[Concept]

Alopecia areata, commonly known as ghost shaved head, is called "hair fall" in Neijing. Zhubing Yuanhou Lun Based on clinical manifestations, it is divided into two syndromes: hair loss syndrome and ghost licking syndrome. At the same time, alopecia areata caused by alopecia areata and alopecia areata are also listed for identification. Doctors in the Ming and Qing Dynasties had a special treatise on flaky alopecia areata, called "alopecia areata", which provided valuable experience for future generations to prevent and treat this disease.

Clinical observation, alopecia areata can be seen in a variety of diseases. This article specifically discusses alopecia areata as the main symptom. Alopecia areata caused by other diseases will not be discussed.

[Syndrome Analysis]

1. Deficiency of Yin and Blood︰The hair is shiny, has lots of flakes, often falls off, and gradually becomes sparse on the top of the head or the corners of the forehead over time. The head is itchy, or may have tinnitus, soreness in the waist and limbs, a red tongue with less coating, and a thready and rapid pulse. It is mostly caused by liver deficiency and insufficient yin and blood. When blood occurs, blood deficiency cannot nourish the hair and the hair will fall out. Or because the skin striae and interstice are not dense, sweating occurs when the wind blows, and wind evil takes advantage of the weakness to enter. The wind is strong and the blood is dry, and the hair loses its support and falls off. Zhubing Yuanhou Lun． Gui Lituhou said: "If a person has wind evil in his head and a weak spot, his hair will be bald." From the clinical manifestations:
   1. The hair is slender and weak, with an obvious oily luster. No breakage phenomenon.
   2. Alopecia areata mostly occurs on the top of the head or the forehead corners. The scalp is oily, or it may be flaky and itchy.
   3. The onset is slow and the course of the disease is long. It is more common in middle-aged people. Alopecia areata often occurs and gradually becomes bald.
   4. The scalp is often itchy.
   Dizziness, tinnitus, soreness in the waist and limbs, red tongue with clean coating, thready pulse, etc. are signs of kidney deficiency and yin and blood deficiency. Use nourishing water to moisten wood, nourishing blood and dispelling wind as the main method to choose Shenying. Add and subtract the nourishing elixir.
2. Deficiency of Yin and Blood︰The hair is shiny, has lots of flakes, often falls off, and gradually becomes sparse on the top of the head or the corners of the forehead over time. The head is itchy, or may have tinnitus, soreness in the waist and limbs, a red tongue with less coating, and a thready and rapid pulse. It is mostly caused by liver deficiency and insufficient yin and blood. When blood occurs, blood deficiency cannot nourish the hair and the hair will fall out. Or because the skin striae and interstice are not dense, sweating occurs when the wind blows, and wind evil takes advantage of the weakness to enter. The wind is strong and the blood is dry, and the hair loses its support and falls off. Zhubing Yuanhou Lun． Gui Lituhou said: "If a person has wind evil in his head and a weak spot, his hair will be bald." From the clinical manifestations:
   1. The hair is slender and weak, with an obvious oily luster. No breakage phenomenon.
   2. Alopecia areata mostly occurs on the top of the head or the forehead corners. The scalp is oily, or it may be flaky and itchy.
   3. The onset is slow and the course of the disease is long. It is more common in middle-aged people. Alopecia areata often occurs and gradually becomes bald.
   4. The scalp is often itchy.
   Dizziness, tinnitus, soreness in the waist and limbs, red tongue with clean coating, thready pulse, etc. are signs of kidney deficiency and yin and blood deficiency. Use nourishing water to moisten wood, nourishing blood and dispelling wind as the main method to choose Shenying. Add and subtract the nourishing elixir.
3. Qi and Blood Deficiency︰The hair is soft, dry and thin, the hair falls out evenly and becomes sparse day by day, shortage of qi lack of strength, faint low voice, complexion, severe palpitation, numbness of the limbs, light tongue texture, less coating, and weak pulse. Due to long-term illness or postpartum and other reasons, Qi and blood gradually become deficient and cannot be moisturized, so the beard and hair fall off. Judging from the clinical manifestations:
   1. The hair is thin and weak, dry and dull, and often broken hair remains.
   2. In areas where alopecia areata occurs, the skin and hair are sparse and scattered all over the head. Occasionally, significant hair loss is seen in areas with frequent friction, such as the back of the pillow.
   3. The onset of alopecia areata is slow and the course of the disease is long. It can occur at any age. Alopecia areata begins after a long illness or after childbirth and becomes sparse day by day.
   4. No subjective symptoms.
   The face is dull, the palpitation is short of breath, the tongue is pale and has less coating, and the pulse is thin and weak, which indicates a deficiency of both qi and blood. Tonifying qi blood should be treated, and Ginseng Yangrong Pill and Shiquan Major Tonifying Pill should be used as appropriate. , tonifying middle and replenishing qi pill, Eight Precious Ingredients Motherwort Pill, etc.
4. Deficiency of Yin and Blood︰The hair is shiny, has lots of flakes, often falls off, and gradually becomes sparse on the top of the head or the corners of the forehead over time. The head is itchy, or may have tinnitus, soreness in the waist and limbs, a red tongue with less coating, and a thready and rapid pulse. It is mostly caused by liver deficiency and insufficient yin and blood. When blood occurs, blood deficiency cannot nourish the hair and the hair will fall out. Or because the skin striae and interstice are not dense, sweating occurs when the wind blows, and wind evil takes advantage of the weakness to enter. The wind is strong and the blood is dry, and the hair loses its support and falls off. Zhubing Yuanhou Lun． Gui Lituhou said: "If a person has wind evil in his head and a weak spot, his hair will be bald." From the clinical manifestations:
   1. The hair is slender and weak, with an obvious oily luster. No breakage phenomenon.
   2. Alopecia areata mostly occurs on the top of the head or the forehead corners. The scalp is oily, or it may be flaky and itchy.
   3. The onset is slow and the course of the disease is long. It is more common in middle-aged people. Alopecia areata often occurs and gradually becomes bald.
   4. The scalp is often itchy.
   Dizziness, tinnitus, soreness in the waist and limbs, red tongue with clean coating, thready pulse, etc. are signs of kidney deficiency and yin and blood deficiency. Use nourishing water to moisten wood, nourishing blood and dispelling wind as the main method to choose Shenying. Add and subtract the nourishing elixir.

Deficiency of yin and blood and deficiency of both qi and blood, alopecia areata, both belong to deficiency syndrome/pattern, and they have something in common: (1) the hair is thin and weak; (2) the onset is slow and the course of the disease is long. Some patients also experience various concurrent symptoms, which can help with syndrome differentiation.