Hair Transplant

Hair care

Dandruff
Dandruff is one of the most common cosmetic problems of non-inflammatory nature leading to increased scaling of scalp affecting one in every five individuals. It is known under various dermatological terms such as Pityriasis Siccal P. Sleatoides/P. furfurance. It may or may not be accompanied by itching. It is usually characterized by white flaking of the scalp with the scales falling on the shoulders, neck and back, Increase in summer and reduction in winter.

Dandruff can also be an early presentation of scalp disorders like Psoriasis and Seborrheic Dermatitis. Avoid excessive use of hair oil but emphasize regular use at night to dislodge scales. Medical Therapy: Topical applications - lotions/shampoos with Ketokenazole.
Treatment of, secondary infections with Antibiotics.
Hair Dyes
No longer are dyes used only to camouflage graying hair, but colouring agents & dyes are actually used to highlight and accentuate hair colour. Hair dyes can be classified into 2 major types: - Semi-permanent and permanent hair colouring agents.
  • Semi-permanent hair coloring
    The originally developed hair dyes are the vegetable dyes. These generally fall under the semi-permanent category as they only minimally penetrate the hair cuticle.
    The most popular vegetable dye used is henna. This is derived from the Lamsonia Alba plant. The dried plant leaves are ground to form a powder that is activated with water to form an acidic naphthoquinone dye. This is applied as a paste to the hair for 40-60 minutes. The henna imparts a reddish hue to the hair. Nowadays, synthetic henna formulations are available which are superior to the natural henna formulations, as they do not leave the hair as stiff and brittle as the natural ones even after repeated applications. In spite of its semi-permanent nature, henna also requires 4-6 washes before it comes out fully. The biggest advantage of henna is that it is not really known to cause allergic contact dermatitis.
  • Permanent Hair Colouring
    The hair dye penetrates the hair shaft to the cortex and forms large colour molecules that cannot be removed by shampooing. Redying is necessary every 6 weeks or so.Permanent hair colour damages the hair shaft by increasing its porosity, making it more brittle, harder to untangle and also increases static electricity. Hence, they should not be used more frequently than 5-week intervals. The most important, being PPD - Paraphenylene diamine. It is most commonly known to cause allergic contact dermatitis and hence patch testing is a must before using this product.
    Permanent color is produced by the oxidation of the primary intermediate by hydrogen peroxide to produce an amine. The hair must be saturated with the product and then the excess dye is rinsed.
  • Gradual hair dyes, Metallic Dyes left in situ - gradually darken hair.
Hair styling by Pinning, Bands, clips, rubbers bands for hair
Apart from contact dermatitis in susceptible individuals to any of the products used - the most important side effect is TRACTION ALOPECIA. Over zealous pulling back and pinning of hair leads to receding of the hairline and loss of hair due to destruction of hair follicles.
Perming of hair
Hair is usually relaxed into a tighter curl than actually required. Waving involves reshaping of hair and "locking" it into the reshaped state. Normally when the hair is set into a "curl", it has a tendency to straighten itself again, because of the stretching of the disulfide bond & Gravitational forces. The perming lotion breaks the disulfide bonds between the keratin molecules in the cortical cells and reforms them in a new position. A permanent wave lasts 3-4 months.

Hair shafts become weaker by 17% therefore they are less able to stand trauma of combing and brushing. They fracture or brake from shaft. Hair becomes more difficult to comb because of increased frictional resistance.

Irritant and allergic contact dermatitis can occur
Hair straightening
This is used for patients with curly hair It is of 2 types temporary and permanent.
Temporary (heat): A metal comb heated to 300 to 500 F is passed repeatedly through the hair. Along with this a pressing cream containing oily substances such as petrolatum is used to help transfer heat and also in faster movement of comb through hair. This method breaks fewer bonds than chemical straightening.

Permanent (Chemical): Chemicals such as ammonium bisulfide, thioglycollate or sodium hydroxide are used.The principle is same as hair waving or perming.The side effects are similar to perming and should not be done more than 3 times a year.
Hair cosmetics & Hair care products
  • Hair oils : Usually consist of natural ingredients like vegetable oils e.g.: castor, olive, peanut, sesame, almond, rosemary, wheatgerm and the most popular coconut oil. These also include herb oils like henna, Amla and Brahmi oils. Largely aid in hair grooming. Doubtful value as far as hair growth is concerned - however traditional use continues. Shampoo your hair immediately. Since hair oils attract dirt and dust wash your hair with a good shampoo after heavy oiling. It is ideal to oil hair before every wash but daily application has adverse effects as it results in the sticky condition of the scalp causing accumulation of dandruff.

  • Hair tonic or nurisher - non-greasy preparations with doubtful scientific value.

  • Hair shampoos: "Shampoo" is an Indian word meaning massage. It is primarily a hair care product which contains a mixture of detergents, oil (fat) and water in varying proportions that is useful for cleaning hair and scalp. Detergent causes degreasing and removes sebum Some sebum has to be left behind or put back to achieve soft, shining hair. They may also contain softeners, conditioners, colouring agents, preservatives, opacifiers, sequestering agents etc.
    Before selecting a shampoo it is important to identify ones hair type.
    Hair that does not have sheen to it, gets knotted easily and splits at the ends is dry hair. Very limp hair and sticky to the scalp is oily hair. Hair which is flowing, easy to style and maintain, easy to brush and comb and has a nice shine to it with no split ends are normal hair. They are easily adaptable to new styles.

    Brush hair thoroughly to remove surface dirt, loosen scalp debris and help eliminate tangles.
    Wet hair thoroughly, works the shampoo into lather as you apply it on the scalp. Massage the entire scalp gently in circular motion with your fingertips for a few minutes. Rinse the hair thoroughly with warm water. Finally rinse with cold water to stimulate circulation. Dry gently with a soft towel.

    How often should hair be shampooed?

    Normal hair - Shampoo weekly
    Oily Hair - As often as required
    Dry Damaged hair - Shampoo weekly
    Dandruff problem - Twice a week till dandruff is under control

    How do I select a shampoo for my hair?

    If shampooing too often causes more hair problems than it solves first switch to a milder shampoo. If that does not work shampoo less frequently. Only with trial and error technique will you hit on the formula that works for your hair.

    What shampoos cannot do?
    No shampoo can "nourish" the hair Shampoos cannot make hair grow faster, grow longer or thicker. They cannot reverse graying of the hair. Shampoos do not cause hair loss
    Avoid shampoos that make the hair extra dry or cause scalp flaking, and those which make hair squeaky and difficult to finger comb while rinsing

    Types of Shampoos
    Basic shampoos
    Oily hair shampoos: excellent cleansing/minimal conditioning.
    Normal hair shampoos: good cleansing/moderate conditioning.
    Only useful for coarse, reasonably seborrhoeic hair.
    Dry hair shampoos: mild cleansing/good conditioning reduces static electricity, increase manageability,
    Damaged hair shampoos: These are for hair chemically treated with permanent hair colours, bleaching agents etc. They are even milder than dry hair shampoos.
    Baby shampoos are indicated for babies who produce limited sebum. They are usually amphoteric.
    Medicated (anti-dandruff shampoos)
    Normal shampoos with additives like tar, salicylic acid, sulfur, selenium sulfide, ZPTO or azole derivatives. What they do is cleansing efficiently, removal of scalp scales, decreases scalp scale production (antimitotic), antifungal and antibacterial action. Market preparations are Nizral, Ketodan, Selsun, Ionax-T, Scarpe, Head and Shoulders, All clear.
    These are cosmetic products designed to aid in styling the hair and maintaining the style in place. They also provide conditioning, style, shine and manageability. Depending on the ingredients, they can be applied on dry or wet hair.

  • Hair conditioner: Defined as a product generally applied to the hair to improve its cosmetic appearance and feel. There are plenty of traditional conditioners, like extract of hibiscus, neem etc. Modern day conditioners contain oils, waxes and silicones to lubricate and smoothen the hair. Other additives are Surfactants, cationic agents, hydrolyzed animal or silk protein, vitamin E, Pantothenol, sun screens etc. They provide lubrication and gloss. They restore protective acidic film of hair. They have anti-static properties and hence prevent tangling and breakage. Cuticle adhesion to hair shaft is induced, thereby reducing inter shaft friction. This adds to the softness and gloss of hair. They temporarily seal split ends.

    Type of conditioners
    Instant conditioners: These are left in contact with hair for 5 minutes immediately after shampooing. They are quick to act but their action is for a limited time.
    Cream conditioners: Concentration of ingredients is more. They remain on the hair for longer periods (20 minutes). They work better in conjunction with heat (dryer/warm towel); heat causes hair shaft swelling and hence better penetration of conditioner. They are most useful for extremely dry hair.
    Leave on conditioners: They are not rinsed off and remain till the next shampooing.
    Blow-drying lotions: Mainly for patients with fine hair and excessive sebum production.
    Hair glaze: also known as hair thickeners. They provide a coating on each shaft that increases its diameter minutely.
    Sun protective conditioners: Excess sunlight causes damage to melanin and keratin structure of hair. Hair protein degradation is caused dry UV rays 250-400 nm. It makes them stiff, dry, lusterless and brittle. Products are Ultradoux, Flex, Samara, Biotique.

  • Hair creams / oily dressings: They provide conditioning, style, shine and manageability.
    A film of oil is used to control the dry hair before combing it into a style. Cream is an emulsified oily dressing e.g. Brylcream or Brillantine. These contain mineral oil / isopropyl myristate.

  • Hair Sprays: Aid in styling the hair and maintaining the style in place.These contain polymers they form a thin film on hair that holds it in place and can be easily removed by shampooing. They are of 2 types Regular hold & Super hold - Contains increased copolymer. Adverse reaction: - Induces temporary hair coarseness and rough feel applied to their shafts by combing on to wet hair. It imparts a wet look and stiff feel to the hair. They are available as Styling gels & Sculpturing gels They are useful in people with dull thinning hair to create an illusion of fullness by holding the hair away from the scalp.

  • Hair styling mousses: This is a PVP and VA containing and pressure foam released spray from an aerosol used can. They are applied on damp or dry hair and give a much weaker hold than gel formulations. They also may contain colouring agents to create / blend gray hair.
Hair removal
  • Shaving
    Most widely practiced method, as it is most economical and rapidly effective. air is cut at the skin surface level in shaving. SHAVING DOES NOT INDUCE AN INCREASED RATE OF HAIR GROWTH.
  • Threading
    Practiced mainly for eyebrow and facial hair. Performed by looping a common thread around the hair, twisting it across the skin so as to cut the hair at the level of skin surface. Adverse reaction: folliculitis.
  • Plucking
    Another physical method where hair is grasped by tweezers and then plucked off removing entire shaft and hair bulb. Hence, hair growth takes longer to become apparent.
  • Waxing
    A variant of plucking where hair is plucked en masse and removed at the level of hair root. Hair regrowth, therefore takes time. It is popular in women who get various areas such as legs, arms, underarms waxed to remove body hair all over. There are 3 methods
    Hot or warm waxing: generally used by beauty parlors.
    In hot wax - paraffin wax along with beeswax, resin, petrolatum and mineral or vegetable oil are melted with direct heat (50oC) and then applied along the direction of the hair with a spatula in long, narrow bands. Wax is allowed to cool and set to form hardened strip embedding the hair. The solid wax is then lifted and stripped away in one piece bringing the embedded hair with it.
    Warm waxing: Similar to hot wax (but temp 430C) hence adheres efficiently to very short hair.
    Cold waxing: can be done at home - more hygienic
  • Bleaching
    It is used most often for unwanted facial hair. Pigments are changed to a lighter or colourless form by the process of oxidation. H2O2 is the main oxidant used - first made alkaline by mixing it with either an oil bleaching or powder bleaching.Extreme alkalinity and strong H2O2 can be damaging to both skin and hair.
  • Electroepilation
    Method of permanent removal of hair by destroying its bulk with various electrical techniques.
    The needle is inserted into the follicular opening to the level of follicular germinative cells. These along with dermal papillae are destroyed facilitating permanent hair removal. Depending on the type of electrical current used electroepilation is classified into 3 types:
    Electrolysis: (chemolysis) using direct (galvanic) current
    Thermolysis: using high frequency alternating current.
    Blend: using combination of both direct and A.C.
    IT MUST BE ENSURED THAT THESE PROCEDURES are always performed by skilled and trained operators.
  • Laser epilation
    This is the latest technique where rays from specialized laser machine are absorbed by melanin pigment causing photothermolysis. This is requires multiple sittings and there could be some problems of pigmentation esp. in dark skin. Thick hair is resistant.