Hair loss can be divided into two main types: sudden hair loss (alopecia), or gradual hair loss (thinning hair). Traditional names for these conditions include glossy scalp wind (yóu fēng 油风), ghost shaved head (gǔi tì tóu 鬼剃頭), and moth-eaten hair baldness (fā zhù tuō fà 发蛀脱发).
Zhu Renkang, a famous Traditional Chinese Medicine (TCM) dermatologist from the middle of the last century, divides sudden hair loss into 4 clinical patterns: blood heat generating wind, qi and blood deficiency, liver and kidney deficiency, and blood stasis. He also divides thinning hair into 4 clinical patterns: blood heat with wind dryness, damp-heat steaming upward, blood deficiency with dryness, and liver and kidney deficiency. Let’s take a look at several of these patterns.
1) Sudden hair loss: blood heat generating wind pattern.
More common in adolescents. Since young people are full of vigor and vitality, they have a tendency towards blood heat. If they are habitually irritable or easily angered, this can lead to blood heat. Blood heat generates wind, which stirs the leaves to drop (causes the hair to fall out). The scalp may have slight itching, there may be headache. The tongue is red with a scanty coating, the pulse is thin, wiry, and rapid. The treatment method is cooling the blood and dispelling wind. Medicinals to use include: sheng di, dan shen, ce bai ye, nu zhen zi, sang ye, hei zhi ma, han lian cao, bai ji li.
2) Sudden hair loss: qi and blood deficiency pattern.
Common after serious illness or postpartum. Because qi and blood cannot ascend, hair is not developed. The treatment method is to strongly build qi and blood. Medicinals to use include: huang qi, dang shen, dang gui, bai shao, fu ling, chao bai zhu, shou wu, gan cao, and so on.
3) Gradual hair loss: Damp-heat steaming upward pattern.
Due to sweet, rich, fatty food, the spleen and stomach fail to transform and transport. Damp-heat in the interior is generated, and steam rises. The scalp is greasy and sticky, the hair roots are lose, there is itching and the hair falls in clusters. The tongue is red with a greasy yellow coat, the pulse is slippery and rapid. The treatment method is to manage dampness and clear heat. Treat with long dan xie gan tang with modifications. Medicinals to use include: sheng di, dang gui, long dan cao, huang qin, chi ling, ze xie, che qian zi, liu yi san, and so on.
4) Gradual hair loss: Liver and kidney deficiency pattern.
More common in middle-aged people who overthink, and work day and night. The hair is yellow and dull, or white. There is dizziness and sore back and knees. The tongue is crimson and lacking a coating, the pulse is thin and rapid. The treatment is to nourish the liver and kidney. Medicinals to use include: shu and sheng di, fu ling, ze xie, shou wu, shan yu rou, nu zhen zi, hei zhi ma, han lian cao, xian ling pi, and so on.
Treatment should be differentiated based on cause of disease, on the basis of clinical characteristics, and pattern identification.
Chinese medicine also recognizes that mental and emotional factors can play a role in hair loss. Qin Wanzhang said “It is recommended that the patient maintain a happy spirit, have ease of mind, and work and study must not be overly stressful. This can accelerate the therapeutic effect of the medicine.” Li Xiumin said "In addition to herbal medicine, patients with hair loss should be light hearted and optimistic in order to get twice the result with half the effort."