Alopecia means loss of hair or baldness. There are different causes and pattern of alopecia. Alopecia areata is a condition in which there is loss of hair in patches. A small patch of hair loss in beard area is called alopecia barbae. It is a type of alopecia areata. Alopecia Barbae can develop at any age in men after puberty. However it is often observed between 30-40 years of age. It is not common, 2% of men suffer from hair loss in sporadic areas of beard. It is characterized by small circular spots of facial hair loss often adjacent to one another or even at a distance. The skin of the patch is smooth and shiny .In the beginning, ,the area is small but as time passes it may increase in size.
There may be occasional burning and tingling sensation in the area. The cause of alopecia barbae still remains inconclusive. However lot of studies indicate it is an autoimmune problem where the immune system mistakenly attacks healthy human tissue .Hair follicles are targeted .the roots of hair becomes inflamed and hair falls out. Alopecia barbae is believed to have a strong family history. Emotional upset, mental stress, environmental situations, and depression are some of the triggering factors responsible for the disease. Alopecia barbae is not fatal but becomes a cosmetic problem for men. There have been several treatments for Alopecia Barbae like, Intra lesional Corticosteroids, Systemic Corticosteroids, , Minoxidil, Dithranol but they have a lot of side effects like obesity ,hypertension, skin thinning and these patients complaint of spontaneous remissions after stopping the treatment. Leeching (Hirudotherapy) is one of the most important and widely practiced method of regimental therapy used since long. Modern study of leech therapy has also shown significant results in many diseases .Surgeons uses the leech therapy in plastic and reconstructive surgery and for the treatment of postoperative venous congestion and graft rejections. Leeches contain more than 100 pharmacologically and biologically active enzymes having different actions like analgesic, vasodilatation, anti thrombotic action.
A male patient, 35years of age, with disease of one year duration was registered for the study. The diagnosis was also done clinically as a circular patchy loss of hair on the right side of cheek near chin. Before starting the therapy, the routine pathological and biochemical investigations including BT and CT were performed to exclude any bleeding disorder. Fresh leeches were procured and were then identified by zoologist. Then under aseptic procedures, 1 to 2 fresh leeches were applied on the affected areas of the beard till leeches were belly filled and fell down of there own ( approximately 45 minutes ). Then antiseptic dressing was applied on the site. This leech therapy was done every after 15 days for two months. The patient was examined for the presence of hair follicles and growth of hair over affected areas.Assessment Criteria: Assessment was done by digital photography and clinically by the presence of hair on the affected site of the beard. Digital photography was done on every follow up to assess the results.Alopecia barbae is definitely on rise and is the second commonest site after scalp. The post treatment follow ups shows no remission for further six months. the complete growth of hair can assumed to the bioactive substances ,coagulation inhibitors, vasodilators, platelet aggregation inhibitors, anti-inflammatory ,antimicrobial, platelet activating factors, proteinase inhibitors, hirustasin, hyaluronidase ,steroids and anaesthetizing agents