Khalitya (alopecia / hair fall) and Indralupta (patchy baldness/alopecia areata) are described as Kṣudra Roga in Ayurveda. They are caused by aggravated Pitta and Vāta in association with Kapha leading to obstruction and damage of hair follicles. Classical texts classify hair disorders under kṣudra roga and mention them as localized but distressing diseases. Modern medicine correlates these conditions with hair fall due to nutritional deficiency, stress, hormones (androgenic alopecia), autoimmune causes (alopecia areata), and environmental factors.

"पित्तानिलाभ्यां पिडिताः केशा लुप्यन्त्यथानिलात्। कफावृतेन वातेन खलित्यं तु प्रजायते॥"
(सुश्रुत संहिता, चिकीसा २०/३३)

Classical view: Pitta + Vāta aggravation burns and dries the hair roots, while Kapha obstructs follicles → hair shedding, thinning, or bald patches.
Modern view: Hair fall is multifactorial: genetic predisposition, nutritional deficiency (iron, protein, vitamin D, B12), stress, hormonal imbalance (thyroid, androgens), infections, autoimmune causes, pollution, and modern lifestyle factors like junk food, late nights, chemical hair products.

• Ati-teekshna, ushna, katu, amla, lavana ahara — aggravate Pitta and damage hair roots.

  "अत्युष्णं तिक्तकट्वम्लं पित्तं दहति मूर्धनि।"
  (चरक सूत्रस्थान २६)

• Viruddha ahara — milk + fish, incompatible combinations → ama, srotorodha.
• Atisevana of dadhi (curd), navanita, abhishyandi foods → Kapha-ama obstruction.
• Nutritional deficiency — lack of protein, iron, minerals (modern correlation).
• Excess alcohol, junk food, preservatives — dosha vitiation + oxidative stress.

• Ati-tapasevana (excess heat/sun exposure) → Pitta aggravation in scalp.

  "आतपात् केशपातः स्यात्।"
  (अष्टाङ्गहृदय)

• Ratri-jagarana (night vigil) → Vata-Pitta dushti.
• Ati-vyayama (over-exertion) → Vata prakopa → hair fall.
• Manasika hetu — stress, anxiety, grief accelerate Khalitya (modern psychosomatic correlation).
• Use of chemical dyes, shampoos, straightening, smoking, pollution — modern causative factors.

Ati-sevana of ushna, amla, katu rasa, combined with vihara like ratrijagarana, stress → Pitta prakopa. Vāta joins and dries the roots. Kapha obstructs follicle openings. Thus, pittānila sammūrchita kapha causes Khalitya / Indralupta.

"पित्तवातसमुत्थाने कफेनावृत्य तिष्ठति। तदा केशपतनं ज्ञेयं खलित्यं तु प्रजायते॥"
(सुश्रुत संहिता, चिकीसा २०/३३)

Ayurveda: Clinical diagnosis based on hair fall pattern, scalp dushti, dosha involvement, associated signs like dandruff, greying, weakness.
Modern: Scalp biopsy, Trichoscopy, Blood tests (thyroid, iron, vitamin D, B12), Autoimmune markers in alopecia areata.

• Scalp burning, kandu (itching)
• Dryness, dandruff
• Thinning of hair strands
• Premature greying

• Severe colicky abdominal pain radiating to groin
• Painful urination (dysuria)
• Blood in urine (hematuria)
• Obstructed urine flow / dribbling
• Frequent urge to urinate
• Nausea, vomiting during colic
• Heaviness and burning in bladder region

• Excessive hair fall
• Receding hairline / bald patches
• Thin, brittle hair
• Patchy alopecia (Indralupta)
• Associated dandruff, itching

• Khalitya — generalized hair fall.
• Indralupta — patchy alopecia (autoimmune correlation).
• Palitya — premature greying associated.

• Low self-esteem, psychological distress
• Secondary scalp infections
• Premature greying

Recent onset, due to ahara-vihara imbalance → Sādhya. Chronic, hereditary, autoimmune alopecia → Yapya/Asādhya.

• चिकित्सा सिद्धान्त (Principles):

  Pitta-śamana, Vāta-samana, Kapha-avarana-nirharaṇa, Rasāyana for keshya (hair promoting).

  "पित्तवातसमुत्थाने कफेनावृत्य तिष्ठति। तदा केशपतनं ज्ञेयं खलित्यं तु प्रजायते॥"
  (सुश्रुत संहिता, चिकीसा २०/३३)

• पंचकर्म (Shodhana):
  • Virechana — Pitta-type Khalitya (using Trivrit, Haritaki, Aragvadha).
  • Basti — Vata-type hair fall with dryness (Eranda taila basti).
  • Raktamokshana — Jalaukavacharana (leech therapy) over scalp patches (Suśruta’s reference for Indralupta).
  • Nasya — Anu taila, Ksheerabala taila to nourish scalp and prevent greying.
• बाह्य चिकित्सा (External therapies):
  • Shiro Abhyanga: Daily scalp massage with Bringaraja taila, Neelibhringadi taila.
  • Shirodhara: With Brahmi taila or Ksheerabala taila for stress-induced hair fall.
  • Takra Dhara: For Pitta-related burning and dandruff.
  • Shiro Pichu: Cotton pad soaked in Keshya taila applied to scalp.
  • Śirōprakṣālana (Hair wash formulas):
    • Triphala + Shikakai + Amla powder decoction.
    • Aritha (Soapnut) + Amla + Neem leaves kwatha (Bhāvaprakāśa Keshya yoga).
    • Mehendi + Bhringaraja + Methi kwatha wash.
• औषध योग (Herbal & Classical formulations):

  Classical Yoga	Reference	Action
  Bhringaraj Taila	Bhāvaprakāśa Nighaṇṭu	Keshya, Rasāyana, prevents hair fall & greying
  Neelibhringadi Taila	Keraliya tradition (Ashtavaidya)	Scalp cooling, nourishes follicles
  Amalaki Rasayana	Charaka Chikitsa	Rich in Vitamin C, Rasayana for hair
  Triphala Churna with ghee	Charaka Samhita	Improves Agni, reduces Pitta, cleanses scalp
  Indralupta Lepana (Jatamansi, Haritaki paste)	Suśruta Chikitsa 20	Applied on bald patches
  Maha Bhringaraj Ghrita	Bhaishajya Ratnāvali, Kṣudra Roga	Oral Rasayana for hair & eyes
  Chyavanaprāsha Avaleha	Charaka Samhita	General Rasayana, supports hair health
  Kesharoga Chikitsa Yoga (Lodhra, Daruharidra, Triphala paste)	Rāja Nighaṇṭu	Topical application for scalp

• आधुनिक समन्वित दृष्टिकोण:

  Along with Ayurvedic line, modern supplementation with biotin, Vitamin D, iron, stress management, and avoidance of chemical products is beneficial.

• योग एवं जीवनशैली:
  • Asana: Sarvangasana, Vajrasana, Adho Mukha Svanasana, Matsyasana.
  • Pranayama: Anuloma Viloma, Bhramari, Sheetali.
  • Mudra: Prana Mudra, Apana Mudra.
  • Mantra: ॐ श्रीं नमः, Dhanvantari Mantra.

• Amalaki, curry leaves, sesame, dates
• Warm oil massage
• Wholesome, fresh food with green leafy vegetables

• Excess spicy, sour, salty, junk food
• Excess alcohol, smoking
• Late nights, stress
• Chemical dyes, harsh shampoos

Hair fall is multifactorial: genetics, hormones, stress, diet, autoimmune causes. Ayurveda identifies it as Khalitya/Indralupta due to Pitta–Vata aggravation and Kapha blockage in hair roots. Treatment integrates Panchakarma, herbal oils, Rasayana, diet, Yoga, and lifestyle corrections.

• Blood tests: Thyroid, Hb, Iron, Vit D, B12
• Trichoscopy
• Scalp biopsy in alopecia areata