This article examines hair care in persons with hair loss. The use of shampoos, conditioners, and hair styling products to camouflage hair loss is discussed. Because hair is nonliving, medical treatments are limited to only inducing change in the follicles within the scalp skin and do not improve the hair loss actually witnessed by the patient. There is therefore a need to accompany medical treatment of hair loss with cosmetic hair treatment to optimize patient satisfaction.
Key Points
- •
Shampoos are used to cleanse the scalp and beautify the hair. These activities must occur simultaneously.
- •
Conditioning shampoos are valuable for patients with hair loss in maintaining adequate hygiene while smoothing the cuticle to maintain hair shine and manageability.
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Dimethicone is a valuable conditioner in the hair-loss patient because it does not make thinning hair limp, while providing decreased static electricity and improved hair styling.
Introduction
Scalp-hair appearance assumes great importance in both men and women. Hair can be cut, shaved, styled, combed, brushed, braided, twisted, glued, shampooed, conditioned, dyed, curled, straightened, and teased. Why are there so many techniques to modify human scalp hair? The answer lies in human behavior patterns whereby such services and products are purchased to support the hair-care industry. The amount of money spent on beautifying scalp hair signifies the preoccupation humans have with their hair. This preoccupation is even more challenging in persons who are experiencing hair loss. This article examines hair care in persons with hair loss. The use of shampoos, conditioners, and hair styling products to camouflage hair loss is discussed.
Introduction
Scalp-hair appearance assumes great importance in both men and women. Hair can be cut, shaved, styled, combed, brushed, braided, twisted, glued, shampooed, conditioned, dyed, curled, straightened, and teased. Why are there so many techniques to modify human scalp hair? The answer lies in human behavior patterns whereby such services and products are purchased to support the hair-care industry. The amount of money spent on beautifying scalp hair signifies the preoccupation humans have with their hair. This preoccupation is even more challenging in persons who are experiencing hair loss. This article examines hair care in persons with hair loss. The use of shampoos, conditioners, and hair styling products to camouflage hair loss is discussed.
Shampoos
Shampoos are designed to primarily clean the scalp and secondarily clean the hair, even though most consumers believe otherwise. In fact, shampoo is a relatively modern invention. Until the mid-1930s bar soap was used to cleanse the hair. This method was somewhat unsatisfactory because hard water in combination with bar soap left behind a scum that dulled the hair appearance. Early shampoo formulations were liquid coconut-oil soaps that lathered and rinsed better than bar soap. Surfactant shampoos were introduced in the late 1930s and represented a significant advance because they performed well even with the hardest water. These new surfactants have allowed the hair-care formulator to develop shampoos that meet a variety of hair and scalp needs, including those of the patient with hair loss.
The act of shampooing involves the following steps: (1) hair and scalp are wetted and the liquid shampoo distributed; (2) shampoo is foamed and massaged into the scalp; (3) shampoo foam is distributed throughout the hair; (4) water is used to thoroughly rinse the hair and scalp; (5) hair is towel dried to absorb excess water; (6) wet hair is combed. Shampooing is actually a very complex procedure because the average woman has 4 to 8 m of hair surface area to clean. It is easy to formulate a shampoo that will remove all of the sebum from the hair and scalp, but this will leave the hair frizzy, dry, and unattractive. The challenge is to remove just enough sebum to allow the hair to appear clean and leave behind enough conditioning agents, actually representing synthetic sebum, to beautify the clean hair. The basic formulation for shampoo is listed in Box 1 .
- 1.
Detergents
Function to remove environment dirt, styling products, sebum, and skin scale from the hair and scalp
- 2.
Foaming agents
Allow the shampoo to form suds, because consumers equate cleansing with foaming even though the two are unrelated
- 3.
Conditioners
Leave the hair soft and smooth after sebum removal by the detergent
- 4.
Thickeners
Thicken the shampoo, because consumers believe that a thick shampoo works better than a thin shampoo
- 5.
Opacifiers
Added to make a shampoo opaque as opposed to translucent for aesthetic purposes unrelated to cleansing
- 6.
Sequestering agents
Function to prevent soap scum from forming on the hair and scalp in the presence of hard water: the basic difference between a liquid shampoo and a bar cleanser
- 7.
Fragrances
Added to give the shampoo a consumer acceptable smell
- 8.
Preservatives
Prevent microbial and fungal contamination of the shampoo before and after opening
- 9.
Specialty additives
Treatment ingredients or marketing aids added to impart other benefits to the shampoo besides hair and scalp cleansing
The cleansing ingredient found in shampoos is known as a detergent or surfactant. These agents are soap-free synthetic substances that possess both lipophilic and hydrophilic structures. The lipophilic end binds to the sebum and the hydrophilic end allows the sebum to rinse away with water down the drain. Chemical moieties that possess this chemical structure are amphiphilic. The most commonly used detergents in shampoos are listed in Box 2 .
- 1.
Sodium laureth sulfate
- 2.
Sodium lauryl sulfate
- 3.
Triethanolamine lauryl sulfate
- 4.
Ammonium laureth sulfate
- 5.
Ammonium lauryl sulfate
- 6.
Diethanolamine lauryl sulfate
- 7.
Sodium olefin sulfonate
The art of shampoo formulation is mixing together detergents to achieve the desired balance between cleansing and hair beautification. Typically several detergents are combined together to achieve the desired end result. For example, if the shampoo is intended for oily hair, detergents with strong sebum removal qualities are selected; conversely, if the shampoo is intended for permanently waved or dyed hair, mild detergents are selected to reduce sebum removal. Persons with hair loss typically want to maximize hair cleansing, because sebum makes the hair appear flat, and then beautify the hair to make it shiny, smooth, and easy to untangle. This action is best accomplished with a product known as a 2-in-1 shampoo. Two-in-1 shampoos are so named because they clean and condition, performing 2 functions, in 1 product. The detergents that can be combined to achieve these results and their attributes are listed in Table 1 .
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