Waking up to comb your hair and suddenly discovering a bare patch on your scalp, as if sliced by an invisible razor... The terrifying experience of alopecia areata (spot baldness) plunges countless people into panic. Blindly applying hair growth tonics or trusting folk remedies often yields minimal results. Does Traditional Chinese Medicine (TCM) offer any effective treatments?
What causes Alopecia Areata?
Dr. Que Poh Yuen Albert, a TCM expert at Gong Fang Tang TCM Clinic in Singapore, explains that alopecia areata is known in TCM as "You Feng" (Oil Wind). Its root cause lies in the disharmony of Qi and Blood, leading to malnourishment of the hair follicles. Clinically, it is mainly divided into three types:
Liver-Kidney Deficiency Type (Over 60% of cases)
Core Pathology: Staying up late, chronic illness, physical weakness → Depletion of Kidney Essence → Insufficiency of Liver Blood → Malnourishment of hair roots.
Typical Manifestations:
Patches of hair loss with clear boundaries.
Accompanied by soreness and weakness in the lower back and knees, tinnitus, poor memory, insomnia, and vivid dreams.
Pale tongue with scant coating, deep and thready pulse.
Dr. Que Poh Yuen Albert Reminder: "The radiance of the Kidneys manifests in the hair" – this is the most common type!
Blood Deficiency with Wind-Dryness Type (Main cause of acute onset)
Core Pathology: Anxiety, depression → Liver Qi Stagnation transforming into Fire → Depletion of Yin and Blood → Blood Dryness generating Wind → Hair loss.
Typical Manifestations:
Itchy scalp in the areas of hair loss.
Rapid progression, multiple areas of hair loss within weeks.
Restlessness, irritability, dry mouth and throat.
Red tongue with reduced moisture, wiry and thready pulse.
Qi Stagnation and Blood Stasis Type (Root cause of stubborn alopecia areata)
Core Pathology: Long-term stress → Stagnation of Qi movement → Blood stasis blocking hair follicles → Hair losing its nourishment.
Typical Manifestations:
Areas of hair loss have sharp, knife-cut-like borders.
Course of illness exceeds half a year, hair regrowth is difficult.
Accompanied by headaches, numbness of the scalp.
Purplish-dark tongue body with stasis spots.
How does TCM treat and regulate Alopecia Areata hair loss?
Targeting the core type of alopecia areata – Liver-Kidney Deficiency combined with Blood Deficiency and Wind-Dryness – Dr. Que Poh Yuen Albert strongly recommends the classic formula from the Ming Dynasty text Orthodox Manual of External Medicine (Wai Ke Zheng Zong): Shen Ying Yang Zhen Tang (Divine Response Hair-Nourishing Decoction). This formula is hailed as the "Number One Hair Growth Formula" with a clinical total effective rate of 86.7%.
Shen Ying Yang Zhen Tang is composed of 8 herbs: Chinese Angelica Root (Dang Gui), Szechuan Lovage Rhizome (Chuan Xiong), White Peony Root (Bai Shao), Gastrodia Rhizome (Tian Ma), Notopterygium Root (Qiang Huo), Prepared Rehmannia Root (Shu Di Huang), Chaenomeles Fruit (Mu Gua), and Dodder Seed (Tu Si Zi).
Within the formula, Chinese Angelica Root (Dang Gui) and White Peony Root (Bai Shao) generate and nourish blood. Combined with Prepared Rehmannia Root (Shu Di Huang) and Dodder Seed (Tu Si Zi), they tonify the Kidneys and benefit essence, nourishing Liver-Kidney essence and blood. This is called "supplementing the genuine [essence]". Only with sufficient Qi and Blood can the hair be nourished.
Notopterygium Root (Qiang Huo) and Szechuan Lovage Rhizome (Chuan Xiong) guide the effects of the herbs upwards. Qiang Huo is a Wind-dispelling herb, a key medicine for treating Wind disorders. Chuan Xiong is also remarkable; it ascends and descends, guiding Qi and Blood upwards to the scalp to nourish the hair roots.
Based on the patient's specific symptoms, blood-tonifying herbs like Fleeceflower Root (He Shou Wu) or Black Sesame Seed (Hei Zhi Ma) may be appropriately added, or Liver-Qi regulating herbs like Bupleurum Root (Chai Hu) or Curcuma Root (Yu Jin) may be included. This allows the formula to both nourish blood and promote hair growth while regulating the functions of the internal organs, fundamentally improving the symptoms of alopecia areata.
Case Study
Patient: Mr. Liu, 23 years old.
Chief Complaint: Discovered a patch of hair loss on the crown of his head 2 months ago, the size of a 5-cent coin. Initially ignored it. Gradually developed other patchy areas of hair loss. Self-treated with fresh ginger juice without effect, so came for treatment.
Initial Consultation: Five circular patches of hair loss on the crown and occiput. Smallest patch ~2-cent coin size, largest ~3cm in diameter. Edges neat, skin smooth and shiny. Tongue pale-red with thin coating, pulse thready.
Diagnosis: Constitutional Liver-Kidney Deficiency, leading to Nutritive Blood failing to nourish the skin, allowing Wind pathogen to invade the deficiency.
Treatment Principle: Tonify Liver and Kidneys, nourish blood, expel wind.
Prescription: Modified Shen Ying Yang Zhen Tang.
Herbs: Prepared Fleeceflower Root (Zhi He Shou Wu), Prepared Rehmannia Root (Shu Di Huang), Dodder Seed (Tu Si Zi) 12g each; Chinese Angelica Root (Dang Gui), White Peony Root (Bai Shao), Szechuan Lovage Rhizome (Chuan Xiong), Gastrodia Rhizome (Tian Ma), Ledebouriella Root (Fang Feng), Tribulus Fruit (Bai Ji Li), Motherwort (Yi Mu Cao) 10g each; Cicada Molt (Chan Tui), Safflower (Hong Hua) 6g each. 20 doses. Decocted in water, taken warm twice daily, morning and evening. Additionally instructed to apply a tincture made by soaking 3g of Cantharides (Ban Mao) in 500mL of 60% alcohol for one week, applied to the affected areas twice daily.
Second Consultation: Fine new hair growth observed in the bald patches, skin appeared flushed. Patient reported no new areas of hair loss since starting medication. Removed Ledebouriella Root (Fang Feng) and Cicada Molt (Chan Tui) from the original formula. Added Glossy Privet Fruit (Nv Zhen Zi) 15g and Stir-fried Peach Kernel (Chao Tao Ren) 6g. Prescribed another 20 doses.
Result: New hair became thicker, harder, and had grown to about 1cm long.
