Scalp Healing with a Unani Therapeutic Regimen in Pityriasis Capitis: A Case Series

Abstract

Pityriasis capitis is a common scalp disorder affecting 50-70% of the global population and has a considerable psychosocial and economic impact. In Unani medicine, it is described as Huzaz, caused by temperamental imbalances (Fasād-i-Mizāj) and abnormal fluids (Fāsid rutubāt). Classical texts recommend sugarcane vinegar and beetroot-borax decoction for treatment, though clinical validation is limited. This case series presents clinical evidence supporting the efficacy of this Unani regimen in managing chronic, relapsing dandruff resistant to conventional therapies. Three patients (aged 20-28 years; two males, one female) presented with persistent scalp itching, burning, and scaling for 2-6 months, unresponsive to antifungal shampoos and corticosteroids. All were diagnosed with pityriasis capitis and treated with a Unani regimen: overnight application of sugarcane vinegar, followed by 30-minute application of beetroot decoction mixed with borax, every third day for 15 days. Symptom severity was assessed using the Visual Analogue Scale (VAS), and trichoscopic evaluation was conducted using the Scalp Photographic Index (SPI). By day 7, patients showed significant improvement (VAS reduced from 7-9 to 1-5). By day 15, two had complete resolution (VAS and SPI: 0); the third showed near-complete relief (SPI-dandruff: 1). No adverse effects were reported. This case series highlights the potential of Unani regimen as safe, and effective approach for pityriasis capitis. The observed outcomes suggest that this regimen may serve as a valuable complementary intervention for dandruff. Further large-scale, controlled studies are needed to substantiate these findings and determine long-term efficacy.