Interesting facts on the topic of scalp

Interesting facts on the topic of scalp skin Facts about the skin Human beings have a skin surface of approx. 1.8- m. Its total weight is between 10 and 1 kg. Each square centimetre of skin contains approximately: • • • • • • • • • • 6,000,000 cells 1 m of blood vessels 4 m of nerve fibres 5 to 50 hairs (body) resp. 00 to 50hairs (scalp) 100 sweat glands 15 to 40 sebaceous glands (body) resp. 00 to 50 sebaceous glands (scalp) 5 pressure receptors  cold receptors  heat receptors 00 pain receptors What are the main functions of the skin? Skin contact and gentle touching are extremely important for the healthy development of new-born babies. If there is no such intensive contact with the mother, the child is likely to suffer from emotional problems or even illness in later life. This clearly shows that the skin is in more than one way the part of our body that is most directly in contact with the environment. It thereby fulfils basically four functions: Protection of the body: The skin protects our body from loss of water and against damaging influences from outside our body (for example microorganisms, chemical substances or UV radiation). Temperature regulation: In connection with the blood circulation system, the skin regulates our body temperature to around 37 °C. Communication: The skin signals to others how we feel, for example by being blushed or pale: on the other hand, it keeps us in touch with the outside world, as physical touch, the outside temperature, pain and other sensations are signalled by peripheral nerve endings in our skin to the brain. Reservoir: The skin is an important energy reservoir for the metabolism. It contains approx. 50% of our entire fat reserves. In addition, it stores and processes a number of other vital substances such as water and salts.  introduction colour Structure of the skin The human skin consists of three main layers: the subcutaneous layer (subcutis) is the base of the skin and provides physical protection to the body and also serves as a nutrient deposit for metabolism. The centre layer of the dermis is composed of a network of elastic and collagen fibres and gives the skin its firm structure. The epidermis is the outer layer of the skin and protects the body against damaging influences. The subcutis - protective cushion and deposit The loose and highly elastic connective tissue of the subcutis connects the skin with the muscles and organs of the body. The subcutis contains fat lobules that serve as energy deposits and provide a protective and heat-insulating layer. The subcutis contains a dense network of blood vessels and nerves that branch off into the dermis. The blood vessels bring the necessary nutrients and oxygen into the skin, ensuring that it can regenerate itself. They also transport the substances required for hair growth. The dermis - fibre network providing structure and firmness The dermis consists mainly of connective tissue composed of loosely connected collagen fibres and elastic fibres (collagen and elastin). This connective tissue retains moisture and is made up of 70 to 80 % water. It therefore gives the skin firmness and suppleness. Epidermis Horny layer Granular layer Prickle cell layer Basal cell layer Dermis Sebaceous gland Arector Pili muscle Hair follicle Sweat glands Subcutis Nerves Blood vessels Embedded in the dermis are the appendages of skin. most important sensory organs: on the other, they play a major role in the regulation of a number of functions of the skin and its embedded features (hair follicles, sweat and sebaceous glands). The epidermis - protective shield against hostile elements in the environment The epidermis does not consist of connective tissue but mainly of cells that are continuously produced in the basal layer. When they move towards the surface, they harden, become horny and are finally shed. A healthy epidermis thereby regenerates itself approximately every 30 days. This layer does not contain blood vessels and its Blood vessels from the subcutis branch into living cells are supplied with nutrients and the dermis and form a network of extremely oxygen from the dermis that lies below the fine capillaries that reach to the basal cell epidermis. layer of the epidermis, supplying it with nutrients nd removing waste products. The The main task of the epidermis is to protect blood vessels also have an important functhe organism from loss of water. Furthertion in connection with the regulation of the more, it serves as a protection against body temperature. environmental influences. The epidermis fulfils this function by shielding the body Here, we also find the peripheral nerve end- from physical impacts (pressure, friction, ings coming up from the subcutis. On the and radiation) as well as by detecting and one hand, they make the skin one of the isolating substances that are foreign to the organism (potential antigenic substances). 3 skin Seen under the light microscope, the epidermis is devided in four layers: 1. The basal cell layer (stratum basale) is located directly at the top of the dermis. Here, new cells are continuously produced by dividing stem cells. . The adjacent prickle cell layer (stratum spinosum) contains the basal cells that move upwards and are keratinised. These cells show virtually no division and are gradually flattened. 3. The granular layer (stratum granulosum) conjunctum is located directly at the top of the basal layer. It consists of flat, keratinised, i.e. horny cells. These cells are thus dying and their nuclei are dissolved. They become flatter, firmer and more compact. 4. The outermost layer of the epidermis is the horny layer (stratum corneum). The cells at its surface are constantly removed by the daily exposure of the skin (shedding of cells) and replaced by new cells rising up from the underlying stratum granulosum. In normal, healthy skin, the processes of cell production and cell loss at the surface are meticulously synchronised. This means that new cells are produced at the same rate at which dead cells are removed at the surface. Disruptions in this balanced system can lead to flaky skin, excessive keratinisation, etc. In addition to the actual skin cells, the epidermis contains a number of highly specialised cells. There are cells that are responsible for the triggering off of allergic reactions that are part of the immune system of our body. In this layer, we also find pigment cells (melanocytes) that are responsible for the darkish colour of our skin, providing effective protection against damaging UV radiation. 4 skin What are the functions of the epidermis? The epidermis Horny layer (stratum corneum) Structure • • • Approx. 15 to 0 layers of cells are held together wax-like with lipids The entire skin surface can shed up to 6 to 14 g per day The thickness of the horny layer varies, depending on the part of the body and the actual stress Function • • • Protection against UVB-radiation Thermal protection Prevents moisture loss and stops antigenic substances from penetrating the body Granular layer (stratum granulosum) Structure • • The cell nucleus decomposes The cell becomes compact, hard and flat and is gradually keratinised Function • • Formation of keratohyalin, which is a base substance of keratin Natural forming of the intercellulare lipids that are expelled upwards and outwards in the upper layer of the granular layer between the cells and form the barrier layer Prickle cell layer (stratum spinosum) Structure • Young cells moving towards the surface; they are supplied with nutrients and show reduced cell growth and division The cells are gradually flattened Function • Start of differentiation to horny cells • Basal cell layer (stratum basale) Structure • • Function Continuous renewal of the skin by production of new cells Protection against ultraviolet (UV) radiation by means of pigment cells (melanocytes) containing melanin Resulting in the brown colour of the skin Germinal layer Interdigitated with the papillae of • the dermis and constantly supplied with nutrients and oxygen • Production of new cells by mitotic division; over a period of 8 to 30 days, the cells are gradually moved upwards until they are • shed as dead skin cells The dermis The subcutis Horny layer 5 skin How does the acidic protective film of the skin work? The horny layer of the skin protects our body against both mechanical impacts and temperature influences. However, the skin actually also protects the organism. The horny layer is covered by a thin film of sweat, sebum and non-pathogentic bacteria: this film is referred to as the hydrolipid film (film made of water and fat), also known as protective acidic film. Its pH is 5 to 5.5, thus slightly acidic. It acts as the “buffer mantle” of the skin. Its capacity to neutralise weak alkaline or acidic substances protects our skin from damage. With proper skin care, for example the use of soaps and shampoos with a pH of around 5 to 5.5, does not destroy this natural protective layer of the skin. The skin and its pH The skin consists mainly of proteins, which again are composed of acidic and alkaline groups. The surface of intact epidermis is slightly acidic, with a pH value of between 5 and 5.5. This slight acidity is primarily responsible for the protection of the body against microbes as well as acidic and alkaline substances. The deeper layers of the epidermis have a pH value of 7., which due to alkaline metabolic products of microorganisms can increase to up to 8 on moist areas such as the armpits and body folds. The pH at the surface of the skin is the result of internal as well as external factors such as: • Reaction with water-soluble substances (amino acids) in the skin cells • Production of sweat, sebum and residue from their decomposition (fatty acids) • Presence of substances from the metabolism of microorganisms • Effects of substances from the environment (dust particles, cosmetics) Other pH-relevant substances are urocanic acid, lactic acid and carbonic acid. The skin constantly produces the protective film. Acidic and alkaline substances that reach the skin from the outside are neutralised by the formation of salts, whereby the skin also regains its specific pH value. These salts (proteinates) are produced by the reaction of proteins that are specific to the skin and the acid. The acidity of substances reaching the skin is also reduced by other reactions of the acids with sweat and salts at the skin surface. Skin contact with weak acids can also contribute to a more stable acidic film. Alkaline substances on the skin are partly neutralised by evaporating carbonic acid and other acidic substances found in the skin. A cream with pH 7 or 8 that is brought into contact with the skin can thus improve its elasticity and texture, without altering the natural pH value at the surface. However, the pH on its own does not determine the effectiveness of a skin care or hair car product. Various other factors play a more decisive role. They are: • the specific effectiveness of a substance • the molecule size of the agents • the substrate • the non-allergenic nature of all substances in a product 6 skin Which organs are found in the skin? Blood vessels of the skin Supply system for the metabolism The heart pumps blood into the main arteries. From there, it flows through a vast network of larger and smaller vessels and eventually reaches the top layer of the dermis. The blood, containing oxygen and nutrients, passes thereby from the arteries to arterioles and subsequently into the extremely fine blood vessel loops referred to as capillaries. Their diameter (approx. ten times smaller than that of a hair) is slightly greater than that of the red blood cells transporting oxygen, which are just able to slip through these loops. Capillaries reach the base of the basal cell layer of the skin and thus nurture the epidermis with all the necessary substances for cell production. Oxygen and nutrients are able to penetrate the thin walls of the capillaries (diffusion) and reach the stem cells of the epidermis. Waste substances (CO and others) of metabolism are absorbed through the capillary walls into the blood, which eventually returns to the heart via venules and veins. Venous valves prevent the reflux of blood. Damaged venous valves combined with prolonged standing and lack of exercise can result in varicose veins. Temperature regulation - sophisticated regulation system for the body temperature The numerous fine capillaries near the body surface serve also a second purpose: in conjunction with the sweat glands, they play a major role in the regulation of the body temperature. Basal cell layer Capillaries Arteriole + arteries Lymph system Sebaceous gland Venules + veins Sweat gland outlet In the dermis, the blood containing oxygen and nutrients from the inside of the body are pumped via arteries and arterioles to the extremely fine capillaries, which directly border on to the basal cell layer of the epidermis. This is where the substances needed for cell production are deposited. Waste substances are absorbed and transported away via the venules and veins. If the body is heated up, due to high outside temperatures or excess heat production within the system (as a result of fever or physical exercise), more blood is pumped into the skin where the heat is released into the environment. When sweat evaporates, this process is accelerated by the cooling effect on the skin and thus the blood. When it is cold, the capillaries contract to reduce blood flow, thus minimising the heat loss of the body. Another effect brought about by the cold is goose pimples, caused by the contraction of the arrector pili muscles, which make hair “stand on end”. 7 skin Glands of the skin Sebum - protective fat of hair and scalp Sebum is produced by fat-filled cells of the sebaceous glands which burst and release secretion. This reaches the skin via the hair follicle orifices making the skin smooth and, thanks to its ability to spread, it distributes well. Sweat promotes the spreading of sebum. Skin however sometimes becomes too oily, due to overactive sebaceous glands producing excessive sebum. This condition is known as seborrhoea. The scalp with its many hair follicles contains more and larger sebaceous glands than any other part of the body. The scalps of people suffering from seborrhoea therefore become quickly greasy. Eccrine glands - the temperature regulators of the skin Whenever we sweat - be it in the sauna or through physical exercise - approximately two million eccrine glands or sweat glands are activated, secreting a special liquid onto the surface of the skin. Sweat consists of water (99%), in which salts, urea and other organic substances are solved. Evaporation at the surface cools the skin and the blood flowing in its capillaries. This effectively protects the body against overheating. However, psychological factors can result in excess sweat secretion. Examples of stress-related excessive sweating are wet hands and armpits or cold sweat on one‘s forehead. Sweat supports the formation of an effective protective film and, together with the sebum and the fats from the horny layer of the skin, provide the hydro-lipid film of the skin. If this protective layer is constantly removed by washing or not produced due to a medical condition. The skin can become very dry and flaky. Hydro-Lipid film (Sebum) Sweat gland outlet Sebaceous gland Eccrine sweat gland Apocrine sweat gland Sebaceous glands: • Dying gland tissue cells form the existing sebum from glycerides and substances similar to fat. • Sebum gets onto the skin through an opening below the follicle outlet and distributes itself on it. Eccrine sweat glands • Sweat consisting of up to 99% water • Is deposited onto the skin via individual pores • Protects the body from overheating by evaporation • Contributes to better spreading of the sebum Apocrine sweat glands • Flow into the hair follicle • Secretion contains cell components from gland tissue • Decomposed bacteria cause the typical odour of sweat Axillary sweat glands (apocrine sweat glands) - glands producing the distinct personal odour Axilliary sweat glands develop in association with hair follicles and are mainly found under the armpits and the area of pubic hair. Similar to sebaceous glands, they undergo enlargement and secrectory development under the influence of hormones, i.e. during puberty. The axillary sweat glands produce a turgid yellow-whitish liquid containing cell components of the gland tissue that provide an excellent medium for the growth of bacteria. The typical acrid odour is actually the result of the bacterial decomposition of the sweat. 8 flaky skin and dandruff How does flaky skin occur? Healthy skin continuously regenerates itself. Over a period of approximately thirty days, skin cells produced in the basal cell layer gradually move to the surface, develop into horny cells and are shed as minute cell particles that are not visible to the naked eye. In flaky skin, the synchronisation of the processes of cell production and scaling is disturbed. Generally, the cell production rate in the basal cell layer is too high. This means that cells reach the surface of the epidermis prematurely without being properly keratinised. They are shed in larger groups of cells, i.e. dandruff. It has been scientifically proven that the skin of people suffering from dandruff renews itself within a period of 0 days. This means that the skin renewal process is one third faster than in people with normal skin. Excessive flaking of the scalp as a result of a skin disorder Psoriasis - a non-contagious condition Psoriasis should in general be differentiated from the up until now known types of dandruff. The cause of this illness is genetically pre-determined. It is an inherited condition, whereby external and internal factors such as stress and poor diet can actually bring about the symptoms. The disease is characterised by distinct, rather large sections of the skin covered in silver-scaled lesions. Psoriasis must be treated by a dermatologist. The use of anti-dandruff products has no effect whatsoever on the condition. Hairdressers are urged to show special care and empathy towards people suffering from psoriasis, as the condition can place a lot of emotional strain on the person. Affected skin must be treated with special care. Avoid any mechanical or chemical irritation and use combs and brushes with great care. Generally, only the mildest products should be used. What types of flaky scalp are there? Dry flaky scalp Especially during the winter months, many people with dry skin suffer from accelerated What are the causes of flaky drying of the scalp in conjunction with skin? sensitive reactions. This can be traced back to reduced air humidity and modified lipid Internal causes: composition in the horny layer of the skin. • The excessive activity of the basal cell Affected persons suffer from dry and itchy layer can be caused by disorders of the scalp. Isolated red spots and a fine flaky layhormone system.Customers suffering er of light grey dead cells are visible on the from dandruff that cannot be successscalp. In such cases, the use of care prodfully treated with a anti-andruff products for sensitive scalp is recommended. uct should consult a dermatologist. • Dandruff and flaky skin can also be a) Dry dandruff symptoms of certain diseases. If the The scalp of persons suffering from dry condition of the skin does not respond scalp (sebostasis) with a predisposition to to treatment and continues over a dandruff sheds dry, fine white or clear flakes prolonged period of time, it is recomthat fall from the hair with every movemended to consult a dermatologist. ment. • There are a number of drugs that are known to stimulate the cell division in b) Greasy dandruff the basal cell layer. Persons with a predisposition to both dan• Many people have a genetic predispodruff and greasy skin (seborrhoea) suffer sition for dandruff (here, good results from yellowish greasy flakes that normally can be achieved with anti-dandruff remain attached to the base of the hair or products). the scalp. 9 flaky skin and dandruff External causes • Irritation by certain chemicals, for example unsuitable hair care products with a high pH; such substances can stimulate excessive scaling. • Mechanical irritation such as fine lesions in the scalp caused by damaged combs, etc. can also lead to excessive cell production in the basal cell layer. • Biological causes include the spreading of microorganisms (yeasts) that cause scaling on the scalp. • Excessive washing can also cause flaky scalp, as the skin reacts with increased secretion of sebum possibly combined with dry dandruff. External and internal causes are known to interact, worsening the problem. The bacterial flora and its protective function One of the main factors for a healthy scalp is an intact film at the surface of the epidermis and a balanced flora of non-pathogenic bacteria and yeast. There are approximately 1 million such organisms on every square centimetre of scalp. This physiological flora in the hydro-lipid film and in the ducts of the sebaceous glands protect the skin against colonies of pathogenic microorganisms. In the case of a genetic disposition towards cosmetic forming of dandruff, the number of the yeast (Pityrosporum ovale - Malassezia furfur) and related types is in percentage significantly increased which leads to the forming of dandruff. Anti-dandruff agents (climbazole, piroctone olamines and zinc pyrithione) target the yeast to achieve a balanced flora of microorganisms, which in turn reduce the scaling of the skin to normal levels. Laboratory tests have shown that the different varieties of the Pityrosporum ovale species are not equally affected by anti-dandruff substances. In order to successfully eliminate all causes for dandruff, a combination of different agents is therefore the most effective method. Should anti-dandruff products show no effect after 3 months of treatment a consultation with a dermatologist should follow. In general it can be said that after stopping use of an anti-dandruff product after successful treatment, the yeasts will once more increase and an intensification of the dandruff will reappear. How do external influences affect the skin? External factors often attack the horny layer of the skin, leading to an irritation of the basal cell layer, which responds with excessive cell production. Where the outer layers of the skin and the protective hydrolipid film are damaged, they are unable to fulfil their function in keeping antigenic substances and organisms away from the deeper layers. This can also result in dry scalp. Dry scalp in turn shows a tendency to excessive scaling and formation of dandruff. Potentially allergenic substances can penetrate the scalp. Specialists refer to this condition as sensitive scalp. 10 skin How can hairdressers assess cases of dandruff and what are the important questions to be asked? Generally dry dandruff Typical symptoms • Dandruff falls from scalp and hair, even if only slightly moved • Small flat transparent flakes • Dull complexion • Distinct red spots after washing • Sensitive scalp • Blood vessels visible on the scalp Generally greasy dandruff Typical symptoms • Flat dandruff particles that remain attached to scalp or hair • When rubbed between the ingers: oily, greasy sheen • Tendency of acne • Large pores in seborrheic skin areas Questions to be asked • • • • • • Do you have any problems regarding your scalp? Do you sometimes suffer from itchy scalp? How often do you wash your hair? For how long do you rinse your hair after shampooing? What shampoo do you use? Are there times where there is more dandruff? 11 sensitive skin What are the influences to which skin reacts? Skin types that show a genetic predisposition for hypersensitivity Often, the degree to which skin reacts to environmental influences is inherited. In this Over the last decades, the number of peocontext, two skin types are most at risk. ple requiring treatment for “dry and sensitive scalp” is increasing. This development is One criteria by which such skin types can be distinguished is their sensitivity to most likely due to various related factors: sunlight (UV radiation): certain people react to UV radiation with sunburn, while others External factors simply get a suntan. In a similar way, skin • Air pollution types can be classified according to their • Sunlight (UV radiation) sensitivity to chemical substances, heat/cold • Excessive drying of skin (by dry air in or mechanical stress. heated rooms, air conditioning, etc.) It is thereby important to note that, for ex• Insufficient care after colouring and ample, skin that reacts sensibly to UV radiaperming • Exposure to chemical substances (clean- tion might not show any increased sensitivity to chemicals. Also, the same skin might ing agents, solvents, pesticides, etc.) react to certain chemicals with clear signs, while it is not affected by other substances. Internal factors Therefore, skin that shows a strong reaction • Inherited predisposition to detergents (shampoos) might not show • Ageing processes any increased sensitivity to alcohol. • Stress • • • • Metabolic disorders Disorders in connection with hormone and vitamin levels Side-effects of drugs Side-effects of certain skin diseases A person‘s skin might not always show the same sensitivity The sensitivity of skin often varies with the seasons (e.g. increased sensitivity during the winter months) or age (example: prior to 0 and after 60 years of age = not particularly sensitive / between 0 and 60 years of age = highly sensitive). Such variations are most prominent in people that are born with highly sensitive skin. However, normal skin can also react strongly to certain strains and substances. As anywhere else, the wisdom of Paracelsus, the great medieval physician applies: it is the quantity that makes a substance a poison. Dry scalp is particularly at risk Dry scalp has a tendency to react very sensitively to both external and internal factors. One of the reasons is that water does not pearl off; it penetrates the horny layer of the skin and dissolves and adsorbs hydrophile substances from the permeability barrier of the horny layer. This effect is increased if the hair is washed frequently. Pathogenic microorganisms and harmful chemical substances also have a better chance to penetrate the skin where they can lead to irritations or even infections. The lack of moisture and skin grease results in a sensation of taunt skin and itchiness. Atopy is frequently the cause of dry skin. By atopy, we understand a genetic tendency to allergies towards substances from the natural environment (e.g. hayfever/pollen) and to neurodermitis. Almost all cases indicate an increased sensitivity of the skin. 1 sensitive skin How does skin react to adverse factors and how does sensitive skin develop? Whenever skin shows a reaction, two conditions are fulfilled: • The substance with which the skin has been in contact contains a component that has irritating properties. • This substance has penetrated the skin in a quantity that is sufficient to cause irritation. In people that show an inherited tendency to sensitive skin, very small quantities that would lead to no reaction whatsoever on normal skin, can result in great irritation. The exact way in which skin irritations develop is highly complex and is not yet fully understood. However, studies show that the contact with the irritating agent results in the release of biochemical substances within the skin, leading to a complicated chain reaction of symptoms. How can a hairdresser assess sensitive skin and what are the important questions to be asked? Sensitive skin Typical symptoms • Visibly red skin (erythema) (example: sunburn). • Locally increased skin temperature (by approx. 1 to 3° C). • Increased permeability of the permeability barrier (in both directions). It is possible to indirectly measure this permeability by means of the water transfusion through the horny layer of the skin (transepidermal water) • Rough skin surface (ranging from tiny flakes to large areas of peeling, e.g. after sunburn) • Sensation of irritation, i.e. itchiness, burning, taunt skin Questions to be asked • • • • How does your scalp react to shampoo? How does your scalp react to products containing alcohol? Are there specific reactions to heat/cold? Do you suffer from contact allergies or hay fever (indicators for sensitive skin)? Irritated skin shows the above symptoms. However, most symptoms become only obvious several hours after contact with the irritating substance (redness within 6 to 4 hours, scaling after several days). The diagnosis and anamnesis of sensitive skin is thus not that simple! Even experienced dermatologists are not always in agreement regarding the significance of “sensitive skin”. The problem lies in the fact that skin often shows a clear reaction to one substance, while it might completely ignore other irritants. 13 greasy skin What are the main adverse factors and how does the skin react? Distribution What is greasy skin? Seborrhoea describes an overactivity of the sebaceous glands and a predisposition to this condition is generally inherited. Sebaceous glands are found everywhere in our skin (with the exception of the soles of the feet and the palms of the hands). The total number of sebaceous glands is determined by genetic factors. The quantity of sebum that is secreted on the surface of the skin depends, however, not only on the number of glands but also on their size. The sebum found on the surface of the skin is thus directly proportional to the density and the size of sebaceous glands. The largest such glands, actually consisting of several sacs, are found in the scalp. Their function is mainly controlled by hormones. Up to the age of puberty, they produce very little sebum. During puberty, the sebaceous glands begin to produce more sebum, mainly stimulated by the male hormones (adrogenic hormones). The cause of a greasy scalp and hair can on the one side be seborrhoea, on the other an intensified spreading of sebum. Sebum Sebaceous gland Seborrhoea is the increased secretion of the sebaceous glands, leading to a greasy scalp. Seborrhoea only describes the condition of overactive sebum production. In addition to the above causes, pollutants in the environment, stress or a poor diet are common contributing factors. For the spreading of the grease, the secretion of sweat also plays an important role. In hot weather, we transpire. Sweat dilutes the sebum and distributes it across the scalp pores and the hair. 14 greasy skin Mixed skin - overactive sebaceous glands in seborrheic zones Depending on the size of the sebaceous glands and the effect of the androgenic hormones, the quantity of sebum produced in the different areas of the skin varies. In the face, there is a distinct area in which the sebaceous glands are most active: it is the zone of the forehead and across the nose and chin and is often referred to as the “T zone”. If the sebum production in the T zone is considerably higher than in the other parts of the face, the facial skin is referred to as “mixed skin”. The T zone has a tendency to appear greasy, even shortly after it has been cleaned, while the dryer parts of the skin remain dry and even irritating. When assessing hair and scalp condition, the facial skin should also be looked at in order to recommend a suitable system treatment. Sebostasis - insufficient activity of the sebaceous glands If skin generally feels very dry and taunt, it is very likely that the sebaceous cells do not secrete enough sebum. This condition is referred to as sebostasis and is due to genetic factors. After washing, the protective hydrolipid film of the skin is only very slowly restored. The epidermis therefore tends to dry out quickly, and the skin shows dry tiny scales. Most affected are elderly persons, as the activity of sebaceous glands is significantly reduced from the age of 50. Dry skin is often chapped and shows tiny lesions through which antigenic substances and germs can penetrate the tissue, causing infections. If this condition is combined with an inherited predisposition for allergic reactions to certain substances, it leads to a high risk of contact allergies. Skin affected by sebostasis is very delicate and requires special care. The hair tends to be rather dry and rough. It is therefore recommended to use products with greasing and moisturising components. 15 greasy skin How does skin react to adverse factors and how does greasy skin develop? A greasy scalp is the result of a functional disorder of the sebaceous glands. This condition can be triggered off by a variety of factors, e.g. hormonal disorders or influences in the environment. The presence of hair also often leads to excessive moisture, due to transpiration, whereby the epidermis is swelled and its barrier function is impeded. Under the influence of heat, sebum and sweat form an emulsion that quickly spreads across the scalp and hair, leading to greasy hair How can a hairdresser assess greasy hair and what are the important questions to be asked? Rather greasy scalp Typical symptoms • • • • • • • • • • • • • • • • • • • • • Oily, greasy sheen Demarcation lines of sebum and sweat Genetic disposition (ask the customer) Hormonal disorder Poor diet Psychological and physical disharmony Chemical and mechanical factors Environment Inappropriate treatment with unsuitable or harsh products Do you have any problems regarding your scalp? How often do you wash your hair? Does your facial skin tend to be greasy? What shampoo do you use? How do you style your hair? Blow-dry at low temperature Always thoroughly rinse out hair care products (shampoo, conditioner, etc.) Consequent system care Only light perms Layered haircut is recommended Wash hair more often Use styling products Possible causes Questions to be asked Recommendations 16 hair loss What are the causes for hair loss? Normal hair growth The average scalp is covered by approximately 00 hairs per square centimetre. At the beginning of each growth phase (anagen), the hair grown during the previous cycle is shed. Given the above hair density, this means that every day, between 80 and 100 hairs are lost. This rate can however fluctuate considerably, a fact that normally should not cause any reason for concern. Hair growth is for example influenced by the seasons. In this context, a unit has been established, called the A/T quotient: it is calculated from the number of hairs in the growth phase (A = anagen) divided by the number of hairs in the resting phase of the hair cycle (T = telogen). For healthy scalps, the A/T quotient is approx. 80/100, while facial hair has a ratio of 50/50. Generally, hair growing on the head has a much higher A/T quotient than body hair. An A/T quotient that is permanently shifting towards a higher telogen ratio indicates hair loss. hairloss per day normal changes to hair 140 130 10 110 100 80 60 40 0 0 Ø hairloss (80-100 hairs per day) normal hair loss short-term hairloss (not problematic) long term hair loss hair loss t = month Normal hairloss: Brief deviations from the normal hair loss rate (possibly seasonally related) are no cause for concern at all. Hairloss: Hairloss is when there is a long-term increase in the loss of hair. • Reversible hair loss can be cured with a supportive treatment. . • Irreversible hairloss can not be reversed, or is difficult to reverse. Causes for hair loss/alopecia/effluvium Hair loss (effluvium/alopecia) occurs if the number of hairs that are shed by the scalp is for a considerable above average period of time. There are rare cases of congenital alopecia caused by anomalies during gestation, whereby the number of hair follicles is reduced in general, or where only a fraction (hypotrichosis) or none (atrichosis) of the hair follicles are actually functioning. There are other forms of congenital forms of alopecia, where the hair growth is normal at birth and hair loss only occurs later in life. On the other hand, there are numerous forms of acquired alopecia. Within this group, specialists distinguish between reversible and irreversible hair loss. Reversible hair loss naturally disappears after a certain period of time; the hair growth can be stimulated and accelerated by proper treatment 17 hair loss What are the causes for and symptoms of reversible hair loss? 1. The development of reversible hair loss and its symptoms If a hair follicle is disturbed in its function during the anagen, its might respond by directly progressing to the telogen, resulting in gradual hair loss. During the telogen, hair follicles are considerably more resistant against adverse influences than during the anagen. As soon as the disturbance is removed, the hair follicle produces a new healthy hair again. Anagen hair loss is due to influences that have an immediate impact on the body. In this case, the follicle is unable to shift to the telogen and the hair is shed immediately. Hair that is lost in this phase of the hair cycle differs from telogen hair in that it lacks the typical bulb at the end (club hair) found in telogen hair. All reversible types of alopecia - with the exception of localised hair loss - show a diffuse shedding of hair (i.e. equally dispersed across the scalp) and a gradual development. The effects are in all cases fully reversible, once the cause behind it is removed. Reversible hair loss is a rather common though not yet fully researched phenomenon. There are no exact statistics regarding this condition. It seams though that hair can in some cases react very sensitively to apparently insignificant influences, which is even the more surprising, as it is normally very robust and strong. While, in the course of evolution, hair has adapted to many adverse influences, today‘s way of life exposes it to completely new conditions that can lead to hair loss. Examples of such conditions are: a) Loss of hair after serious infections A strong attack of influenza is sometimes sufficient to induce telogen alopecia. Sequence of reversible Telogen hair loss healthy hair dysfunktion hair loss healthy hair + germ formation density of hair Causes: External influences • Feverish infections • Long periods of stress • Poor diet or malnutrition • Drastic weight loss • Certain drugs • Mechanical influences Internal influences • Hormonal fluctuations after pregnancy • Disturbances to the immune system (circular patches of hairloss in mild cases) The general weak state of the body thus also affects the hair follicles, although the exact causes are not yet known. b) Hair loss after periods of great stress or shock Research suggests that prolonged stress and shock can lead to reversible loss of hair. It is however not yet fully clear whether hair loss can be directly related to specific stress levels or trauma. Also to be taken into consideration here is the role of a possible genetic predisposition. 18 hair loss c) Hair loss as a consequence of malnutrition In the case of malnutrition, the body does not receive a sufficient level of energy and nutrients required for growth and regeneration of the organism. This lack of substances, including vitamins and trace elements, directly affects the hair, leading to hair loss in the telogen. Depending on the extent of malnutrition, the shafts of hairs also become thinner. With an unbalanced diet, the body lacks certain vital substances (e.g. certain vitamins or trace elements). This has an adverse effect on the entire metabolism of the organism, including the hair. f) Hair loss after giving birth During pregnancy, special hormones (gestagens) are produced. They also affect the growth of hair, as more follicles than usual remain in the anagen. After delivery, the gestagen level is suddenly reduced, with a reverse affect on the hair growth cycle. In order words, hair in the anagen goes over to the telogen (rest phase) and is shed after a few months. The new hair is still short and the impression is that of thinning hair, although the number of active follicles is not reduced. As soon as the growing hair has reached its normal length, the hair volume returns to normal. g) Hair loss due to trauma Hairstyles that produce a constant pull on The following trace elements and vitamins the hair roots can promote hair loss. Such are necessary for keratinisation, i.e. the pro- stress impairs the formation of the hair duction of keratinised cells: iron, zinc and shaft in the anagen follicles. Telogen hair vitamin H (biotin) A deficiency in these sub- is gradually pulled out, leading to bald stances can result in hair loss and reduced patches. The hair shafts can be broken by hair diameters. Similar symptoms are known excessive mechanical stress for example by in connection with protein deficiency. unsuitable combs, also giving the impression of thinning hair. d) Hair loss during slimming The above effects of malnutrition on hair h) Appearance of bald patches growth imply that radical dieting can lead to (alopecia areata) telogen hair loss. This type of hair loss is characterised by round patches of baldness on the scalp. It e) Hair loss caused by drugs is believed to be caused by autoimmune Certain drugs can lead to hair loss. The bedisorders and is thus not directly related stknown example are anti-cancer drugs to other types of hair loss. The smaller the (carcinostatics in chemotherapy), where number and size of the affected areas, the patients suffer from reversible anagen hair greater the chance of full recovery. If the loss. Such substances reduce the mitotic hairdresser spots such typical round bald rate of all cells in the body that normally patches, the customer should be informed undergomitosis, including of course the and urged to consult a dermatologist. targeted cancer cells. Particularly drastic is however the effect of such drugs on the hair-producing trichocytes, that normally have the highest mitotic rate of all body cells. This leads to complete hair loss within only a few days after the commencement of chemotherapy, whereby the hair roots have not sufficient type to go over to the telogen (rest phase). After termination of the cancer treatment, the hair grows back within a few months. 19 hair loss 2. The development of irreversible hair loss Irreversible hair loss occurs: • If the hair follicles are considerably reduced in volume (as is the case in androgenetic hair loss) • If the function of the hair follicles is permanently impaired (as in serious cases of alopecia areata) • As a result of certain skin diseases terminal hair vellus hair Sequence of androgenetic hair loss The following explanations are limited to androgenetic hair loss, alopecia areata and hair loss due to age: a) Androgenetic hair loss in men and women This most common type of hair loss is currently considered irreversible. It is characterised by the gradual replacement of the terminal hair on the head into vellus hair. In many men, this process begins as early as 17 years of age and is accompanied by a gradually receding hairline. Androgenetic hair loss is normally completed at the age of 50. density of terminal hair Irreversible androgenetic hairloss through the miniturisation of the hair follicle formed to terminal hair follicles (as in beards). Women can also suffer from androgenetic hair loss, though such cases are much rarer. Male pattern hair loss is caused by androUp to the menopause, the condition leads genic hormones (androgens). The role that to a diffuse thinning of the hair around the these hormones play in the development of centre parting. After the menopause, male pattern hair loss was already known to female pattern hair loss can in certain cases Aristotle, who observed that eunuchs never resemble the pattern of hair loss in men. suffered from baldness. However, normally only a small portion of the terminal hair develops into vellus hair. The two main androgens responsible for the Therefore, only very few women sufcondition are testosterone and its derivative fer from total baldness, as female pattern dihydrotestosterone (DHT). hair loss is characterised by a more or less prominent thinning of the hair. An enzyme called 5 alpha reductase converts testosterone to DHT. Scientists agree b) Age-related hair loss that the hormone causing androgenetic alo- Both men and women of an advanced age pecia is actually DHT. It is directly responsi- often show a diffuse thinning of the scalp, ble for the replacement of normal follicles caused by continuing or newly induced with vellus hair follicles. conversion of the strong terminal hair to thin intermediary hair resp. vellus hair. The However, it is interesting to note that these causes for this type of hair loss are not fully androgens have the opposite effect on body understood yet but are believed to be part hair: there, vellus hair follicles are transof the general ageing process of the body. 0 hair loss c) Severe cases of alopecia areata If large circular areas become completely bald, the patient suffers from a severe form of alopecia areata. The following rule applies here: the larger the bald patches, the greater the probability that the hair loss is irreversible. In such cases, hairdressers should urge their customers to immediately consult a dermatologist. Amongst men, androgenetic hairloss is marked by the gradual receding of the roots of the hair, starting from the temples. Hamilton-Norwood Skala androgenetischer Haarausfall 1  3 4 5 6 7 8 Ludwig Skala This type of hairloss is much rarer amongst women and is associated with a diffuse clearing of the hair. 1 hair loss How can a hairdresser assess hair loss and what are the important questions for such an assessment? Hair is the fastest growing part of our body. Comparable cell splitting activities in humans can only be found in the bone marrow and enteric mucosa. Two main processes are responsible for the development of healthy hair: 1. Continued production of trichocytes in the hair matrix. . The conversion of trichocytes to hollow hair cells during the process of keratinisation. Healthy hair has an even sheen and is robust and elastic. It allows hairdressers to produce attractive hairstyles with lasting hold. Healthy hair can only grow on a healthy scalp. A fine and efficient network of blood transport all the essential nutrients to the hair root. The hair follicles can also be supplied through the scalp (i.e. epicutaneously) with special substances preventing hair loss and improving hair condition through the scalp (i.e. epicutaneously). How can hairdressers assess hair loss? Obviously, an assessment by a hairdresser can never replace a diagnosis by a dermatologist. However, due to the often confidential relationship between hairdresser and customer and based on professional experience, hairdressers can: • Describe the type of hair loss with great accuracy • Initiate the appropriate treatment, if any • Assess whether the customer should urgently consult a dermatologist The following questionnaire can be very useful in cases, where hairdressers are consulted by their clients in connection with hair loss. Objectives of such treatment: • prevention of hair loss and improvement of hair quality • stimulation of hair growth in cases of reversible hair loss • in the case of irreversible androgenetic hair loss: slowing down of the transformation of terminal hair follicles to vellus hair follicles, and reversion of the process, as far as possible  hair loss QUESTIONNAIRE: Age of customer: □ less than 20 □ between 20 and 50 □ over 50 years of age Hair is washed: □ daily □ 2-3 x per week □ 1x per week Customers that wash their hair every day find less hair in the wash basin than persons that wash their hair only once or twice per week; in the latter case, hair loss is more obvious. reversible hair loss (see 1 b). □ after dieting □ after a prolonged period of poor nutrition Hair loss possibly due to malnutrition (see 1 c/d). □ during puberty □ after puberty [Possible first sign of androgenetic hair loss (see 2 a). Customer‘s hair style puts individual hairs under considerable strain: □ yes □ no Constant pull on hair can result in hair loss (see 1 g). Family background: have other members of your family suffered from hair loss? □ yes □ no The hair loss began in: □ spring □ summer □ autumn □ winter Consider the option that the hair loss is due to seasonal fluctuations in the hair growth cycle and is thus harmless and reversible. Subjective impression of hair loss is increased when the hair is grown longer: □ yes □ no Possibility that there is no hair loss. In long hair, the natural hair cycle is often more visible than in short hair (due to the length of the individual hair). □ after illness □ disorder of the thyroid gland function □ hormonal change (pregnancy, menopause, etc) □ iron deficiency □ after major surgery The hair loss might have been caused by a serious infection (see 1 a) or by a drug (see 1 e). Increased hair loss is in many cases directly related to thyroid insufficiency or iron deficiency. Hair loss already continues for: □ weeks □ months □ years The longer the period of hair loss, the more serious the condition. It could be irreversible. Advise customer to immediately consult a dermatologist. □ after treatment with certain drugs The hair loss could be an adverse side-effect of the drug (see 1 e). The hair loss is: □ limited to certain areas □ diffuse (i.e. all over the scalp) Diffuse hair loss is reversible (see 1 a to g), a symptom of female pattern androgenetic hair loss (see 2 a) or of hair loss due to age (see 2 b). Distinct bald patches often indicate androgenetic hair loss, commonly in men (see 2 a), alopecia areata (see 2 c / 1 h) or a skin disorder in both genders. □ during or after prolonged periods of stress □ after a mental shock Such experiences are known to cause temporary 23 hair loss The hair loss: □ commenced in the forehead corners □ the hair line is already receding across the entire forehead PLEASE NOTE: The products of System Professional stimulate hair growth in cases of reversible hair loss. In cases of irreversible hair loss, the System Professional products are very suitMost likely a case of androgenetic hair loss (see 2 a) able in supporting the treatment prescribed by the dermatologist. The typical symptoms of androgenetic hair lines have already developed: □ yes □ no (see above) The bald patches are circular in shape: □ yes □ no Possible case of alopecia areata (see 1 h / 2 c). Advice the customer to immediately consult a dermatologist. The scalp is: □ reddish □ infected Obvious sign for irritation, damaged scalp or serious skin disorder. Advise customer to urgently consult a dermatologist. If the above questions are discussed in detail during the customer‘s visit at the hairdresser‘s, it is comparatively simple to assess the hair loss. If the customer does not require the immediate attention of a dermatologist, the hairdresser should recommend that the further development of the hair loss should be closely monitored. Encourage the customer to report back at the next visit. Based on the completed questionnaire, the hairdresser is in many cases in a position to assess whether the hair loss is reversible or not. The hairdresser will also know whether the consultation of a dermatologist is necessary or not. 24 hair loss The System Professional concept for healthy hair growth System Professional products against hair loss support the above treatment with highly effective natural substances, targeting various crucial aspects of hair growth: • Caffeine (1,-3,7-trimethylxanthine): this natural substance is found in various plants. Caffeine dilutes the blood vessels and thus improves the blood circulation in the scalp tissue and thereby the supply of the hair follicles with nutrients. Biotin (vitamin H, W factor): the optimum supply with biotin is the main requirement of proper keratinisation. It improves the strength of normal and fine hair and increases its resistance against damaging external influences. Biotin is also one of the main contributing factors for the proper anchoring of club hair in the follicles, thus minimising hair loss. Laurinic acid: substance extracted from the palm tree, Serenoa repens, inhibiting the activity of 5 alpha reductase. This enzyme is responsible for the conversion of testosterone into dihydrotestosterone (DHT). Connective skin tissue Matrix trichozytes Hair papilla • Better circulation of the blood with caffeine • Dilutes the blood vessels • Thus improves the blood circulation in the scalp tissue • Increases the supply of nutrients Scalp tissue Blood vessels (coloured in blue) Hair shaft • Hair papilla Improved keratinisation with biotin • Is a key requirement for the function of keratinisation • Considerably improves the tear resistance and resistance of the hair • Provably strengthens the anchorage of the club hair in the scalp Keratinisation zone Hair papilla Scalp tissue Inhibition of follicle conversion with lauric acids The active substance combination with the element, „lauric acid”, shields the roots of the hair against influences that cause genetic hairloss. Keratinising hair shaft Keratinisation zone Hair papilla Haarmatrix 5