Plica Polonica also known as Plica neuropathica is a rare disorder of hair shaft that presents as matted hair, which are entangled to form a sticky mass.
Plica Polonica appears as compact or solid mass of scalp hair with irregular twists. The hair is irreversibly entangled to form plaits. The hair plaits get very hard over time as the keratin mass gets cemented together with dirt and exudates. The scalp hairs have matted appearance that is impenetrable. Plica Polonica is also known as birds nest due to its resemblance to irregular twists of a nest.
How is Plica Polonica prevented?
Prevention tips for plica Polonica or matted hair include:
- Regular cleaning of the hair with mild cleansers,
- Avoiding harsh chemicals or shampoos,
- Regular scalp massage with oil,
- Gentle combing to avoid entangling,
- Regular hair trimming,
- Avoiding piling hair over the crown while washing,
- Changing habit of twisting hair.
Symptoms
Plica Polonica shows some very typical symptoms such as:
- Irregular twists and tangles in scalp hair,
- Formation of hard keratin mass that is impenetrable,
- Foul smell from hair mass,
- Hair cemented together with formation of pus, blood, crusts and dirt,
- Hair loss from rest of the scalp,
- Infestation with nits and lice,
- Inflammation of scalp.
Causes of Plica Polonica 
The causes of Plica Polonica are combination of physical, chemical and behavioral factors.
The common causes of Plica Polonica include:
- Frequent use of harsh shampoos that causes hair splitting,
- Poor scalp hygiene,
- Infestation with lice,
- Irritant contact dermatitis of the scalp,
- Psychological disturbances,
- Vigorous rubbing of hair.
Risk factors
Plica Polonica has been reported in adults as well as children. Factors that include the likelihood of developing tangles and twisted hair include:
- Having kinky hair,
- Women with long curly hair,
- Longitudinal splitting and weathering of the hair,
- Habit of vigorously rubbing, pulling or twisting hair,
- Mental condition such as schizophrenia, depression, hysteria etc,
- Pyoderma scalp,
- Taking some allopathic medication e.g. azathioprine,
- Febrile illness,
- Excessive sweating on the scalp,
- Wearing tight caps of scarves that increase friction on the scalp.
Allopathic treatment of Plica Polonica
The allopathic treatment of Plica Polonica begins once the diagnosis of hair matting is confirmed on the basis of appearance of twisted hair mass and careful examination of scalp. Tracheoscopy may be used to detect hair twisting, formation of hard keratin mass and nits and lice infestations.
The allopathic treatment for severe Plica Polonica is usually difficult. People with psychological disturbances and those with religious belief may get aggressive during treatment. 🤷♀️🤷♂️
The early stage of Plica Polonica can be performed by:
- Thorough washing of hair with shampoo,
- Manually separating the entangled hair using organic solvents.
In severe case of Plica Polonica where an inflammation of scalp, infestation with lice, and formation of hard keratin mass is observed the treatment includes:
- Cutting the matted hair,
- Completely shaving off the head,
- Overnight application of insecticides such as 1% permethrin lotion for lice infestation,
- Broad-spectrum oral antibiotics to treat bacterial infection.
Homeopathic Treatment for Plica polonica 
Treatment of dirty patients, of skin diseases especially scalp and hairs are very easy, time saving and cheap with Homeopathic medication, having no steroids, antibiotics etc. Here are very few (of my experienced – Dr Qaisar Ahmed) medicines for skin especially hair diseases:
Vinca Minor
A remedy for skin affections, eczema, and especially plica polonica also, for hemorrhages and diphtheria. Tearing pain in vertex, ringing and whistling in ears. Whirling vertigo, with flickering before eyes. Spots on scalp, oozing moisture, matting hair together. Corrosive itching of scalp. Bald spots. Plica polonica. Irresistible desire to scratch. Difficult swallowing. Ulcers. Frequent hawking. Diphtheria. Corrosive itching. Sensitiveness of skin, with redness and soreness from slight rubbing. Eczema of head and face; pustules, itching, burning, and offensive odor. Hair matted together. Plica Polonica.
Nasal tip gets red easily. Moist eruption on septum. Stoppage of one nostril. Sores in nose. Seborrhoea upper lip and base of nose.
Staphysagria
Eczema of head, ears, face, and body; thick scabs, dry, and itch violently; scratching changes location of itching. Plica Polonica. Fig-warts pedunculated. Arthritic nodes. Inflammation of phalanges. Night-sweats. Itching eruption in hairs, above and behind ears.
Oleander
Itching, scurfy pimples; herpes; sensitive and numb. Nocturnal burning. Very sensitive skin: slightest friction causes soreness and chapping. Violent itching eruption, bleeding, oozing; want of perspiration. Pruritus, especially of scalp, which is sensitive. Eruption on scalp. Plica Polonica. Humid, fetid spots behind ears and occiput, with red, rough, herpetic spots in front. Corrosive itching on forehead and edge of hair; worse, heat.
Phosphoric Acidum
Pimples, acne, blood-boils. Ulcers, with very offensive pus. Plica Polonica. Burning red rash. Formication in various parts. Falling out of the hair. Tendency to abscess after fevers.
Rhus Toxicodendron
Scalp sensitive. Skin red, swollen; itching intense. Vesicles, herpes; urticaria; pemphigus; erysipelas; vesicular suppurative forms. Plica Polonica. Glands swollen. Cellulitis. Burning eczematous eruptions with tendency to scale formation. Humid eruptions on scalp; itching greatly.
Caladium Seguinum
Pruritus. Sweet sweat-attracts flies. Insect bites burn and itch intensely. Scalp itching and rash alternates with asthma (due to allergy to dandruff). Plica Polonica. Burning sensation and erysipelatous inflammation.
Natrium Muriaticum
Skin greasy, oily, especially on hairy parts. Dry eruptions, especially on margin of hairy scalp and bends of joints. Fever blisters. Urticaria; itch and burn. Crusty eruptions in bends of limbs, margin of scalp, behind ears. Plica Polonica. Warts on palms of hands. Eczema; raw, red, and inflamed. Affects hair follicles. Alopecia. Hives, itching after exertion.
Selenium Metallicum 
Dry, scaly eruption with itching about the ankles and folds of skin, between fingers. Hair falls out from brows, beard, and genitals. Plica Polonica. Vesicular eruption between fingers. Seborrhoea oleos; comedones with an oily surface of the skin; alopecia.
Petroleum
Very marked skin symptoms, acting on sweat and oil glands. Moist eruption on scalp, behind ears – sore to touch; eczema, intertrigo, etc, in and behind ears, with intense itching with deafness and noises. Fissures in meatus. Chilblains, moist, itch and burn. Bedsores. Skin dry, constricted, very sensitive, rough and cracked, leathery. Plica Polonica. Herpes. Slightest scratch makes skin suppurate. Intertrigo; psoriasis. Thick, greenish crusts, burning and itching; redness, raw; cracks bleed easily. Eczema. Rhagades worse in winter.
Heper Sulphuricum
Eruptions and glandular swellings. Unhealthy skin. Plica Polonica. Scalp sensitive and sore. Humid scald-head itching and burning. Cold sweat on head. Abscesses: suppurating glands are very sensitive. Papules prone to suppurate and extend. Acne – suppurate with prickly pain. Easily bleed. Every little injury suppurates. Chapped skin, with deep cracks on hands and feet. Ulcers, with bloody suppuration, smelling like old cheese. Ulcers very sensitive to contact, burning, stinging, easily bleeding. Sweats day and night without relief. “Cold sores” very sensitive. Cannot bear to be uncovered; wants to be wrapped up warmly. Sticking or pricking in afflicted parts. Putrid ulcers, surrounded by little pimples. Chronic and recurring urticaria. Herpes circinate. Constant offensive exhalation from the body.
Calcarea Sulphurica
Cuts, wounds, bruises, etc, unhealthy, discharging pus; they do not heal readily. Yellow, purulent crusts or discharge. Purulent exudations in or upon the skin. Skin affections with yellowish scabs. Many little matterless pimples under the hair, bleeding when scratched. Dry eczema. Eczema and torpid glandular swellings. Cystic tumors. Fibroids. Suppurative processes. Plica Polonica.
Sulphur
Tinea capitis, dry form. Scalp dry, falling of hair; worse, washing. Plica Polonica. Itching; scratching causes burning. Skin dry, scaly, unhealthy; every little injury suppurates. Freckles. Itching, burning; worse scratching and washing. Pimply eruption, pustules, rhagades, hangnails. Excoriation, especially in scalp in folds. Skin affections after allopathic local medication. Pruritus.
Tuberculinum
Plica polonica. Crops of small boils, intensely painful, successively appear in the nose; green, fetid pus. Chronic eczema; itching intense; worse at night. Acne in tuberculous children. Measles. Psoriasis.
Mezerium 
Scaly eruption, white scabs. Plica Polonica. Head covered with thick, leathery crusts, under which pus collects. Eczema scalp – intolerable itching; chilliness with pruritus. Ulcers itch and burn, surrounded by vesicles and shining, fiery-red areola. Zona, with burning pain. Eruptions ulcerate and form thick scabs under purulent matter exudes.
Graphite
Burning on vertex. Humid, itching eruption on hairy scalp, emitting a fetid odor. Cataleptic condition. Skin: Rough, hard, persistent dryness of portions of skin unaffected by eczema. Early stage of keloid and fibroma. Pimples and acne. Eruptions, oozing out a sticky exudation. Rawness in bends of limbs, groins, neck, behind ears. Unhealthy skin: every little injury suppurates. Ulcers discharging a glutinous fluid, thin and sticky. Swelling and induration of glands. Gouty nodosities. Cracks in nipples, mouth, between toes, anus. Plica Polonica.
Arsenicum Album
Scalp itches intolerably; circular patches of bare spots; rough, dirty, sensitive, and covered with dry scales; nightly burning and itching; dandruff. Plica Polonica. Scalp very sensitive; cannot brush hair. Skin itching, burning, swellings; oedema, eruption, papular, dry, rough, scaly; worse cold and scratching. Malignant pustules. Ulcers in hairs with offensive discharge. Anthrax. Poisoned wounds. Urticaria, with burning and restlessness. Psoriasis. Scirrhous. Epithelioma of the skin. Gangrenous inflammations.
Thuja Occidentalis
White, scaly dandruff; hair dry and falling out. Plica Polonica. Greasy skin of face and scalp. Polypi, tubercles, warts epithelioma, naevi, carbuncles; ulcers. Freckles and blotches. Perspiration sweetish, and strong. Dry skin, with brown spots. Zona; herpetic eruptions. Tearing pains in glands. Glandular enlargement. Nails crippled; brittle and soft. Eruptions only on covered parts; worse after scratching. Very sensitive to touch. Sarcoma; polypi.
Lycopodium Clavatum
Falling out of hair. Eczema; moist oozing behind ears. Deep furrows on forehead. Premature baldness and gray hair. Plica Polonica. Eczema about and behind ears – thick, yellow, offensive discharge. Otorrhea and deafness with or without tinnitus. Ulcerates. Abscesses beneath skin; worse warm. Hives; worse, warmth. Violent itching; fissured eruptions. Acne. Chronic eczema (associated with urinary, gastric and hepatic disorders) bleeds easily. Skin becomes thick and indurated. Varicose veins, naevi, erectile tumors. Brown spots, freckles worse on left side of face and nose. Skin dry, shrunken, hair becomes prematurely gray. Dropsies. Offensive secretions; viscid and offensive perspiration, especially of feet and axilla. Psoriasis.
PS: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).
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Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS); X-senior research officer Dnepropetrovsk state medical academy Ukraine; is a leading Homeopathic physician practicing in Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.
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