EADV Fostering Training Course in Hair & Scalp

EADV Fostering Training Course in Hair & Scalp
Bologna, Italy - 18-20 November 2011
Hair Cosmetics
Professor Ralph M. Trüeb, M.D.
Center for Dermatology and Hair Diseases
Zentrum Wallisellen
Bahnhofplatz 1a
CH-8304 Wallisellen (Zurich)
Switzerland

Significance of Hair
Hair care, color and style play an important role in
people’s physical appearance and self-perception.
Hair defines an individual’s:
• gender
• age
• sexual attitude
• social status.
There are no significant differences in the number of
hair follicles between men and women, or between
different races.
Differences in the appearance of hair are due to:
• type of hair produced by a follicle
• type of hair care and cosmetics practiced by the
individual.

Relevant Criteria for Condition of Hair
in Men (Swiss Survey)
Criteria: 1
(unimportant)
Wellgroomed
appearance
Good hairstyle
Appropriate
hair-style
Hair growth:
• Length
• Density
6 %
13 %
19 %
27 %
35 %
2 3 4 5
(very
important)
3 %
7 %
9 %
17 %
19 %
12 %
21 %
22 %
24 %
21 %
From: Trüeb RM et al. Schw Rundsch Med 2001;90:241-248
24 %
31 %
24 %
9 %
13 %
55 %
28 %
26 %
13 %
12 %
Mean
4.2
3.5
3.3
2.7
2.5

Condition of the Hair Fibre
• Hereditary and ethnic factors
• Age and sex
• Nutritional and overall health status
• Condition of the scalp
• Hair length
• Hair care and styling habits
• External factors and hair damage
incl. from cosmetic hair treatments

Hair Weathering: Hair Damage Resulting from External Factors
„Wear and tear“ from environment and cosmetic procedures that mainly
affects the free end of the growing hair fiber:
• Friction damage from combing and brushing
• Damage from excessive heat „blown“ or from
curling irons
• Structural and chemical damage from
chemical treatment of hair, i.e., bleaching,
coloring, perming, and straightening
• Effects of UVR (photoaging)

Hair Weathering
Alterations in the ultrastructure, physical and chemical properties of the hair fiber:
• Mechanical abrasion of the cuticle
• Damage of the hair cortex with alterations of visco-elastic properties and
tensile strength of the hair fibre
• Depletion of specific amino acids: methinonine (- 50%), tryptophane (- 50%)
cystine (- 20%), histidine (- 20%), tyrosine (- 15%), lysine (- 10%),
Gummer and Schiel. 4th Intercontinental Hair Research Societies Meeting, Berlin, June 17-19, 2004
Trichorrhexis nodosa

Effect of UVR on Hair
Photodamage is a common cause of poor hair condition
(and underscores the significance of photoprotection)
Effects of UVR on hair (color, structure, and growth):
• Sunlight damages both hair color and hair structure (hair photoaging)
• Gray hair is more susceptible to UV-induced damage than pigmented hair
• acute telogen effluvium
Hoting et al. J Soc Cosmet Chem, 46, 85-99, 1995
Camacho et al. Arch Dermatol 1996;132:1398-1399
• production of porphyrins by Propionibacterium sp. in the pilosebaceous duct, with
photoactivation leading to oxidative tissue injury and follicular microinflammation
Piérard-Franchimont et al. Exog Dermatol 2002;1:203-206
• direct physicochemical stress from UVR to keratinocytes with production of radical oxygen
species and nitric oxide and release of proinflammatory cytokines, eventually leading to
injury of the putative site of follicular stem cells in the superficial portion of the hair
follicle
Mahé et al. Int J Dermatol 2000;39:576-584

Cosmetic Hair Treatment:
• Cleansing hair
• Conditioning hair
• Styling hair
• Changing hair
colour/colouring hair
• Perming hair
Trüeb. J Invest Dermatol Symp Proc 2005;10:289-292
Science of Hair-Care
„Cosmeceutical“
• Promoting hair
growth?
• Preventing hair
aging?
Medicinal Treament of
Specific Problems
Relating to Superficial
Condition of Scalp:
• Dandruff (pityriasis)
• Itchiness (pruritus)
• Hair loss (alopecia)
• Specific dermatologic
conditions of the scalp

Hair Cosmetics
Hair Shampoos: To remove sebum and
environmental dirt without decreasing cosmetic
appearance of hair.
Hair Conditioners: To improve hair manageability,
decrease hair static electricity, add luster, and
enhance styling ease.
Hair Styling Aids: To maintain hair in fashionable
arrangement while improving the quality of hair fibers.
Hair Dyes: To lighten or darken hair color while
covering gray hair
Permanent Hair Waving/Straightening: To
reposition hair keratin disulfide bonds in a new curly
or straight position

Hair Shampoos
The art of shampoo formulation is selecting the right detergent
combination to cleanse the scalp and beautify the hair simultaneously.
Term from Hindi câpnâ, „to press or knead“
Most common form of cosmetic hair treatment. 50% of total
units sold in hair products sector
Today‘s consumer expectations (multifunctionality):
• Cosmetic benefit
• Tailored to variations associated with :
- age
- hair quality
- hair care habit
- problems relating to the superficial condition of scalp,
i.e. greasiness, dryness, itchiness, flaking (dandruff)

Modification of
surfactant activity
Amphoterics
Foam stabilizers
Humefactants
Thickeners
Cleansing agents
Detergency
Anionics
Nonionics
+
Additives
Product stability Product comfort
Preservatives
Chelating agents
UV absorbers
Buffering agents
Emulsifiers
Solvents
Shampoo Ingredients
Conditioners
Special care
ingredients
Treatment of specific problems related to the
superficial condition of the scalp
Cationics
Cationic polymers
Hydrolized proteins
Silicones
Waxes
Lecithine
Panthenol
Ceramide
Fragrances
Colorants
Pearlescents
Opacifiers
Herb extracts
Crude coal tar
Selenium disulfide
Zink pyrithione
Octopirox
Ketoconazole

Cleansing Agents
Lipophilic fatty chain Hydrophilic end
Surfactant type:
(polar group charge)
Anionics
(negative)
Cationics
(positive)
Amphoterics
(both)
Nonionics
(none)
-
+
+
-
0 0 0
There are four categories of shampoo detergents
with different hair cleansing and conditioning qualities,
combined to yield the final shampoo characteristics
Chemical class/examples: Characteristics: Purpose:
Lauryl sulfates, laureth
sulfates, sarcosines,
sulfosuccinates
Long chain amino esters,
ammonioesters
Betaines, sultaines,
imidazolinium derivatives
Polyoxethylene fatty
alcohols, polyoxyethylene
sorbitol esters,
alkanolamides
Deep cleansing, may
leave hair harsh
Poor cleansing, poor
lather, impart softness
and manageability
Nonirritating to eyes,
mild cleansing, impart
manageability
Mildest cleansing,
impart manageability
Cleansing
Conditioning
Additive for
modification of
surfactant activity
Cleansing

Conditioning Agents
Sebum is the ideal hair conditioner. Excessive removal of sebum in the course
of washing the hair and scalp created the need for synthetic sebum-like
substances that attempt to supply hair with the positive attributes of sebum while
avoiding the greasy appearance of excessive sebum and dirty hair.
Aim of conditioners:
• Impart softness
• Increase luster and gloss
• Reduce fly-away
• Enhance disentagling facility
• Alleviate defects related to certain types of
hair and hair treatments (hair weathering)
Products:
• Shampoos for dry or damaged hair
• Conditioning („2-in-1“) shampoos
• Hair conditioners (liquids, creams, pastes, gels)

Conditioning Agents
Hair conditoner
category
Fatty ingredients Fatty alcohols, lanolin
derivatives, oils,
waxes, lecithins
Cationic detergent
and film formers
Primary ingredient Main advantage Hair grooming benefit
Quaternary
ammonium
compounds („quats“)
Polymers
(polyquaternium)
Protein-containing Hydrolyzed proteins
(keratin, collagen, silk,
wheat, soya)
Silicones Dimethicone,
cycolmethicone,
amodimethicone
Increase hair shine,
increase hair
manageability
Smooth cuticle,
decrease static
electricity
Fill hair shaft defects,
decrease static
electricity, improve
shine
Penetrate hair shaft to
minimally increase
strength
Thin coating placed on
hair shaft
Improve appearance of
dry hair
Excellent to restore
damaged, chemically
processed hair
Improve appearance of
dry hair, improve
grooming of coarse,
kinky hair
Temporarily mend
splits
Decrease static
electricity, decrease
combing friction, add
shine

Special Care Ingredients
Aim at specific problems relating to the superficial condition of the scalp:
Dandruff
Greasiness/
Dryness
(seborrhoes/sebostasis)
Diffuse red scalp disease
Itchiness (pruritus)
Scalp dysesthesia (trichodynia)
Specific dermatologic
conditions of scalp
Scalp excoriations

Dandruff: Pathogenic Triangle
Malassezia
Yeast
Inflammatory
Initiator
Inflammation
Hyperproliferation
Parakeratosis
Sebaceous
Lipids
Skin Surface

Special Care Ingredients
Condition: Effect: Agent:
Dandruff Keratostatic
(slows cell turnover)
Keratolytic
(exfoliant)
Anti-fungal
(Malassezia spp.)
Itch Anti-pruritic
Crude coal tar (MIC: 250 – 5‘000)
Salicylic acid (MIC: > 100)
Colloidal sulfur
Selenium disulfide (MIC: 1.56-3.3)
Zink pyrithione (MIC: 0.78 – 1.66)
Ketoconazole (MIC: 0.1)
Others: Octopirox, Climbazole, Ciclopirox
olamine (available only in select regions of
the world)
Menthol
Polidocanol
Dry Humefactant Panthenol
Urea
Greasy Sebosuppressive Crude coal tar

Anti Dandruff Shampoo
Potency in terms of MIC‘s is important, but it is not the
sole factor that determines efficacy.
Other influential aspects of treatment pharmacology
include:
• Delivery
• Retention
• Bioavailability
• Mildness
• Aesthetics
Patients are compliant for only 30 seconds: Shampoos
that achieve antimycosis on contact lead to more
successful management of dandruff.
Because dandruff must be controlled through regular
treatment, the cosmetic aspects of shampoo-based
therapy must be acceptable to patients or compliacne will
be compromised.
3 out of 4 women suffering from dandruff would prefer to
use a medicated shampoo with conditioning benefits.

Aging Hair
• Loss of follicle rigor, consistent with slowing of other body activities with age
• Senescence of the hair is particularly visible
• Failure to pigment the hair shaft (graying)
• Decrease in rapidity of hair growth
• Reduction in the diameter of the hair shaft
• Senescent alopecia is different from androgenetic alopecia
Trüeb RM. Aging of hair. J Cosmet Dermatol. 2005;4:60-72.
Trüeb RM. Pharmacologic interventions in aging hair. Clin Interv Aging. 2006;1:121-9.

Cosmetic Treatment for Aging Hair
• 8 grooming rules for maintaining good looking hair
• Special shampoo selection for aging hair
• Conditioner use
• Use of hair styling aids
• Hair photoprotection

Eight Grooming Rules for Maintaining Good Looking Hair
• Manipulate hair as little as possible
• Comb hair gently
• Avoid combing wet hair
• Avoid high temperature appliances
• Select a vented ball tip styling brush
• Avoid scratching of hair and scalp
• Cut away split ends
• Preferably wear short hair style

Special Shampoo Selection for Aging Hair
Primary cleanser:
• Anionic, usually a lauryl sulfate, in combination with
a laureth sulfate
• or a sarcosine for dry hair
• resp. a sulfosuccinate for greasy hair
Secondary cleanser (for mild shampoos):
• Nonionic or amphoteric (in baby shampoos)
Shampoo conditioners:
• Mature individuals should select conditioners
developed for fine hair, preferably:
• silicone (dimethicone)
• panthenol (humefactant)
• hydrolyzed proteins (no build up)
Special „anti-aging“ ingredients (effect?):
• Antioxidants (protect shampoos from oxidation)
• Melatonin
• „Energizers“ (caffeine, guarana, gingko)
• Others from TCM (heshouwou) or Ayurweda

Adverse Effects from Cosmetic Hair Treatment: Hair Loss
Women with telogen effluvium often blame hair cosmetics for their hair loss.
Diffuse hair loss associated with the use of
keratostatic anti-dandruff agents has been
discussed in the literature.
Grover RW. Diffuse hair loss associated with selenium
(Selsun) sulfide shampoo.
J Am Med Ass 1956;160:1397-1398
Archer et al. Effect of selenium sulfide suspension
on hair roots. J Invest Dermatol 1960;35:65-67
Orentreich et al. Selenium disulfide shampoo.
It’s influence on hair growth and the follicular cycle. Arch Dermatol 1964;90:76-80
The absence of effects of shampoos on hair loss rates has been demonstrated.
Kullavanijaya et al. Absence of effects of dimethicone- and non-dimethicone-
containing shampoos on daily hair loss rates. J Soc Cosm Chem 1992;43:195-206
Acute diffuse telogen effluvium may follow allergic contact dermatitis of the
scalp to hair dyes.
Tosti et al. Telogen effluvium after allergic contact dermatitis of the scalp.
Arch Dermatol 2001;137:187-190

Hot-Comb Alopecia
Hot-comb alopecia (follicular degeneration syndrome,
central centrifugal scarring alopecia)
• Well-defined area of partial hair loss over the top of
the head
• Seen almost exclusively in patients of African origin
• Presumably related to peculiarities of African hair
anatomy and grooming habits
• Possibly related to excessive use of heat
LoPresti et al. Arch Dermatol 1968;98:234-8
• Adverse effects reported by persons who used a commercial hair-straightening
product known as the „Rio Hair Naturalizer System“ (World Rio Corporation).
Most reported substantial hair loss, with a majority indicating growth of new hair
that was abnormal in both quantity and quality.
Swee et al. A nationwide outbreak of alopecia associated with the use of a
hair-relaxing formulation. Arch Dermatol 2000;136:1104-1108

Hair Matting
Rare condition of dramatic onset of
irreversible tangling of scalp hair.
Hair matting is not a primary hair disorder:
Physical conditions, chemical agents, and
behavioural factors play the main roles:
•There is invariably a history of previous
chemical hair treamtment.
•The piling of long hair on the top of the head
while shampooing and the repeated friction of
wet hair facilitate the process of matting.
Microscopy showes twisting and bending of the
hairs through 180 degrees.
Cutting off the affected hair and avoiding all
possible trigger factors are the treatment of
choice.
Al-Ghani et al. Matting of hair: a multifactorial enigma. Dermatology 2000;20:101-104

Bubble Hair
Acquired hair shaft abnormality characterized by
a localized area of weak, dry and brittle hair
which breaks easily, and bubble-like areas in
the hair shaft seen with light microscopy
The overall texture of the hair may change from
soft and naturally curly to straight and stiff.
Bubble hair is a reproduceable hair shaft
defect caused by heat.
Brief, focal heating of damp hair is sufficient to
cause bubbles to form inside the hair fibres.
The use of overheating hair dryers, or any other
hair care equipment that overheats, should be
avoided.
Gummer CL. Bubble hair: a cosmetic abnormality caused by brief,
focal heating of damp hair fibers. Br J Dermatol 1994;131:9801-903

Cosmetically Induced Hair Beads
Monilethrix-like appearance of hair shafts
through build-up of polymers (PVP, vinyl
acetate, methacrylates) on hair.
Due to excessive use of hair lacquer and
hair styling gel.
Light microscopy reveals that the hair is
encircled by a material with a flassy
appearance.
Itin et al. Cosmetically induced hair beads. JAAD 1997;36:260-261

Thank you for your attention!
www.derma-haarcenter.ch
„Ah, such are the lures of the toilet
that none will for long hold aloof from them.
Cosmetics are not going to be a mere
prosaic remedy for age and plainess,
but all ladies and all young girls
will come to love them.“
Max Beerbohm.
A Defence of Cosmetics, 1894