Multimodal Ayurvedic treatment along with Icchabhedi Rasa Lepa in the Management of Moderate Alopecia Areata (~Indralupta): A Case Report

Abstract

Alopecia areata (~Indralupta) is an immune-mediated, non-scarring hair disorder corresponding to Alopecia Areata (ICD-10: L63.9). Clinically, Indralupta is characterized by well-defined areas of hair loss, typically presenting as smooth, circumscribed patches on the scalp. A 33-year-old female homemaker presented with a six-month history of progressive patchy hair loss over the parieto-occipital region, aggravated following self-application of a non-prescribed herbal oil. Disease severity was graded as moderate (SALT Score S2: 25–49% scalp involvement), with an AASIS score of 76 and DLQI score of 18. She was managed with a multimodal Ayurvedic protocol comprising Nidana Parivarjana, internal Shamana medications medications (Br. Manjishthadi Kwatha 20 mL, Gandhaka Rasayana 125 mg, Arogyavardhini Vati 500 mg, Avipattikara Churna 3 g, Saptamrita Lauha 250 mg; each orally twice daily for 4–5 weeks), Madhuyashthyadi Taila Nasya (2 drops/nostril once daily for 3 months), and local applications of Icchabhedi Rasa Lepa and Dhatturadi Taila, with concurrent dietary and lifestyle modification. The protocol was adjusted mid-course based on an Anupashaya response to the initial Amalaki–Yashtimadhu Lepa. Visible hair regrowth was observed within 21 days of treatment initiation, with complete regrowth achieved at approximately three months. SALT improved from S2 to S0, AASIS from 76 to 29, and DLQI from 18 to 6. Mild, transient scalp erythema and local irritation were noted following topical therapy, with no systemic adverse drug reactions recorded, and no recurrence was reported over a one-year follow-up period. A multimodal Ayurvedic protocol incorporating Icchabhedi Rasa Lepa, along with internal Shamana medications, Nasya, and dietary–lifestyle modification showed clinically meaningful improvement in moderate Alopecia Areata. Findings from this case warrant further evaluation in larger, controlled studies.