BHI / Heel Corporation