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					Interesting facts
  about the topic   scalp
                                                                                                            scalp
Facts about the skin                           What are the main functions of
                                               the skin?
Human beings have a skin surface of
approx. 2 m2. Its total weight is between 10   Skin contact and gentle touching are extre-
and 12 kg. Each square centimetre of skin      mely important for the healthy development
contains approximately:                        of new-born babies. If there is no such inten-
                                               sive contact with the mother, the child is li-
s   6.000,000 cells                            kely to suffer from emotional problems or
s   1 m of blood vessels                       even illness in later life. This clearly shows
s   4 m of nerve fibres                        that the skin is in more than one way the
s   5 to 50 hairs                              part of our body that a most directly con-
s   100 sweat glands                           tact with the environment it thereby fulfils
s   15 to 40 sebaceous glands                  basically four functions:
s   25 pressure receptors
s   2 cold receptors
s   7 heat receptors                                                    Protection of the body:
s   200 pain receptors                                                  The skin protects our body from loss of water
                                                                        and against damaging influences from outside
                                                                        our body (for example microorganisms, che-
                                                                        mical substances or UV radiation).




                                                                        Temperature regulation:
                                                                        In connection with the blood circulation sy-
                                                                        stem, the skin regulates our body temperatu-
                                                                        re to around 37 °C.




                                                                        Communication:
                                                                        The skin signals to others now we feel, for exam-
                                                                        ple 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
                                                                        metabolism. It contains approx. 50% of our
                                                                        entire fat reserves. In addition, it stores an
                                                                        processes a number of other vital substances
                                                                        such as water and salts.
                                                                                                                   scalp
Structure of the skin
The human skin (cutis) consists of three
                                                                                                             epidermis
main layers: the subcutaneous layer (subcu-
tis) is the base of the skin and provides phy-                                                               horny layer
sical protection to the body and also serves
as a nutrient deposit for metabolism. The                                                                    germinal layer

centre layer of the dermis is composed of a
network of elastic and collagen fibres and                                                                   sebaceous gland
gives the skin its firm structure. The epider-
                                                                                                             dermis
mis is the outer layer of the skin and pro-
tects the body against damaging influences.                                                                  arrector pili muscle


The subcutis – protective cushion and                                                                        hair follicles
deposit                                                                                                      sweat gland
The loose and highly elastic connective                                                                      nerves
tissue of the subcutis connects the skin with
                                                                                                             subcutaneous layer
the muscles and organs of the body The
subcutis contains fat lobules that serve as                                                                  blood vessel
energy deposits and provide a protective
and heat-insulating layer. The subcutis con-      Appendages of the skin are incorporatet into the dermis.
tains a dense network of blood vessels and
nerves that branch off into the dermis. The
blood vessels bring the necessary nutrients       other, they play a major role in the regula-
and oxygen into the skin, ensuring that it        tion of a number of functions of the skin
can regenerate itself. They also transport the    and its embedded features (hair follicles,
substances required for hair growth               sweat and sebaceous glands).

The dermis – fibre network providing              The epidermis - protective shield against
structure and firmness                            hostile elements in the environment
The dermis consists mainly of connective tis-     The epidermis does not consist of connec-
sue composed of loosely connected collagen        tive tissue but mainly of cells that are conti-
fibres and elastic protein, collagen and ela-     nuously produced in the basal layer. When
stin fibres. This connective tissue retains mo-   they move towards the surface, they harden,
isture and is made up of 70 to 80 % water.        become horny and are finally shed. A heal-
It therefore gives the skin firmness and sup-     thy epidermis thereby regenerates itself ap-
pleness.                                          proximately every 30 days This layer does
                                                  not contain blood vessels and its living cells
Blood vessels from the subcutis branch into       are supplied with nutrients and oxygen from
the dermis and form a network of extremely        the dermis that lies below the epidermis.
fine capillaries that reach to the basal cell
layer of the epidermis, supplying it with nu-     The main function of the epidermis is to pro-
trients and removing waste products The           tect the organism against hostile or dama-
blood vessels have also an important func-        ging influences from the environment. The
tion in connection with the regulation of the     epidermis fulfils this function by shielding
body temperature.                                 the body from physical impacts (pressure,
                                                  friction, and radiation) as well as by detec-
Here, we also find the peripheral nerve en-       ting and isolating substances that are fo-
dings coming up from the subcutis. On the         reign to the organism (potential antigenic
one hand, they make the skin one of the           substances).
most important sensory organs: on the
                                                                                                        scalp
The epidermis consists of two distinct cell           In addition to the actual skin cells, the epi-
layers:                                               dermis contains a number of highly speciali-
1. the basal cell layer (stratum germinati-           sed cells. There are cells that are responsible
   vum)                                               for the triggering off of allergic reactions
2. the outer layer of “dead” horny cells              that are part of the immune system of our
   (stratum corneum)                                  body. In this layer, we also find pigment
                                                      cells (melanocytes) that are responsible for
The basal cell layer is again built of two            the darkish colour of our skin, providing an
layers:                                               effective protection against damaging UV
1. a) The basal cell layer is located directly        radiation.
      at the top of the dermis. Here, new
      cells are continuously produced by divi-
      ding stem cells.
1. b) 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.

The horny layer, also referred to as the
corneal layer, again consists of two distinct
layers:
2. a) The stratum corneum 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, more firm and com-
      pact.
2. b) The outermost layer of the epidermis is
      called the stratum disjunctum and is
      only 3 to 4 cells thick. 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 con-
      junctum.

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.
                                                                                                      scalp
What are the functions
of the epidermis

                                                                Epidermis
Stratum Corneum disjunctum
 Structure                                   Function
 s   approx. 15 to 20 layers of cells        s   Protection against
     that are held together by a wax-like        UVB-radiation
     substance                               s   Thermal protection
 s   the entire skin surface can shed up     s   Prevents moisture loss and
     to 6 to 4 g per day                         stops antigenic substances
 s   the thickness of the horny layer            from penetrating the body
     varies, depending on the part of
     the body and the actual stress




                                                                                   horny layer
Stratum Corneum conjunctum
 Structure                                   Function
 s   the cell nucleus decomposes             s   formation of keratonhyalin,
 s   the cell becomes compact, hard              which a base substance of
     and flat and it gradually keratinised       keratin
                                             s   natural permeability barrier of
                                                 the basal cell layer




Stratum Corneum
 Structure                                   Function
 s   young cells moving towards the          s   formation of horny cells due to
     surface; they are supplied with nu-         gradual differentiation
     trients and show redcued cell
     growth and division.
 s   the cells are gradually flattened
                                                                                   basal cell layer




Stratum Basale
 Structure                                   Function
 s   interdigitated with the papillae of     s   continuous renewal of the skin
     the dermis and constantly supplied          by production of new cells
     with nutrients and oxygen               s   protection against ultraviolet
 s   production of new cells by mitotic          (UV) radiation by means of
     division; over a period of 28 to 30         pigment cells (melanocytes)
     days, the cells are gradually moved         containing melanin
     upwards until they are shed as          s   resulting in the brown colour
     dead skin cells                             of the skin


                                                     Dermis


                                                    Subcutis
                                                                                                     scalp
How does the acidic protective                     The skin constantly produces the protective
film of the skin work?                             film. Acidic and alkaline substances that re-
                                                   ach the skin from the outside are neutralised
The horny layer of the skin protects our           by the formation of salts, whereby the skin
body against both mechanical impacts and           also regains its specific pH value. These salts
temperature influences. However, the skin          (proteinates) are produced by the reaction
actually also protects itself. The horny layer     of proteins that are specific to the skin and
is covered by a thin film of sweat, sebum          the acid. The acidity of substances reaching
and bacteria: this film is referred to as the      the skin is also reduced by other reactions of
hydro-lipid film (film made of water and           the acids with sweat and salts at the skin
fat), also known as protective acidic film. Its    surface. Skin contact with weak acids can al-
pH is 5 to 5.5, thus slightly acidic. It acts as   so contribute to a more stable acidic film.
the “buffer mantle” of the skin. Its capacity
to neutralise weak alkaline or acidic substan-     Alkaline substances on the skin are partly
ces protects our skin from damage. With            neutralised by evaporating carbonic acid and
proper skin care, for example the use of so-       other acidic substances found in the skin. A
aps and shampoos with pH around 5 to 5.5,          cream with pH 7 or 8 that is brought into
does not destroy this natural protective layer     contact with the skin can thus improve its
of the skin.                                       elasticity and texture, without altering the
                                                   natural pH value at the surface. However,
The skin and its pH                                the pH on its own does not determine the
The skin consists mainly of proteins, which        effectiveness of a skin care or hair care pro-
again are composed of acidic and alkaline          duct. Various other factors play a more deri-
groups. The surface of intact epidermis is         sive role.
slightly acidic, with a pH value between 5
and 5.5. This slight acidity is primarily          They are:
responsible for the protection of the body
                                                   s the specific effectiveness of a substance
                                                   s the molecule size of the agents
against microbes as well as acidic and alkali-
                                                   s the substrate
ne substances The cell layers deeper down
                                                   s the non-allergenic nature of all substances
in the epidermis have a pH of approx 7.2, ri-
sing to 8 in areas where more moisture is            in a product
contained such as armpits.

The pH at the surface of the skin is the re-
sult of internal as well as external factors
such as
s reaction with water-soluble substances

  (amino acids) in the skin cells
s production of sweat, sebum and residue

  from their decomposition (fatty acids)
s presence of substances from the meta-

  bolism of microorganisms
s effects of substances from the environ-

  ment (dust particles, cosmetics) Other pH
  relevant substances are urocanic acid,
  lactic acid and corbonic acid
                                                                                                                    scalp
Which organs are found
in the skin?
Blood vessels of the skin

Supply system for the metabolism                                                                              basal cell layer
The heart pumps blood into the main arte-                                                                     capillary
ries From there, it flows through a vast net-                                                                 arteriole + arteries
work of larger and smaller vessels and even-                                                                  lymphatic system
tually reaches the top layer of the dermis                                                                    venules + veins

The blood, containing oxygen and nutrients,                                                                   arector pili muscle

passes thereby from the arteries to arterioles
                                                                                                              sweat gland channel
and subsequently into the extremely fine
blood vessel loops referred to as capillaries.
Their diameter (approx ten times smaller
                                                 Blood rich in oxygen and nutrients is pumped to the
than that of a hair) is slightly greater than    corium via arteries, arterioles and fine capillaries loca-
that of the red blood cells transporting oxy-    ted direct in the basal layer of the epidermis where the
gen, which are just able to slip through         substances needed to build cells is deposited. At the
                                                 same time waste products are absorbed and transported
these loops.
                                                 away by venules and veins.

Capillaries reach the base of the basal cell
layer of the skin and thus nurture the epider-   When it is cold the capillaries contract to re-
mis with all the necessary substances for cell   duce blood flow, thus minimising the heat
production. Oxygen and nutrients are able        loss of the body. Another effect brought ab-
to penetrate the thin walls of the capillaries   out by the cold is goose pimples, caused by
(diffusion) and to reach the stem cells of the   the contraction of the arrector pill muscles,
epidermis. Waste substances of metabolism        which make hair “stand on end” In the pro-
are absorbed through the capillary walls into    cess, the arrector pill muscles stimulate the
the blood, which eventually returns to the       sebaceous glands, which secrete more se-
heart via venules and veins.                     bum to the skin surface. This reduces the
Venous valves prevent the reflux of blood.       evaporation rate of water from the skin,
Damaged venous valves combined with pro-         further protecting the body against heat
longed standing and lack of exercise can re-     loss.
sult in varicose veins.

Temperature regulation – sophisticated
regulation system for the body temperature
We numerous fine capillaries near the body
surface serve also a second purpose: in con-
junction with the sweat and sebaceous
glands, they play a major role in the regula-
tion of the body temperature.

If the body is heated up, due to high outside
temperatures or excess heat production wit-
hin the system (as a result of fever or physi-
cal exercise), more blood is pumped into the
skin where the heat is released into the envi-
ronment. When sweat evaporates, this pro-
cess is accelerated by the cooling effect on
the skin and thus the blood.
                                                                                                                   scalp
Glands of the skin
                                                                                                              hydro-lipid-film
Sebum – protective fat of the horny layer
Sebum consists of dying and decomposing
sebaceous cells and contains glycerides and                                                                   sweat gland channel
fat-like substances. Through a duct, the sub-
stances are transported to the base of a hair
follicle and from there to the surface. Due                                                                   sebaceous gland
to the ability of the substances to spread
themselves evenly over the skin, they keep it                                                                 eccrine sweat gland
soft and supple. Sweat promotes the sprea-                                                                    apocrine sweat gland
ding of sebum. Skin however sometimes be-
comes too oily, due to overactive sebaceous
glands producing excessive sebum.

This condition is known as seborrhoea. The          Sebaceous glands:
scalp with its many hair follicles contains         s   Dead cells from gland tissue form sebum consi-
                                                        sting of glycerides and other fatty components.
more and larger sebaceous glands that any           s   The sebum is expelled through an opening below
other part of the body. The scalps of people            the exit of the follicle to the surface of the skin
suffering from seborrhoea becomes therefo-              where it spreads.
re quickly greasy
                                                    Eccrine sweat glands
                                                    s   Sweat consisting 99 % of water
Eccrine glands – the temperature regulators         s   is expelled to the skin via individual pores
of the skin                                         s   where it evaporates and protects the body from
Whenever we sweat – be in the sauna or                  overheating.
                                                    s   Contributes to better spreading of sebum.
through physical exercise – approximately
two million eccrine glands or sweat glands          Apocrine sweat glands
are activated, secreting a special liquid onto      s   empty into the hair follicle canal
the surface of the skin. Sweat consists of          s   Secretion contains components of the cells of the
                                                        gland tissue
water (99 %), in which salts, urea and other        s   The typical odour of sweat is caused by bacteria.
organic substances are solved. Evaporation
at the surface cools the skin and the blood
flowing in its capillaries This effectively pro-   Axillary sweat glands
tects the body against overheating.                (apocrine sweat glands) – glands producing
However, psychological factors can result in       the distinct personal odour. Axilliary sweat
excess sweat secretion. Examples of stress-re-     glands develop in association with hair folli-
lated excessive sweating are wet hands and         cles and are mainly found under the armpits
armpits or cold sweat on one’s forehead.           and the area of pubic hair.

Sweat supports the formation of an effecti-        Similar to sebaceous glands, they undergo
ve protective film and, together with the se-      enlargement and secrectory development
bum and the fats from the horny layer of           under the influence of hormones, i.e. during
the skin, provide the hydro-lipid film of the      puberty. The axillary sweat glands produce a
skin. If this protective layer is constantly re-   turgid yellow-whitish liquid containing cell
moved by washing or not produced due to a          components of the gland tissue that provide
medical conditions, skin can become very           and excellent medium for the growth of bac-
dry and flaky.                                     teria. The typical acrid odour is actually the
                                                   result of the bacterial decomposition of the
                                                   sweat.
                                                                                                   dandruff
Flaky Skin and Dandruff                            Greasy dandruff
                                                   Persons with a predisposition to both dand-
                                                   ruff and greasy skin (seborrhoea) suffer
How does flaky skin occur?
                                                   from yellowish greasy flakes that normally
                                                   remain attached to the base of the hair or
Healthy skin is continuously regenerating it-
                                                   the scalp.
self. Over a period of approximately thirty
days, skin cells produced in the basal cell
layer gradually move to the surface, develop
                                                   Excessive flaking of the scalp as a
into horny cells and are shed as minute cell
                                                   result of a skin disorder
                                                   Psoriasis – a non-contagious conditions
particles that are not visible to the naked
                                                   Not to be compared with the above types of
eye. In flaky skin, the synchronisation of the
                                                   flaky skin and dandruff is the medical condi-
processes of cell production and scaling is di-
                                                   tion of psoriasis. It is an inherited condition,
sturbed. Generally, the cell production rate
                                                   whereby external and internal factors such
in the basal cell layer is too high. This means
                                                   as stress and poor diet can actually bring ab-
that cells reach the surface of the epidermis
                                                   out the symptoms. The disease is characteri-
prematurely without being properly kerati-
                                                   sed by distinct, rather large sections of the
nised. They are shed in larger groups of
                                                   skin covered in silver- scaled lesions.
cells, i.e. dandruff. It has been scientifically
                                                   Psoriasis must be treated by a dermatolo-
proven that the skin of persons suffering
                                                   gist. The use of anti-dandruff products has
from dandruff renews itself within a period
                                                   no effect whatsoever on the condition.
of 20 days. This means that the skin renewal
process is one third faster than m persons
                                                   Hairdressers are urged to show special care
with normal skin.
                                                   and empathy towards people suffering from
                                                   psoriasis, as the condition can place a lot of
What types of flaky skin are                       emotional strain on the person. Affected
there?                                             skin must be treated with special care. Avoid
                                                   any mechanical or chemical irritation and
Dry flaky skin                                     use combs and brushes with great care.
Especially during the winter months, many          Generally, only the mildest products should
people with dry skin suffer from accelerated       be used.
drying of the scalp in conjunction with sensi-
tive reactions This can be traced back to
                                                   What are the causes for flaky
reduced air humidity and modified lipid
composition in the horny layer of the skin.
                                                   skin?
Affected persons suffer from dry and itchy
                                                   Internal causes:
scalp. Isolated red spots and a fine flaky lay-
                                                   s The excessive activity of the basal cell
er of light grey dead cells are visible on the
                                                     layer can be caused by disorders of the
scalp. In such cases, the use of care products
                                                     hormone system. Customers suffering
for sensitive scalp is recommended.
                                                     from dandruff that cannot be successfully
                                                     treated with special products should con-
Dry dandruff
                                                     sult a Dermatologist.
The scalp of persons suffering from dry
                                                   s There are a number of drugs that are
scalp (sebostasis) with a predisposition to
                                                     known to stimulate the cell division in the
dandruff sheds dry, fine white or clear flakes
                                                     basal cell layer.
that tall from the hair with every movement.
                                                   s Many people have a genetic predisposi-

                                                     tion for dandruff (here, good results can
                                                     be achieved with anti-dandruff products).
                                                                                                      dandruff
External causes (for dry, flaky and sensitive       The bacterial flora and its protective
scalp):                                             function
s Irritation by certain chemicals, for example      One of the main factors for a healthy scalp
  unsuitable hair care products with a high         is an intact film at the surface of the epider-
  pH; such substances can stimulate exces-          mis and a balanced flora of non-pathogenic
  sive scaling                                      bacteria and yeast. There are approximately
s Mechanical irritation such as fine lesions        1 million such organisms on every square
  in the scalp caused by damaged combs,             centimetre of scalp. This physiological flora
  etc. can also lead to excessive cell produc-      in the hydro-lipid film and in the ducts of
  tion in the basal cell layer.                     the sebaceous glands protect the skin
s Biological causes include the spreading of        against colonies of pathogenic microorga-
  microorganisms that cause scaling on the          nisms.
  scalp.
s Excessive washing can also cause flaky            Persons who have a predisposition to dand-
  scalp, as the skin reacts with increased se-      ruff also generally show an excess growth of
  cretion of sebum possibly combined with           the Ùted species on the scalp, promoting
  dry dandruff.                                     the formation of dandruff. Anti dandruff
                                                    agents (climbazole, piroctone olamines and
External and internal causes are known to           zinc pyrithione) target the yeast to achieve a
interact, worsening the problem.                    balanced flora of microorganisms, which in
                                                    turn reduced the scaling of the skin to nor-
How do external influences                          mal levels. Laboratory tests have shown that
affect the skin?                                    the different varieties of the species
                                                    Pityrosporum ovale are not equally affected
External factors often attack the horny layer       by anti-dandruff substances. In order to suc-
of the skin, leading to an irritation of the        cessfully eliminate all causes far dandruff, a
basal cell layer, which responds with exces-        combination of different agents is therefore
sive cell production. Where the outer layers        the mast effective method. However, if the
of the skin and the protective hydro-lipid          anti-dandruff product is not used all the
film are damaged, they are unable to fulfil         time, the yeast again starts to take over and
their function in keeping antigenic substan-        dandruff returns.
ces 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 pene-
trate the scalp. Specialists refer to this condi-
tion as sensitive scalp.
                                                                                                                dandruff
How can hairdressers assess
cases of dandruff and what are
the important questions to be
asked?
Generally dry dandruff                                    Generally greasy dandruff
Typical symptoms                                          Typical symptoms
s   Dandruff falls from scalp and hair, even if only      s   Flat dandruff particles that remain attached to
    slightly moved                                            scalp or hair
s   Small flat transparent flakes                         s   When rubbed between the fingers: oily, greasy,
s   Dull complexion                                           sheen
s   Distinct red spots after washing                      s   Tendency of acne
s   Sensitive scalp                                       s   Large pores in seborrheic skin areas
s   Blood vessels visible on the scalp


                             Questions to be asked
                             s   Do you have any problems regarding your scalp?
                             s   Do you sometimes suffer from itchy scalp?
                             s   How often do you wash your hair?
                             s   For now long do you rinse your hair after shampooing?
                             s   What shampoo do you use?
                             s   Are there times where there is more dandruff?
                                                                              sensitive scalp
What are the influences to                        Certain people react to UV radiation with
which skin reacts?                                sunburn, while others simply get a suntan.
                                                  In a similar way, skin types can be classified
Over the last decades, the number of peo-         according to their sensitivety to chemical
ple that require treatment for “dry and sensi-    substances, heat/cold or mechanical stress.
tive scalp” is increasing. This development is    It is thereby important to note that for
most likely due to various related factors:       example skin that reacts sensibly to UV radi-
                                                  ation might not show any increased sensiti-
External factors                                  vity to chemicals. Also, the same skin might
s Air pollution
                                                  react to certain chemicals with clear signs,
s Sunlight (UV radiation)
                                                  while it is not affected by other substances.
s Excessive drying of skin (by dry air in hea-
                                                  Therefore. skin that shows a strong reaction
  ted rooms, air conditioning, etc.)              to detergents (shampoos) might not show
s Insufficient care after colouring and perm
                                                  any increased sensitively to alcohol.
s Exposure to chemical substances (cleaning

  agents, solvents, pesticides, etc.)             A person´s skin might not always show the
                                                  same sensitivity
Internal factors                                  The sensitivity of skin often varies with the
s Inherited predisposition
                                                  seasons (e.g. increased sensitivity during the
s Ageing processes
                                                  winter months) or age (example: prior to 20
s Stress
                                                  and after 60 years of age = not particularly
s Metabolic disorders
                                                  sensitive/between 20 and 60 years of age =
s Disorders m connection with hormone
                                                  highly sensitive). Such variations are most
  and vitamin levels                              prominent in people that are born with high-
s Side-effects of drugs
                                                  ly sensitive skin. However, also normal skin
s Side-effects of certain skin diseases
                                                  can react strongly to certain strains and sub-
                                                  stances. As anywhere else, the wisdom of
Dry scalp is particularly at risk                 Paracelsus, the great medieval physician ap-
Dry scalp has a tendency to react very sensi-     plies to the quantity that makes a sub-
tively to both external and internal factors.     stance a poison.
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 mi-
croorganisms and harmful chemical substan-
ces have also 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.

Skin types that show a genetic predisposi-
tion for hypersensitivity
Often, the degree to which skin reacts to
environmental influences is inherited. In this
context, two skin types are most at risk.
One criteria by which such skin types can be
distinguished is their sensitivity to sunlight
(UV radiation):
                                                                                       sensitive scalp
How does skin react to adverse How can a hairdresser assess
factors and how does sensitive sensitive skin and what are the
skin develop?                  important questions to be
                               asked?
Whenever skin shows a reaction, two con-
ditions are fulfilled:
s The substance with which the skin has             sensitive skin
  been in contact contains a component              Typical symptoms
  that has irritating properties                    s   Visibly red skin (erythema) (example: sunburn)
s This substance has penetrated the skin in             The redness is caused by the presence of red
                                                        blood cells from capillary vessels that penetrate
  a quantity that is sufficient to cause irrita-        and disperse in the tissue
  tion. In people that show an inherited ten-       s   Locally increased skin temperature (by approx.
  dency to sensitive skin, very small quanti-           1 to 3° C)
  ties, that would lead to no reaction
                                                    s   Increased permeability of the permeability bar-
                                                        rier (in both directions). It is possible to indi-
  whatsoever on normal skin, can result in              rectly measure this permeability by means of
  great irritation.                                     the water transfusion through the horny layer
                                                        of the skin (transepideirmal water)
                                                    s   Rough skin surface (ranging from tiny flakes to
The exact way in which skin irritations deve-           large areas of pealing, e.g. after sunburn)
lop is highly complex and not yet fully un-         s   Sensation of irritation, i.e. itchiness, burning,
derstood. However, studies show that the                taunt skin
contact with the irritating agent results in        Questions to be asked
the release of biochemical substances within
                                                    s   How does your scalp react to shampoos?
the skin, leading to a complicated chain            s   How does your scalp react to products contai-
reaction of symptoms.                                   ning alcohol?
                                                    s   Are there specific reactions to heat/cold?
                                                    s   Do you suffer from contact allergies or hey
                                                        fever (indictors for sensitive skin)?




                                                   Irritated skin shows the above symptoms.
                                                   However, most symptoms become only
                                                   obvious several hours after the contact with
                                                   the irritating substance (redness within 6 to
                                                   24 hours, scaling after several days). The
                                                   diagnosis and anamnesis of sensitive skin is
                                                   thus not that simple! Even experienced der-
                                                   matologists 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 sub-
                                                   stance, while it might completely ignore
                                                   other irritants.
                                                                                            greasy scalp
What are the main adverse
factors and how does the skin
react?
                                                                                                             spreading of the
What is greasy skin?                                                                                         sebum
Seborrhoea describes an overactivty of the
sebaceous glands and a predisposition to                                                                     sebaceous
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                                                                    sebaceous gland
total number of sebaceous glands is deter-
mined by genetic factors. The quantity of
sebum that is secreted on the surface of the      The condition of seborrhoea is an increased secretion of
skin depends however not only on the num-         sebum. This leads to a greasy scalp.
ber of glands but also on their size. The
sebum found on the surface of the skin is         Seborrhoea only describes the condition of
thus directly proportional to the density and     overactive sebum production. In addition
the size of sebaceous glands. The largest         to the above causes, pollutants in the envi-
such glands, actually consisting of several       ronment, stress or a poor diet are common
sacs, are found in the scalp. Their function is   contributing factors.
mainly controlled by hormones. Up to the
age of puberty, they produce very little          For the spreading of the grease, the secre-
sebum. During puberty, the sebaceous              tion of sweat also plays and important role.
glands begin to produce more sebum, main-         In hot weather, we transpire. Sweat dilutes
ly stimulated by the male hormones (adro-         the sebum and distributes it across the
genic hormones).                                  scalp pores.

However, there are different types of greasy
hair. As regards its causes, specialists diffe-
rentiate between greasy scalp, i.e. sebor-
rhoea and greasy hair due to the spreading
of the sebum.
                                                                                     greasy scalp
Mixed skin – overactive sebaceous glands          Sebostasis – insufficient activity of the
in seborrheic zones                               sebaceous glands

Depending on the size of the sebaceous            If skin generally feels very dry and taunt, it
glands and the effect of the androgenic           is very likely that the sebaceous cells do not
hormones, the quantity of sedum produced          secrete enough sedum. This condition is re-
in the different areas of the skin varies. In     ferred to as sebostasis and is due to genetic
the face, there is a distinct area in which the   factors. After washing, the protective hydro-
sebaceous glands are most active: it is the       lipid film of the skin is only very slowly re-
zone of the forehead and across the nose          stored. The epidermis therefore tends to dry
and chin and is often referred to as              out quickly, and the skin shows dry tiny sca-
“T zone”.                                         les. Most affected are elderly persons, as the
                                                  activity of sebaceous glands is significantly
If the sebum production in the T zone is          reduced from the age of 50.
considerably higher than in the other parts
of the face, the facial skin is referred to as    Dry skin is often chapped and shows tiny
“mixed skin”. The T zone has a tendency to        lesions through which antigenic substances
appear greasy, even shortly after it has been     and germs can penetrate the tissue, causing
cleaned, while the dryer parts of the skin        infections.
remain dry and even irritating.
                                                  If this condition is combined with an inher-
When assessing hair and scalp condition,          ited predisposition for allergic reactions to
the facial skin should also be looked at in       certain substances, it leads to a high risk of
order to recommend a suitable system treat-       contact allergies. Skin affected by sebostasis
ment.                                             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.
                                                                                                greasy scalp
How does skin react to adverse
factors and how does greasy
skin develop?
A greasy scalp is the result of a functional di-
sorder of the skin, in particular of the seba-
ceous glands. This condition can be trigge-
red 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
burner function is impeded. Under the
influence of heat, sedum 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             s   Oily, greasy sheen
                             s   Demarcation lines of sebum and sweat

Possible causes              s   Hormonal disorder
                             s   Poor diet
                             s   Psychological and physical disharmony
                             s   Chemical and mechanical factors
                             s   Environment
                             s   Inappropriate treatment with unsuitable or harsh products

Diagnosefragen               s   Do you have any problems regarding your scalp?
                             s   How often do you wash your hair?
                             s   Does your facial skin tend to be greasy?
                             s   What shampoo do you use?
                             s   How do you style your hair?

Recommendations              s   Dry-blow at low temperature
                             s   Always thoroughly rinse out hair care product (shampoo, conditioner, etc.)
                             s   Consequent system care
                             s   Only light perms
                             s   Layered haircut is recommended
                             s   wash hair more often
                             s   Use styling products
                                                                                                                             hair loss
What are the causes for hair                                      Hair growth is for example influenced by the
                                                                  seasons. In this context, a unit has been
loss?
                                                                  established, called the A/T quotient: it is
                                                                  calculated from the number of hairs in the
Normal hair growth
                                                                  growth phase (A = anagen) divided by the
The average scalp is covered by approxi-
                                                                  number of hairs in the resting phase of the
mately 200 hairs per square centimetre.
                                                                  hair cycle (T = telogen). For healthy scalps,
                                                                  the A/T quotient is approx. 80/100, while
At the beginning of each growth phase (ana-
                                                                  facial hair has a ratio of 50/50. Generally,
gen), the hair grown during the previous
                                                                  hair growing on the head has a much higher
cycle is shed. Given the above hair density,
                                                                  A/T quotient than body hair. An A/T quo-
this means that every day, between 80 and
                                                                  tient that is permanently shifting towards a
100 hairs are lost This rate can however
                                                                  higher telogen ratio indicates hair loss.
fluctuate considerably, a fact that normally
should not cause any reason for concern.


    hairloss per day


          normal changes to hair                                         hair loss
  140
  130
  120
  110
  100
   80
   60
   40
              Ø hairloss               normal hair loss     short-term hairloss      long term hair loss
   20         (80-100 hairs per day)                        (not problematic)
    0                                                                                                          t = month


Hair loss:                                                        Normal changes to hair:
We would only talk of “hair loss” when there is a                 Short-term variations from the normal rate of hair loss
longer-term increase in rate of hairs falling out.                (possibly due to the season of year) are not a cause for
s Reversible hair loss can be cured with supporting               concern .
s Irreversible hair loss cannot be reversed, or only with

  difficulty.




Causes for hair losses/alopecia/effluvium                         There are other forms of congenital forms of
                                                                  alopecia, where the hair growth is normal at
Hair loss (effluvium/alopecia) occurs if the                      birth and hair loss only occurs later in life.
number of haws that is shed by the scalp
is for a considerable period of time above                        On the other hand, there are numerous
the average. There are rare cases of congeni-                     forms of acquired alopecia. Within this
tal alopecia caused by anomalies during the                       group, specialists distinguish between reversi-
gestation, whereby the number of hair folli-                      ble and irreversible hair loss. Reversible hair
cles is reduced in general, or where only a                       loss naturally disappears after a certain peri-
fraction (hypotrichosis) or none (atrichosis)                     od of time; the hair growth can be stimula-
of the hair follicles are actually functioning.                   ted and accelerated by proper treatment.
                                                                                                                    hair loss
What are the causes for and                         Sequence of reversible Telogen hair loss

symptoms of reversible hair
loss?
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            healthy hair   dysfunction       hair loss     healthy hair
anagen. As soon as the disturbance is                                                      +
                                                                                    germ formation
removed, the hair follicle produces again a
new healthy hair.

Anagen hair loss is due to influences that
have an immediate impact on the body. In                                    density of hair

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     Causes for hairloss:
the typical bulb at the end (club hair) found        external factors
in telogen hair.                                     s   infections
                                                     s   long-term stress
                                                     s   drastical dieting
All reversible types of alopecia – with the          s   malnutrition
exception of localised hair loss – show a dif-       s   side-effects of medication
fuse shedding of hair (i. e. equally dispersed       s   external mechanical factors
across the scalp) and a gradual develop-             internal factors
ment. The effects are in all cases fully rever-      s   hormonal fluctuation due to pregnancy
sible, once the cause behind it is removed.          s   dysfunction of the immune system
Reversible hair loss is a rather common
though not yet fully researched phenome-
non. There are no exact statistics regarding        a) Loss of hair after serious infections
this condition.                                     A strong attack of influenza is sometimes
                                                    sufficient to induce telogen alopecia.
It seems though that hair can in some cases         The general weak state of the body thus
react very sensitively to apparently insignifi-     affects also the hair follicles, although the
cant influences, which is even the more sur-        exact causes are not yet known.
prising, as it is normally very robust and
strong. While, in the course of evolution,          b) Hair loss after periods of great stress or
hair has adapted to many adverse influen-           shock
ces, today’s way of life exposes it to comple-      Research suggests that prolonged stress and
tely new conditions that can lead to hair           shock can lead to reversible loss of hair. It is
loss. Examples of such conditions are:              however not yet fully clear whether hair loss
                                                    can be directly related to specific stress
                                                    levels or trauma. Also to be taken into consi-
                                                    deration here is the role of a possible gene-
                                                    tic predisposition.
                                                                                                     hair loss
c) Hair loss as a consequence of                   f) Hair loss after giving birth
malnutrition                                       During pregnancy, special hormones (gesta-
In the case of malnutrition, the body does         gens) are produced. They also affect the
not receive a sufficient level of energy and       growth of hair, as more follicles than usual
nutrients required for growth and regenera-        remain in the anagen. After delivery, the
tion of the organism. This lack of substances      gestagen level is suddenly reduced, with a
including vitamins and trace elements direct-      reverse affect on the hair growth cycle. In
ly affects the hair, leading to hair loss in the   order words, hair in the anagen goes over to
telogen. Depending on the extent of malnu-         the telogen (rest phase) and is shed after a
trition, the shafts of hairs also becomes thin-    few months. The new hair is still short and
ner.                                               the impression is that of thinning hair, alt-
                                                   hough the number of active follicles is not
The following trace elements and vitamins          reduced. As soon as the growing hair has
are necessary for keratinisation, i.e. the pro-    reached its normal length, the hair volume
duction of keratinised cells: iron, zinc and vi-   returns to normal.
tamin H (biotin). A deficiency in these sub-
stances can result in hair loss and reduced        g) Hair loss due to trauma
hair diameters.                                    Hairstyles that produce a constant pull on
                                                   the hair roots can promote hair loss. Such
Similar symptoms are known in connection           stress impairs the formation of the hair shaft
with protein deficiency.                           in the anagen follicles. Telogen hair is gradu-
                                                   ally pulled out, leading to bald patches. The
d) Hair loss during dieting                        hair shafts can be broken by excessive me-
The above effects of malnutrition on hair          chanical stress for example by unsuitable
growth imply that radical dieting can lead to      combs, also giving the impression of thining
telogen hair loss.                                 hair.

e) Hair loss caused by drugs                       h) Appearance of bald patches (alopecia
Certain drugs can lead to hair loss. The best-     areata)
known example are anti-cancer drugs (carci-        This type of hair loss is characterised by
nostatics in chemotherapy), where patients         round patches of baldness on the scalp. It is
suffer from reversible anagen hair loss. Such      believed to be caused by autoimmune disor-
substances reduce the mitotic rate of all cells    ders and is thus not directly related to other
m the body that normally undergo mitosis,          types of hair loss. The smaller the number
including of course the targeted cancer cells.     and size of the affected areas, the greater
Particularly drastic is however the effect of      the chance of full recovery. If the hairdresser
such drugs on the hair-producing trichocy-         spots such typical round bald patches, the
tes, that normally have the highest mitotic        customer should be informed and urged to
rate of all body cells. This leads to a com-       consult a dermatologist.
plete hair loss within only a few days after
the commencement of the 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.
                                                                                                                    hair loss
The development of                                 Sequence of androgenetic hair loss

irreversible hair loss
Irreversible hair loss occurs:
s if the hair follicles are considerably

   reduced in volume (as is the case in andro-
   genetic hair loss)
s if the function of the hair follicles is per-

   manently impaired (as in serious cases of
   alopecia areata)
                                                                                                Wirkung Androgene
s as a result of certain skin diseases

                                                          terminal hair                                             vellus hair
The following explanations are limited to
androgenetic hair loss, alopecia areata and
hair loss due to age:

a) Androgenetic hair loss in men and                                            density of terminal hair

women                                              Irreversible hair loss due to miniaturization of the hair
This most common type of has loss is               follicle

currently considered irreversible. It is charac-
terised by the gradual replacement of the          However, it is interesting to note that these
terminal hair on the head by downy thin            androgens have the opposite effect on body
hair (vellus hair). In many men, this process      hair: there, vellus hair follicles are transfor-
begins as early as 17 years of age and is ac-      med to terminal hair follicles (as in beards).
companied by a gradually receding hairline.
Androgenetic hair loss is normally comple-         Women can also suffer from androgenetic
ted at the age of 50.                              hair loss, though such cases are much rarer.
                                                   Up to the menopause, the condition leads
Male pattern hair loss is caused by androge-       to a diffuse thinning of the hair around the
nic hormones (androgens). The role that            centre parting. After the menopause, female
these hormones play in the development of          pattern hair loss can in certain cases resem-
male pattern hair loss was already known to        bled the pattern of hair loss in men.
Aristotle, who observed that eunuchs never         However, normally only a small portion of
suffered from baldness.                            the terminal hair develops into vellus hair.
                                                   Therefore, only very few women suffer from
The two main androgens responsible for the         total baldness, as female pattern hair loss is
condition are testosterone and its derivative      characterised by a more or less prominent
dihydrotestosterone (DHT).                         thinning of the hair.

An enzyme called 5 alpha reductase con-
verts testosterone to DHT. Scientists agree
that the hormone causing androgenetic alo-
pecia is actually DHT. It is directly respon-
sible for the replacement of normal follicles
with vellus hair follicles.
                                                                                                      hair loss
b) Age-related hair loss
Both men and women of an advanced age
often show a diffuse thinning of the scalp,
caused by continuing or newly induced con-
version of the strong terminal hair to thin
intermediary hair and vellus hair. The causes
for this type of hair loss are not fully under-
stood yet but are believed to be part of the
general ageing process of the body.

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 ap-
plies here: the larger the bald patches, the
greater the probability that the hair loss is ir-
reversible. In such cases, hairdressers should
urge their customers to immediately consult
a dermatologist.




               I               II              IIa             III   IIIa              III-vertax




             IV               IVa               V              Va     VI                      VII
men                                                                   Hamilton-Norwook Skala
                                                                      Hamilton-NorwoodScale,
                                                                      androgenetic hair Haarausfall
                                                                      androgenetischer loss




              1                2               3               4




              5                6               7              8
                                                     Ludwig Skala
                                                     Ludwig Scale
women
                                                                                                    hair loss
How can a hairdresser assess                       How can hairdressers assess
hair loss and what are the                         hair loss?
important questions for such
an assessment?                                     Obviously, an assessment by a hairdresser
                                                   can never replace a diagnosis by a dermato-
Hair is the fastet growing part of our body.       logist. However, due to the often confidenti-
No other cells have a comparably high              al relationship between hairdresser and cu-
mitotic rate than hair cells. Two main pro-        stomer and based on professorial
cesses are responsible for the development         experience, hairdressers can:
                                                   s describe the type of hair loss with great
of healthy hair:
                                                     accuracy
                                                   s initiate the appropriate treatment, if any
1. continued production of trichocytes in the
                                                   s assess whether the customer should
   hair matrix.
2. the conversion of trichocytes to hollow           urgently consult a dermatologist
   hair cells during the process of keratini-
   sation.                                         The following questionnaire can be very use-
                                                   ful m cases, where hairdressers are consulted
Healthy hair has an even sheen and is              by their clients in connection with hair loss.
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
vessel 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).

Objectives of such treatment:
s prevention of hair loss and improvement

  of hair quality
s stimulation of hair growth in cases of re-

  versible hair loss
s in the case of irreversible androgenetic

  hair loss: slowing down of the transforma-
  tion of terminal hair follicles to vellus hair
  follicles, and reversion of the process, as
  far as possible
                                                                                                                             hair loss
Questionnaire:                                               s after dieting
                                                             s after a prolonged period of poor nutri-
Age of customer:                                               tion
s less than 20                                               Hair loss possibly due to malnutrition (see 5.2 c/d).

s between 20 and 50
s over 50 years of age                                       s during puberty
                                                             s after puberty
Hair is washed:                                              Possible first sign of andorgnetic hair loss (see 5.2. a).

s daily
                                                             Customer´s hair style puts individual hairs
s 2-3 x per week
                                                             under considerable strain:
s 1x per week
                                                             s yes
Customer that wash their hair every day find less hair in
the wash basin than persons that wash their hair only        s no
once per week; in the latter case, hair loss is more ob-     Constant pull on hair can result in hair loss (see 5.2 g).
vious.

                                                             Subjective impression of hair loss is
Family background: Have other members of                     increased when the hair is grown longer:
your family suffered from hair loss?
                                                             s yes
s yes
                                                             s no
s no                                                         Possibility that there is no hair loss. In long hair, the na-
                                                             tural hair cycle is often more visible than in short hair
The hair loss began in:                                      (due to the length of the individual hair).

s spring
                                                             Hair loss already continues for:
s summer
                                                             s week
s autumn
                                                             s months
s winter
                                                             s years
Consider the option that the hair loss is due to seasonal
                                                             The longer the perios of hair loss, the more serious the
fluctuations in the hair growth cycle and thus harmless
                                                             condition. If could be irreversible. Advice customer to
and reversible (see 5.1.).
                                                             immediately consult a dermatologist.

s after illness                                              The hair loss is:
s disorder of the thyroid gland function                     s limited to certain areas
s hormonal change (pregnancy,                                s diffuse (i.e. all over the scalp)
  menopause, etc)                                            Diffuse hair loss is reversible (see 5.2. a) to g), a symp-
s iron deficiency                                            tom of female pattern androgenetic hair loss (see 5.2 a)
                                                             or of hair loss due to age (see 2.4. b).
s after major surgery                                        Distinct bald patches often indicate androgenetic hair
(The hair loss might have been caused by a serious in-       loss, commonly in men (see 5.2. a), alopecia areata (see
fection (see 5.2 a) or by a drug (see 5.2 e). Increased      5.2. c) / 5.2. h)) or a skin disorder in both genders.
hair loss in in many cases directly related to thyroid in-
sufficiency or iron deficiency.


s after treatment with certain drugs
The hair loss could be an adverse side-effect of the drug
(see 5.2. e).


s during or after prolonged period of stress
s after a mental shock
Such experiences are known to cause temporyty rever-
sible hair loss (see 5.2. b).
                                                                                                             hair loss
The hair loss:                                              Based on the completed questionnaire, the
s commenced in the forehead corners                         hairdresser is in many cases in a position to
                                                            assess whether the hair loss is reversible or
s the hair line is already receding across
                                                            not. The hairdresser will also know whether
  the entire forehead
                                                            the consultation of a dermatologist is neces-
Most likely a case of androgenetic hair loss (see 5.2. a)
                                                            sary or not.
The typcial symptoms of andorgenetic hair
lines have already developed:                               Maintaining healthy hair
s yes                                                       growth
s no
                                                            As outlined above, it is possible to stimulate
(see above)
                                                            and improve hair growth by the application
                                                            of agents that penetrate the scalp in order
The bald patches are circular in shape:
                                                            to support the function of the follicles. The
s yes                                                       following three objective are crucial for a
s no                                                        successful treatment:
Possible case of alopecia areata (see 5.2. h / 5.2. c).     s Unimpaired blood supply to the hair roots.
Advice the customer to immediately consult a derma-         s Optimised supply of substances that are
tologist.
                                                              of special importance for the keratinisa-
                                                              tion of the trichocytes.
The scalp is:
                                                            s Protection of the hair root against
s reddish                                                     Influences that promote inherited hair
s infected                                                    loss.
Obvious sign for irritation, damaged scalp or serious
skin disorder. Advice customer to urgently consult a
dermatologist.


If the above questions are discussed in detail
during the customer´s visit at the hairdres-
ser´s, it is comparatively simple to assess
the hair loss. If the customer does not requi-
re the immediate attention of a dermatolo-
gist 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.

				
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