A Case of Alopecia in a 13-year-old Boy

A young boy came to see me a few years back. He always wore a baseball cap, the removal of which revealed patches of very thin hair primarily on top of his head and virtually no hair on the sides and occiput. His scalp was intermittently red and inflamed.

The boy suffered from Alopecia Areata. The problem began when the boy was 6, apparently following a bad cold. Initially there was one discrete patch of hair loss, but as months went by, baldness affected his entire scalp. Symptoms followed a sporadic course; worse after any sort of upper respiratory virus and worse in the spring and fall. At times the hair would begin to grow back here and there – especially in the summer – but would inevitably fall out again.

From 2 ½ to 6 years of age, the boy also had bouts of significant asthma. It flared up 2-3 times per year, sometimes necessitating trips to the emergency room. The asthma was associated with upper respiratory infections and seasonal allergies and treated with Albuterol and inhaled steroids. Interestingly, the asthma had stopped when the alopecia appeared.

Numerous practitioners had been consulted for the boy’s alopecia over the years, including an allergist (positive for various tree pollens and also dust mites) and several naturopaths. A number of treatments were tried, including dietary elimination of allergenic foods (based on ELISA testing), various nutritional and botanical supplements, various homeopathic medicines, acupressure and Chinese herbs, as well as some Ayurvedic protocols.

A dermatologist prescribed a series of topical steroid treatments without any significant benefit and his parents would not agree to the use of oral steroids. I tried five homeopathic medicines over the span of one year, but the results were also unsuccessful. He stopped coming for about 6 months, and then his parents brought him back.

Two years prior, some blood tests were run, including an ANA screen (negative), anti-Thyroglobulin (normal) and anti-TPO (slightly above high normal) antibodies. These tests had not been repeated.

He was quite soft-spoken, hesitant and timid in manner, answering most questions with one or two words. It was difficult to get information from him.

Here are a few pertinent excerpts from the first case:

Doctor: What’s it like to have this?

Patient: It’s ok, I’m used to it. I put on my hat so everyone doesn’t see it. People try to knock it off and they laugh and make fun of me….They don’t do it as much now….(His mother later described how devastated he had been by this over the years, kids calling him a freak, etc.)

D: What do you think might be the cause of the hair situation?

P: I have no idea about the cause.

D: Any guesses?

P: My body is weak, not strong, and it’s trying to attack something. My head gets weak and the hair falls out.

D: Describe yourself a little bit?

P: I’m quiet….I like to do quiet stuff at home, to build stuff, put stuff together, build things. I stay busy at home. I don’t like going out, talking everywhere, asking this, asking that…talking out of turn….my whole class talks out of turn. I don’t want to be like them…. Also, I play chess. I go to tournaments. (His mother later told me how very competitive he is, constantly comparing himself to other players, constantly strategizing how to improve his position in the chess rankings. He’s very good, placed 21 out of 500 kids in his age bracket at the national tournament.)

D: What were you like when you were little?

P: I was wild, I think, running around everywhere. I followed everyone, tried to do what everyone else was doing. I tried to copy them, do what they were doing. I tried to be like everyone else….

D: What about now?

P: Now I don’t try to be like everyone else or do the same stuff as them. I try to do it differently. I try to play different chess moves, try new stuff. I try to do it on my own. It’s not good to copy. It’s bad.

D: What would it be like, to copy?

P: You would feel like you can’t do anything. You think you can’t do it, so you copy other people. You don’t want to get it wrong, because then people will laugh at you.

D: So what bothers you the most, out of everything?

P: Ants! Bugs in the house really scare me. They’re black and they crawl around everywhere in the house. I’m afraid of bugs in the house.

I was grateful to have a second chance to help this boy. I tried to keep an open mind, realizing that the previous case analyses and careful repertorization had not led to a good result. I tried to just inquire about things and see where it might lead me. Fortunately, I did find a very successful homeopathic medicine for him.

Excerpts from the re-opened case:

(Again he has his cap on.)

D: So what has been happening?

P: I’ve been in school, getting good grades. I have some friends. They’re not wild or bad and they don’t get in trouble. We’re not like the other kids.  I’ve been trying to practice for chess tournaments. There was a 2-day tournament last weekend. I played five games, won three, felt happy, but also felt I should learn from my mistakes and do better.

D: What was it like, playing at the tournament?

P: The games were so long and tough. I was nervous, thinking through the moves. Make the wrong move and you lose. You’re done for. It’s tiring, having to think so much.

D: What else is going on?

P: My hair has been coming out more. It’s thicker in the back.

(Exam of hair: there is some fairly thick hair in the occiput area, and some thinner hair on top, in the midline; otherwise, the scalp is mostly bare.)

D: What else?

P: It’s really hard to get up in the morning. I just want to hit the alarm clock and go back to sleep, because I’m so sleepy.

D: So tell me, what is your favorite stuff to do?

P: Well, playing chess, thinking through all the moves, all the possibilities. And playing computer games. And looking at interesting news stuff.

D: Like what?

P: Like how they found Bin Laden. And like mystery shows, where someone killed someone and then they run away, and the police try to find them. Wondering what will happen. Will the bad person be caught? Things like that.

D: So those are things you like—What things do you really not like?

P: I really don’t like people getting mad at me, like when I don’t do a chore right away, and my father gets mad at me. Or if people make fun of me.

D: What is it like, when that happens?

P: Really, really sad.

D: Certain foods you really like or dislike?

P: I like chicken, potatoes, and broccoli. I hate fish and all seafood—their eyes look like bugs to me.

D: Bugs?

P: Yeah, I can’t stand bugs. I’m afraid of them. They crawl everywhere. So small and so fast. So ugly and unattractive. It makes me want to run away. I don’t want to touch them. I’m afraid they will crawl all over me. I’d scream. Especially ants and spiders, because they could be in my house.

D: Ants, spiders, bugs…..What do you imagine it would be like, to be a bug?

P: Well, you are in your group of bugs, just following everyone else. You are trying to survive, trying to find food to eat. And you are so tiny and a lot of things can kill you. You are scared all the time. You might not find food. You are so small, and something can just fall on you. Make a wrong move and you’re dead!

D: What would you say is unique about you?

P: I’m quiet. I raise my hand before talking in class, to be respectful. I’m not like the other kids. They just talk without waiting.

Mother’s info (summarized):

He seems mild, but he’s very intense. He often doesn’t express what he’s thinking and feeling. He has a problem with rules and authority, feels restricted, pushes everything to the limit, goes around our rules, then is defiant and angry when found out. “I hate my family!” “So many rules!” Acts like we are treating him like a servant or a slave. Very angry and sometimes crying about this, storms off to his room.

About the hair—It’s pretty much like it was a year ago. Worse in the spring, then it tries to fill in during the summer, then worse again in the fall. The thickest part right now is in the back. The sides have really thinned out in the last few months. (It’s May at this point.)

He loves fire, likes to light something small on fire, likes burning ants with a magnifying glass. He’s really afraid of ants.

He likes new things, novel and unusual things, strange things. He finds strange videos on YouTube and then wants me to come watch them, things like tooth extractions! “Look, Mom!” Anything unusual, exciting to him. Magic tricks, roller coasters, thrill rides. How to do something strange, maybe even scary or gory. This part of him seems kind of odd.

My analysis at this point:

I had previously tried five common remedies without success, including Calcarea phosphorica, Phosphoric acid, and Lycopodium. This time I tried to look at the information as simply and directly as possible. I looked at four rubrics: Falling out of the hair; Ailments from mortification combined with Embarrassment; and Eccentricity.

The remedies covering these rubrics were: Petroleum, Lachesis, Belladonna, Sepia, Arsenicum, Lycopodium, Natrum muriaticum, Colocynthis, Apis, Opium, Ambra grisea, Silicea, Sulphur, Calcarea carbonica, Causticum, Mercurius, Zincum, Kali carbonicum, Pulsatilla, Cyclamen, Ammonium carbonicum, Helleborus, and . . . . . . .Formica rufa, which is made from the “red ant.”

I reflected on his specific and pronounced fear of ants, and his vivid, imagined description of an ant’s life — “You are in your group. . . just following everyone else. . . . make a wrong move and you’re dead!” — was quite similar to his description of his own life and experience: ”I followed everyone, ….tried to do what everyone else was doing. . . . make the wrong move and you lose.”You’re done for.”

In addition, I noted that he had talked about survival, weak versus strong, and sudden death. His mother described his tendency for competitiveness and comparison of self with others. These could be seen as elements suggesting a remedy made from an animal substance. The issue of being in a group and being just like everyone else or being different from the others could suggest a social animal of some kind.

So, with considerable hesitation, I gave him Formica rufa 30c, to be taken once per day.

The results were quite gratifying. At the next follow-up two months later, his hair was 75% filled in, and he had had a viral illness without a setback in the hair growth.

At the next follow-up three months later, his scalp was completely filled in with thick hair, and it has remained so to the present time, which is now two years and eight months since the Formica rufa prescription.

His mother also reported that he became calmer, more mature, and more emotionally expressive after the remedy was given.

But the best moment was the day he came to see me for a follow-up, and he was no longer wearing his baseball cap!

I would be happy to answer any questions anyone might have about this case.

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