May 2015|Vol 12|Is 5

   
 
Case
 
   
Dynamic perspectives of Homoeopathy in Hirsutism
 

 

Dr.R.Gnanasambandam, a renowned clinician and academician, research scholar writes and shares his views in this article about efficacy of Homoeopathy Dynamic perspectives of Homoeopathy in Hirsutism. He had authored books and articles published in scientific journal. He also presented many papers in the scientific conferences, lectured in many Homoeopathic Medical Colleges. He served in many positions in the state and central Government. He can be contacted at 6, Llyod's II Lane Royapettah, Chennai -600014

 
 
 

Introduction
      Hirsutism is unwanted, Excessive hair growth which is is a frequent complaint among women. Many women feel that they are very "hairy," over face, limbs, chest and abdomen. This problem can be very embarrassing since excessive body hair and particularly facial hair is deemed unsightly in women in our society. Eventhough intial make up is with cosmetic clinics, later approach Cosmetologists, Dermatologists and finally approach a homoeopath with hydra headed disease syndrome. Hirsutism represents not only a cosmetic problem, but also mirrors the disease of an endocrine gland.The unwanted hair growth results clinical more along with Poly cystic Ovarian Disease and Hypothyroidim. The clinical studies are overwhelming with scientific evidences in offering radical cure for these entire solutions positively with dynamic perspectives in Hirsutism, Virulism and trichorexis

Pathophysiology

      We know that the hair grows from hair follicles within the skin. There are two types of hair, Vellus hair and Terminal hair. Vellus hairs are soft, fine, and usually short. They may be colorless giving the impression of “hairless skin” Vellus hairs are found in a woman on the face, chest, back and extremities. Terminal hairs are longer, coarser, and thicker such as those found in the scalp, pubic area and axilla of both men and women. In men, they are also found on the face and body.
All hairs are not visible on the surface of the skin at the same time, due to varying stages in the hair growth cycle. The hair growth involves two main periods called Anagen and Telogen. Anagen is a long growing phase; its duration determines the length of the hair in a particular area. For instance in scalp the anagen phase is too long; the resting phase telogen is short. So the length of the hair depends upon only the growing phase it differs to everyone. Short anagen and long telogen results short stable hair in forearms and other parts.

      Various hormones control hair growth. Thyroid hormone and growth hormone affects hair growth. The most important hormone controlling growth are "androgens" commonly known as “male” hormones. The one more important hormone is testosterone. Except in the scalp, androgens cause hair to change from "vellus" to "terminal". A good example is puberty in which both sexes, androgens induce the appearance of pubic and axillary hair.

      All women have terminal hair in some parts of the body, specifically the scalp, pubic and axillary area. A few hairs around the nipple or over the thighs may be normal. “Hirsutism” or excess body hair in women is the presence of thick, dark hair over the face, chest, abdomen, upper thighs or upper arms. There is no hirsutism if only the forearms and calves are affected.

Clinical manifestations
      Clinically, many girls in teen age or those in early twenties develop excess hair growth with scanty, irregular periods. Pimples, Obesity, Hair loss are the additional symptoms. Polycystic ovarian disease is very common now a day, which secretes high levels of androgens to turn the terminal hair to vellus hair. PCOD is associated normally with hypothyroidism in majority. Family history of diabetes also noted in some cases who are resistant to their own insulin. To counter this resistance, the pancreas makes extra insulin. High insulin levels somehow boost the secretion from ovaries or adrenal glands. Polycystic ovarian disease patients ovulate rarely, thus it becomes a primary cause for infertility in many women.
The abnormal growths in the adrenal and ovaries also considered. Master of gland “Pituitary” also has some impaction, since it has the control of all endocrines. Clinically, these can be studied well appreciating the investigations.
There are some patients who present with hirsutism, but ovulate regularly. Their hormonal levels are normal and no apparent explanation is found for their hirsutism. These categories of patients have been labels "idiopathic" or "familial hirsutism". The only satisfactory explanation for this distressing problem is hypersensitivity of the skin's hair apparatus to normal levels of androgens. Fortunately, even these cases respond to a further decrease of androgen levels with homoeopathic medication. The treatment is only for the purpose of cosmetic improvement since these patients are otherwise entirely "normal”. Likewise some women may show “hairy” during menopause.
The existing hormonal imbalance is provoked by administration of some drugs like oral contraceptives, anti epileptic drugs had shown hair growth in some cases.

Clinical Organon

      Eventhough we can simply say a similitude will be suitable, Hahnemann prescribed some guidelines to apply the art of cure. We know that Hirusutism is not a single entity and hydraheaded . Hence the deep pathology understading of the disease knowledge is very important as Hahnemann postulated in Aphorism no 3 . His message on disease classification id dynamic chronic disease with fully developed symptoms . He guide us to understand and apply Aphorism § 5
Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.
And also emphasis in Aphorism § 206 .Hence understanding the miasm ,interpretation on cellular pathology helps us to which layer to considered to offer ideal cure rapidly

Clinical Materia Medica

      The anamnesis on Hirsutism can be easily made out thorough our vast ,Materia Medica , The similitude that arises in every one’s mind is sepia, the masculinity features and allied features call as primary remedy , the next common drug is Oleum Jecoris Aselli . The remedies Thuja Occidentalis, Apis melifica are usually when Poly cystic ovarian disease ruled out . Thyroidinum is most choice of remedy in many cases of Hypothyroidism with Hirsutism Natrum mur , Calcarea carb , there are lot ploycrest clinically highly useful

Clinical applications

      Clinically the most of the hirsutism patients presents along with irregularity in periods which are co related with finding of Ultra Sonogram on Poly cystic ovarian Disease . Hence further study on serum testosterone could illustrate the basic cause for undated hair growth and a study on cortical will differentiate the involvement of adrenal gland pathology Obese patients require Thyroid profile to rule out . Many patients with family history of Diabetes will show Insulin resistance which can be studied by insulin levels

      A Girl aged 23 years was suffering from unwanted facial hair growth since three years. She also had irregularity in periods since six years. Her mother took her to a Gynaecologist, she advised Hormone therapy to regularize periods. Meanwhile she had been asked to undergo a pelvic scan, which studied tiny follicles on both sides of ovaries giving impression as polycystic ovaries. Her hormonal count for testosterone was very high. They were fed up with the treatment and finally approached homoeopathic treatment.

      After a thorough study, the serum testosterone was again analyzed which gave the reading as 727ng/ml and the scan study for pelvis also suggested poly cystic ovarian disease. The hormone level is as high in male who can produce hair growth during teen age. She took homoeopathic treatment and underwent palliative measures like bleaching to avoid social embarrassment. When she resumed her periods back another blood study and scan was taken. The blood serum testosterone level was 0.43ng/ml and pelvic sonogram stated that her ovaries were normal (Refer Plate I and II)
After a period of three or four months she informed that “My hair growth has considerably reduced and I go for bleaching occasionally. Now my periods are also normal .She discontinued the medicine after few months
The recue miasmatic remedy is Thuja Occ prescribed on sycotic manifeations in her history and allied illness

      Another teen aged girl was suffering from unwanted facial hair growth since three years was detected as Poly Cystic Ovarian Disease had responded and the reduction in serum testosterone levels gives scope to continue in succeed . The Serum testosterone 165ng /dl reduced to 42 ng/dl(Refer Plate III and IV)

Conclusion

      Hirsutism is a sign of a disease, so it seeks drugs that help to reduce Androgen levels and physical removal could not solve the problem. Hormone replacement therapy fails to establish a “cure” but a similitude could bring the harmony to balance every individual. Miasmatic understanding will help to understand the expression of symptom to give importance and benefits rapid result to the patient