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Hair Problems and Scalp Disoders . Assoc. Prof. Dr. Pleumchitt Rojanapanthu Pharmacy Department, Faculty of Pharmacy Mohidol University, Bangkok, Thailand. Hair Problems. Loose hairs telogen hairs : hairs that are ready to fall follicle root is a little hard, white bead

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Hair Problems and Scalp Disoders

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hair problems and scalp disoders

Hair Problems and Scalp Disoders

Assoc. Prof. Dr. Pleumchitt Rojanapanthu

Pharmacy Department, Faculty of Pharmacy

Mohidol University, Bangkok, Thailand


Hair Problems

Loose hairs

  • telogen hairs : hairs that are ready to fall
      • follicle root is a little hard, white bead
      • as called “brushed-out” hair

Loose hairs (con.)

  • anagen hairs : hair that is “pulled out”
      • follicle root is fat
      • soft to touch and sticky, stick to your hand
      • still carry fluid from the follicle
      • pulling it out hurts
      • one which was not ready to be shed

Hair Damage

Causes of hair damage

  • Weathering
  • Cutting and styling
  • Sunlight
  • Mechanic
  • Heat
  • Hair treatment

Damage from weathering

  • gradually wearing away of cuticle of the
  • hair shaft
  • exposes the cortex, which becomes worn down
  • badly weathered hair is quite common
  • all hair has its limit

Weathering (con.)

  • once that limit is passed and the hair

has seriously broken down

  • new hair first grow up out of the scalp
  • cuticle consist of up to ten layers of long “scale”
  • it is in credible thin : only 3-4 micron
  • only thing to be done is to cut it off

Very highly magnified electronmicrograph of

normal cuticles, showing how the scales overlap

(the scale run from the base of the hair towards the tip)


The tip of a normal hair

that has been normally



Damage form hair cutting and styling

  • blunt scissors a long jagged edge at

which cuticle scale further damage

  • good quality scissors cut clearly
  • razor long, tapering section of the

cuticle which weather quickly and even bask


Damage form hair cutting and styling

  • cutting dry hair belief it savehair form

have brushing when is damp and

therefore vulnerable is damaging

  • a circular or semicircular brush is preferable

and least damaging


The continuing destruction of the cortex of a hair: the long parallel bundles of keratin have been exposed and can be seen clearly


The cortex has ruptured and canno

t be repaired, so that the only course

of action is to cut off the hair

The use of good-quality scissors is

a vital part of hair care

Damage from the sunlight

UV from direct sunlight

  • affcets the cuticle in similar way to a bleach
  • keratin protein of the hair breaks down
  • hair is gradually weakened and become dryer

Sunlight (con.)

  • break up some of the chemical links with

in amino acid

  • particular those between carbon and

sulphur atoms

  • does not affect disulphide linkages or

hydrogen bonds


Mechanical damage

  • hair can be damaged by brushing

especially when it wets and tangling

  • metal combs are hard for the hair
  • back brushing and backcombing are

extremely harmful


Mechanical damage (con.)

  • backcombing tug against the scale of


  • delicate scales are lifted and will be

ripped off for the next combing

  • backcombing process is one of the most

damaging physical treatment


Heat damage

  • blow drying reduces the moisture content
  • hair dryer first softens the keratin of the hair
  • it’s too hot actually cause the water in the hair

to be boiled

  • ting bubbles of steam form inside the soften

hair shaft


Damage from hair treatment

  • shampooing should not damage the hair

modern shampoos do not lift the cuticle

  • hash shampoos acute and irreversible

tangling or matting

  • modern shampoos contain conditioning agents

and help to protect the hair


Damage from hair treatment (con.)

  • wetting and drying hair without shampoo

small amount of matting or small lock

of hair

  • friction is higher in wet hair than in dry
  • cosmetic procedure : permanent waving,

bleaching and dyeing all damage the hair

Permanent waving
  • permanent waving agent break the

disulphide bond which give the hair

shaft its structure

  • the hair is then put into new shape



Permanent waving (con.)

  • neutralization reforming of chemical bonds in their

new positions

fixing the hair permanently in to its new shape

  • neutralization lotion should be applied at the right

length of time

perm is fixed, the hair is damaged as little as



The cuticle of this hair has been significantly

damaged by repeated and excessive perming


Perm shock

  • putting on perming lotion hair is in a very

vulnerable condition

keratin is soften and greatly swollen

  • during rinsing with neutralizing lotion

cortex is in the process of being chemical changed

cuticle may have been slightly damaged


Problems in perming and straightening

  • not all of hair suitable for perming
  • although some of disulphide linkages reform

during neutralizing, a proportion fail to do so

and remain broken

  • the hair is weaken
  • the cuticle scale fail to close up tightly again after



Problems in perming and straightening (con.)

  • the hair rough surface and weather more


  • in correct application of perming, straightening or

relaxing solution

can dissolve the hair fibers/lead to brakage

usually quite close to the scalp


Summary of hair damage

  • the hair is weakened
  • the cuticle begins to breakdown
  • the cuticle disappear
  • the cortex is exposed
  • splits and appears
  • the hair breaks

A split end that has been

temporarily repaired

A case of trichorrhexis nodosa, where the cortex was disrupted by an overheated hair dryer


Cosmetic Problems

Green hair

Condition is always associated with copper

  • lost in the background color
  • swimming pool water using chloride or
  • copper as algicides
  • high levels of copper in pipes increase
  • copper levels in drinking water
Bubble hair
  • tiny ‘bubbles’ in the end of the hair cause by :
  • some kind of heating appliance
  • most often curling irons

Heating between 120 C– 180 C

  • hot curling put on the wet hair
  • boils the water inside the hair

Bubble hair (con.)

  • boiling water softens the keratin of cortex
  • steam from the boiling water expands
  • form ting bubble inside the hair
  • eventuallythe hair breaks off somewhere

near a bubble


Hair spray accumulation

  • forming a perfectly smooth cylinder around

the hair, not touch each other

  • spray droplet touching each other
  • the spray welded two hairs together
  • will create replica of cuticle of the second hair

Hair spray accumulation (con.)

  • spraying quite often hair spray built

up on the hair

  • modern shampoos technology is excellent at removing even a week’s accumulation of hair spray, grease and dirt

A spot weld between two hairs produced by

a droplet of a modern hair spray


In this photo you can see a perfect replica of

the cuticle of the second hair, here.

This kind of replica may be seen in heavily

sprayed hair which is not washed often enough

Hair and

Scalp Disorders


Hair loss is extremely common

in both men and women; it is

slightly more common in people

with Caucasoid hair than in other



From this... this


The typical Ludwig pattern of

baldness, seen here in a young


Extreme Ludwig pattern hair

loss in a elderly lady


Female pattern balding: in spite of extensive hair

loss, this lady has (just) retained her original hairline


Natural shedding

  • all hairs naturally fall out at the end of

growing period

  • everyone loses between 50 and 80 hairs a days
  • tend to come out with brushing and shampooing
  • washing hair once a week loses several




  • a person may start to loose more hairs than usual
  • the hair loss is significant and persist
  • sooner or later the scalp may become

visible through the thinning hair

  • this condition is called “Alopecia”

(Greek : alopekia = fox, dog

suffer from bald patches due to an

unpleasant disease “mange”



  • commonest kind of hair loss
  • it is not a disease
  • it is perfectly normal event
  • it has caused concern and anxiety
  • affects both men and women

Baldness (con.)

  • much more obvious in men
  • by the age of 25 : 25% of men have lost

some of their hairs

: 50% by the age of 50

  • baldness is genetic

In men

  • baldness usually begins at the temple
  • above the forehead and the crown of the head
  • the hair follicles are genetically pre-programmed to revert from producing terminal hairs to produce vellus-like hairs

Baldness (con.)

  • thegrowth phase of hair (anagen)

becomes shorter and shorter

  • the change happens under the influence

of male hormone (androgen)

  • can begin as early as the time of puberty

or soon after

“Androgenic Alopecia”


Some facts about baldness

  • is not due to the wearing of hats, caps

turbans or helmets

  • is not due to the air pollution
  • no causmetics : soaps, shampoos or coditionerscan cause the boldness
  • “scalp tonics” and other lotions do not make

hair re-grow


Diffuse hair loss

  • the hair is shed from all parts of the scalp
  • the hair may fall during either the growing

(anagen) or the resting (telogen phase)

  • a sudden diffuse loss of hair may be both

dramatic and distress

  • wellknown cause : anti cancer drug

Telogen effluvium

  • women may have some diffuse hair loss after

the birth of a baby

  • during pregnancy female hormone
  • stay in anagen phase throughout the pregnancy
  • baby born female hormone
  • folloicles enter the catagen phase
  • soon afterwards, they enter the lelogen phase

lost some two or three months


Scalp disorders

  • skin ofscalp is different from the skin


  • very rich supply of grease from sebaceous


  • carry follicles that produces the terminal hair
  • scalp and hair more expose to sunlight

Scalp disorders (con.)

  • scalpitself may be affected by many

cosmetic procedures from shampooing

to perming

  • understanding these conditions and

advising client correctly is a vital part

of client care

Scaling condition


  • named “Pityriasis Capitis”
  • about half or Caucasians will have dandruff
  • to some degree before they are 20
  • disappear after 50 or so

Dandruff (con.)

  • top layer of scalp (epidermis) consists of dead cells
  • dandruff is associated with a tiny yeast
  • “Pityrosporum ovale” normally presentson the sealp
  • more cells on the surface are lost more quickly
  • the yeast grow more rapidly
  • the cells may clump to together to produce the
  • all-to-familiar flakes of dandruff

Dandruff (con.)

  • dandruff” a clinical syndrome,is a

dislocation of stratum corneum function

  • associated with the presence of the fungal

microorganism Malassezia

  • the hair is technically dead and may carry

some of the damaged skin away


Dandruff (con.)

  • the fungus Malassezia,which has relevance

to the clinical condition of dandruff

occurs between the outer-most corneocyte

lamelle in the acroinfundibulum near

the skin surface, in company with many

other microorgnism


Hormonal influences on sebum production

  • testosterone and anabolic androgens sebum

secretion rate and skin-surface lipid levels

  • synthetic anti-androgens used for the control

of acne block testosterone receptors in the

pilosebaceous unit

  • in the conditions of pathological excess of

androgens such as polycystic ovary syndrome

(severe greasiness, seborrhea, of the skin)


Aeteology of Dandruff

Normal skin

  • balancing of newly generated
  • keratinocytes
  • preservation of integrity of the stratum
  • corneum

Dandruff skin

  • there is invariably abnormally accelerated

renewal of scalp epidermal cells associated

with abnormal desquamation

  • renewal cycle in daudruff person may be

5-14 days instead of 25-30 days (normal)


Dandruff skin (con.)

  • the depth of stratum corneum is reduced

to < 10 cell (typically 25-35 fully


  • closely coherent cell

The dandruff hypothesis

  • lipophillic Malassezia use a lipase to cleave

sebacaous triglyceides free fatty acid

  • Malassezia required saturated fatty acids

for survival

  • sebum mainly consists of triglyceride of

oleic acid (OA) with lower concentration of

stearic and palmetic acids


The dandruff hypothesis (con.)

  • Malessezia lipase in non specific (to saturation

and chain length

  • OA is skin irritation and it has been

experimentally demonstrated that

  • OA can induce dandruff at the absence

of Malessezia


The dandruff hypothesis (con.)

  • OA penetrates the stratum corneum to

the patho-physiological changes of clinical


  • Mallessezia globasa on the scalp digests

sebaceous triglyceride, releassing OA

  • OA penetrates the stratum corneum, breaking

down the skin barrier function


The dandruff hypothesis (con.)

  • the resultant barrier repair process causes
  • hyper proliferation and
  • increasing secretion of sebum
  • providing the Malessizia population
  • with a greater nutritional material

Simple treatment

  • using high quality of anti-dandruff shampoos

containing substances that are active against

the yeast

  • the best known is “zinc pyrithione”
  • regular use this type of shampoo

really helps


Antidandruff treatment

The essential of dandruff control

The products can be determined by 4 key factors :

  • intrinsic anti-fungal potency
  • delivery system of the anti-fungal agent to the


  • the presence of secondary mechanism of action

in addition to anti-fungal activity

  • delivery a cosmetically acceptable product

Antidandruff treatment (con.)

Antidandruff agents

  • cytostatic agents
  • Keratolytic agents
  • Antimicrobial agents

Antidandruff treatment (con.)

Depending on the mechanism of action

  • cytostatic (inhibiting cellular replication)
  • keratolytic (removing the surface layer of

affected stratum corneum by clevage

  • antimicrobial (inhibiting or destroying the

initiating biological entity)



  • the action depends on a reductionof the

stratum corneum cell renewal rate

  • as the length of the cell renewal cycle is

restored the normal physiology and desquamation improves

  • most agents have some anti-microbial activity

but show some irritation


Keratolytic agents

  • having a keratolytic effect remove a proportion

of the stratum corneum cells

  • products in this group including coal tar, sulphur

and salicylic acid

  • they have aesthetic disadvantages in smell and



Antimicrobial agents

  • antidandruff effect of anti-microbial products

depends on the present of substances that reduce and control the population of

Malassezia on the scalp

  • well recognized active ingredients :
      • zinc purithione (ZPT)
      • Azolio L ketoconazole and climbazole
      • Selenium disulphide