TABLE OF CONTENTS :
- Introduction • What is Oxidative Stress? • The aim of this post • Our Scalp Health and Disease • Why does skin disease affect the scalp? • Conditions that lead to hair loss • Do you think that your skin condition of the scalp well? • Which health problems affect the scalp? • What are the causes of bad scalp conditions? • What are the symptoms of scalp conditions? • Dandruff and Seborrhoeic Dermatitis? • What is Psoriasis? • what is Atopic Dermatitis? • Why Scalp Ageing? • Role of Oxidative Stress in Scalp health& Ageing • An unhealthy Scalp leads to unhealthy hair. • Concept of the pre-and post-emergent hair fibre. • When we should have taken medical support? • How to scalp care effects on hair growth and quality? • Treatment for scalp conditions • Keywords • Reference
• INTRODUCTION: FOR HEALTHY SCALP
” I like hair each and every way. I like to give scalp massages – to pull and tug on it. But my favorite style is long, real hair in a dusty blonde-brown color”. – Author: Trey Songz
Nowadays, scalp problem and hair loss is common to all. Why it is? How to keep healthy scalp naturally? We know that each hair grows from, and through, an individual follicle which surfaces on your scalp.
Sebum (a.k.a. oil) is also produced by each follicle via the sebaceous gland. Mostly, the amount of sebum will vary from person to person. It is essential that the follicle and the scalp, at the point of exit, are clean, clear, healthy and maintained.
But follicles that are full of sebum or blocked by dead skin, dandruff or infection will have an impact on the quality of hair growth.
In fact, permanently blocked or obstructed follicles may eventually cease to produce hair at all.
The scalp is made up of cells that divide and continually work their way to the surface and then shed – as such, dead skin must be removed by brushing or washing, but also by weekly exfoliation.
On the other hand, It’s now proved that Scalp Condition Impacts Hair Growth and Retention via Oxidative Stress. Now we discuss about oxidative stress.
• What is oxidative stress?
Oxidative stress is an imbalance of free radicals and antioxidants in the body. It can lead to cell and tissue damage. Oxidative stress occurs naturally and plays a role in the ageing process.
How it impacts on our body? A large body of scientific evidence suggests that long-term oxidative stress contributes to the development in a range of chronic conditions. Such conditions include cancer, diabetes, and heart disease.
Excessive proliferation of Malassezia and scalp dermatoses such as seborrheic dermatitis, psoriasis, and atopic dermatitis can also affect oxidative balance. Therefore, a treatment aiming for a healthy scalp should be part of the treatment of hair loss.
Dermatologists show that there may be a therapeutic role in the use of antioxidants and anti-inflammatories to counteract oxidative stress which is related to hair loss.
According to this data, a new cosmetic formulation was developed containing anti-inflammatory, antioxidants, and conditioning agents. …
Read also: How Can We Get White Teeth Using the Best Toothpaste?
It’s true that the condition of the hair plays an important role in our physical appearance and self-perception. The quantity, quality, and styling of our hair define our gender, age, health, and social status.
There are no significant differences in the number of hair follicles between men and women, or between the different races. Differences in the appearance of hair are due to the type of hair produced by the follicle and the type of hair care practised by the individual.
• THE AIM OF THIS POST: HEALTHY SCALP
So this post aims to provide evidence that the condition of the scalp affects the natural growth and retention of hair, and consequently, that appropriate scalp care may deliver fundamental benefits for hair growth and its quality.
Pre-emergent hair can be negatively impacted by the oxidative stress that occurs with an unhealthy scalp. It’s possibly due to the incubatory environment, specifically the metabolic activity of resident microbes.
Therefore, hair care products with active agents have a massive role in restoring hair. That can reduce the population of respective microbes and restore a healthy scalp. As it is reducing the associated oxidative stress which may have an impact on hair health.
• OUR HEALTHY SCALP AND DISEASE
The scalp is the anatomical area bordered by the face at the front and by the neck at the sides and back. It is characterised by a usually high density of terminal hair growth with numerous sebaceous glands. It contributes to a specific microenvironment with significant differences from the rest of the skin.
Moreover, the scalp is a rich environment for microbes. Ecologically, sebaceous areas have greater species richness than dry ones, with implications both for skin physiology and pathologic conditions.
Specifically, dandruff and Seborrhoeic dermatitis, psoriasis, atopic dermatitis, and ultimately alopecia represent pathologic conditions. Therefore, oxidative stress is very commonly detected in this case.
However, quantitation of lipid peroxidation is a particularly prevalent method in dermatology to detect the underlying oxidative stress.
• Why Skin diseases affecting the scalp?
| Dandruff or pityriasis capitis | Diffuse scaling |
|---|---|
| Head lice | Adult lice, nits on hair shaft, tiny haemorrhagic spots and excoriations |
| Lichen simplex | Well demarcated lichenified intensely itchy plaques, usually on occiput |
| Folliculitis | Chronic scattered and irritable follicular pustules |
• Conditions that lead to hair loss
One of the most common types of scalp condition involves hair loss or damage. This can range from a complete loss of hair to easy breakages or small patches of hair loss:
- Male pattern baldness is common in men and occurs because of genetics and male sex hormones.
- Alopecia areata is a chronic autoimmune disorder that results in a patchy balding pattern.
- Nutritional deficiencies can cause hair loss, including protein deficiency or iron deficiency anemia.
- Three thyroid conditions can lead to hair loss:
- hyperthyroidism, which is an overproduction of thyroid hormone
- hypothyroidism, or an underactive thyroid
- Hashimoto’s thyroiditis, an autoimmune disease in which the immune system attacks the thyroid gland
- Hypopituitarism, or an underactive pituitary gland, can cause hair loss.
- Lichen planus is a skin condition that can cause discoloration of the scalp, as well as hair loss.
- Celiac disease is an autoimmune disease that leads to damage in the small intestine when gluten is ingested. Hair loss due to malabsorption of nutrients may result.
- Systemic lupus erythematosus is an autoimmune disorder with hair loss as one of its symptoms.
- Trichorrhexis nodosa occurs when hair shafts break easily. It’s normally due to genetics, but it can also be the result of certain disorders.
- Some women notice hair loss after giving birth, which is due to the drop in hormones like estrogen. (Hair growth returns within a few months.)
- Stress can lead to hair loss.
- Certain medications, such as birth control pills, blood thinners, and some of the ones that treat arthritis, depression, gout, heart conditions, and high blood pressure, can lead to hair loss.
- Eating disorders such as anorexia and bulimia can lead to hair loss.
- Some people experience temporary hair loss after an extreme weight loss of 15 pounds or more.
In addition, certain chemicals and tools people use for styling hair can lead to hair loss and damage to your scalp.
• Is the Skin conditions of the scalp well? :
Other conditions affect the scalp because they’re skin conditions or they cause skin rashes:
- Seborrheic eczema, or dermatitis, is a common inflammatory skin condition that causes flaky, scaly patches on the skin, especially the scalp. When those flakes fall off, it’s called dandruff.
- Cradle cap is seborrhoeic eczema in infants.
- Psoriasis is a common inflammatory skin condition. In many cases, it affects the scalp, which develops red, scaly, dry patches.
- Ringworm, or tinea capitis, is a fungal skin infection that produces ring-like patches. It’s common in children.
- Scleroderma is a rare
- disease of the skin and connective tissue. It causes skin to develop patches that are tight and hard.
- Ito syndrome, or incontinentia pigmenti achromians, is a rare birth defect that causes light patches of skin to develop on the body.
- Graft-versus-host disease is a potential complication after having a bone marrow or stem cell transplant. A skin rash may form when the host rejects the transplanted tissue.
- Leishmaniasis is a tropical parasite that sand flies spread. It can cause skin lesions.
• Which health problems affect the scalp?
Other health problems that affect the scalp include the following:
- Lice are small insects that infest the hair and scalp.
- Head trauma can refer to any accident that causes skull fractures or cuts on the scalp.
- Temporal arteritis occurs when arteries that supply the head with blood are inflamed or damaged. It results in a sensitive scalp.
• What are the Causes of bad scalp conditions?
The exact cause of certain scalp conditions is often unknown, or multiple causes are involved, possibly due to genetics.
These include:
Others scalp conditions, like ringworm, lice, and leishmaniasis, are known to be caused by infections.
• What are the Symptoms of scalp conditions?
The symptoms of scalp conditions depend on the exact condition, but they include:
You may experience other symptoms :
• Dandruff and seborrhoeic dermatitis: Inquest of healthy scalp
The specific anatomic features of the scalp skin, such as a large number of terminal hair follicles and the enlarged epidermal surface due to numerous hair canals, contribute to a specific microenvironment of the scalp and a higher rate of exfoliation.
Even a normal scalp will develop some degree of flaking within 1 or 2 weeks if the hair is not washed, while pathological dandruff results from accelerated proliferation of epidermal cells.
This leads to a breakdown of the normal columnar structure of the stratum corneum with increased exfoliation of variously large collections of abnormally keratinizing epidermal cells and the formation of cell aggregates, which determine the size of the flakes.
The process results from focal inflammation of the scalp with parakeratosis which causes abnormal exfoliation and an altered light refractive index of the keratinized cell aggregates.
The clinical appearance of dandruff is determined by the size, adherence, and light refractive characteristics of the flakes. Among the factors that lead to inflamed patches on the scalp are microbial colonization with Malassezia fungi, sebaceous lipids, and individual sensitivity.
Seborrheic dermatitis represents a chronic recurrent condition characterized by scaling and poorly defined erythematous patches, with a predilection for areas rich in sebaceous glands.
In contrast to dandruff, in seborrheic dermatitis, the redness and scaling frequently extend beyond the scalp to include the folds of the nose and eyebrow areas.
The cause of seborrhoeic dermatitis is again understood to involve fungi of the genus Malassezia. Therefore, there seems to exist a pathogenic link with dandruff that is understood to represent the mildest form of the clinical presentation of seborrhoeic dermatitis.
The scalp microbiome consists primarily of Propionibacteria, Staphylococcus bacteria, and Malassezia yeast.
Malassezia are responsible for essentially the entire scalp microbiome. The inflammatory process is believed to be mediated by fungal metabolites, specifically free fatty acids released from sebaceous triglycerides.
Both dandruff and seborrhoeic dermatitis have clear signs of oxidative stress as indicated by perturbed surface and systemic antioxidant enzyme levels.
There have also been observations from surface samples of elevated lipid peroxidation accompanying dandruff and seborrhoeic dermatitis.
• What is Psoriasis? Inquest of healthy scalp
Psoriasis is a chronic inflammatory condition of the scalp, and the most thoroughly studied skin condition linking oxidative stress, the role of Malassezia spp., and risk of hair loss. In contrast to seborrhoeic dermatitis, the condition is characterised by sharply demarcated erythematous lesions with silver-white scaling.
The most dramatic expression of the immune-mediated condition is tumour necrosis factor-alpha inhibition – treatment-induced psoriasiform dermatitis of the scalp with the risk of permanent alopecia from scarring.
Overgrowth of the scalp with Malassezia spp. is again a well-known feature of scalp psoriasis. Indicators of oxidative stress in psoriasis include altered antioxidant enzymes, oxidized proteins, as well as oxidized lipids.
• What is Atopic dermatitis? Inquest of healthy scalp
Atopic dermatitis is yet another common, chronic, relapsing, inflammatory skin disorder that may affect the scalp in a significant manner.
Its pathogenesis is complex and involves genetics, environmental factors, disrupted permeability of the skin, and immunologic mechanisms. A subset of patients with head-and-neck dermatitis may have a reaction to resident Malassezia flora exacerbating their condition.
This reaction is likely related to both humoral- and cell-mediated immunity. Even in the absence of differences in Malassezia spp. colonization, patients with head-and-neck atopic dermatitis are more likely to have positive skin prick test results and Malassezia-specific IgE compared to healthy controls and to patients with atopy without head-and-neck dermatitis.
Again, atopic dermatitis is a condition that is strongly associated with oxidative stress: quantitation of urinary indicators of stress is elevated, as are oxidized surface protein levels, which in addition may be exacerbated by environmental impacts.
• Why Scalp ageing? In quest of healthy scalp
So ageing of the scalp underlies the same principles as ageing of the skin, except for a natural protection from UVR depending on the amount of scalp hair.
Moreover, ageing represents the accumulation of changes over time, involving both programmed factors and damage-related factors (non-programmed factors).
Programmed factors follow a biological timetable. It’s perhaps a continuation of the one that regulates childhood growth and development.
This regulation would depend on changes in gene expression that affect the systems responsible for maintenance, repair, and defence responses. Damage-related factors include internal and environmental assaults that induce cumulative damage at various levels.
As a result, ageing of the hair itself affects hair colour (graying), hair production (alopecia), and structural properties of the hair fibre (hair diameter, hair fibre curvature, stretching, bending, torsional rigidity of the hair fibre, and lipid composition). Ultimately, with its consequence for the manageability and overall appearance of hair.
In contrast, the ageing effects on the nonbalding scalp are relatively unnoticed. Underneath the hair, the scalp may appear pale and dry, with a certain degree of laxity.
Moreover, a balding scalp exhibits the features of photo-aged skin, including irregular pigmentation, wrinkling, atrophy, telangiectasia, and findings of cutaneous premalignant and malignant diseases.
These are such as actinic keratosis, basal cell carcinoma, and squamous cell carcinoma.
Secondly, onset of solar elastosis of the scalp precedes the onset of hair loss in androgenetic alopecia. It provides the evidence that scalp hair does not completely protect from the effects of UVR. Finally, it needs for added scalp UVR protection.
Other ageing features seen in the sun-damaged scalp include variability in thickness and cellularity in the epidermis, unevenly distributed melanocytes, and increased inflammatory cells in the dermis.
Due to the decrease in volume and elasticity, the skin becomes thinner and more easily damaged. Moreover, ageing skin receives less blood flow and exhibits lower glandular activity.
So the net result of these effects is the decreasing ability of skin to heal itself, with an increase of skin pathologies.
Remarkably, ageing does not appear to follow a perfectly regular course over time. Periods of stability, or even partial remission, alternated with periods of more marked evolution, reflecting perhaps the influence of individual factors.
Therefore, the individual’s general health and nutritional status, lifestyle and hygiene, and risk factors for accelerated ageing are related .
• ROLE OF OXIDATIVE STRESS IN SCALP HEALTH AND AGEING
Experimental evidence supports the hypothesis that oxidative stress plays a major role in the ageing process. In 1956, Harman originally proposed the free radical theory of ageing.
Free radicals are highly reactive molecules with unpaired electrons that can directly damage various cellular structural membranes, lipids, proteins, and DNA.
The damaging effects of these reactive oxygen species are induced internally during normal metabolism and externally through exposure to various oxidative stresses from the environment.
While the body possesses endogenous defence mechanisms, such as anti-oxidative enzymes (superoxide dismutase, catalase, and glutathione peroxidase) and nonenzymatic anti-oxidative molecules (Vitamin E, Vitamin C, glutathione, and ubiquinone), to protect it from free radicals by reducing and neutralizing them, with age, the production of free radicals increases, while the endogenous defence mechanisms decrease.
This imbalance leads to the progressive damage of cellular structures, presumably resulting in the ageing phenotype.
Nishimura (oral communication, 7th World Congress for Hair Research, May 4–6, 2013, Edinburgh, Scotland) found hair follicles to age through the defective renewal of hair follicle stem cells much in the manner as maintenance of melanocyte stem cells becomes incomplete with ageing.
Hair production and pigmentation are fuelled by stem cells, which transition between cyclical bouts of rest and activity. Aged hair follicle stem cells exhibit enhanced resting and abbreviated growth phases and are delayed in response to tissue-regenerating cues.
Ultimately, aged hair follicle stem cells are poor at initiating proliferation and show diminished self-renewing capacity upon extensive use.
Ageing-related loss of hair follicle stem cell marker expression starts well before hair follicles have shortened. Using genomic instability syndromes and exposure to ionising radiation as models, Nishimura proposed an accumulation of DNA damage be involved in the ageing process.
• Concept of the pre-and post-emergent hair fibre:
Conventionally, the study of hair ageing has focused on two main streams of attention: on the one hand, the aesthetic problem of ageing hair and its management, in other words, everything that happens outside the skin.
On the other hand, the biological problem of hair ageing, in terms of microscopic, biochemical, and molecular changes within the follicle in the depth of the scalp.
The condition of the hair fibre must be viewed as the result of a combination of pre-emergent and post-emergent factors.
Sources of oxidative stress with impact on the pre-emergent fibre include oxidative metabolism; smoking; UVR; inflammation from microbial, pollutant, or irritant origins; and oxidized scalp lipids.
Sources of oxidative stress with impact on the post-emergent fibre include again UVR and chemical insults from oxidizing hair colourants and pollutants.
While age-dependent thinning of hair is understood to be genetically determined and linked to peculiarities of hormone metabolism, it is primarily treated with the respective hair growth-promoting agent minoxidil and the 5-alpha-reductase inhibitors finasteride or dutasteride.
Studies have demonstrated oxidative stress associated with alopecia. The measures are similar to those in other skin conditions: antioxidant enzymes, protein oxidation, and lipid oxidation.
The oxidized lipids are now understood to negatively influence the normal growth of hair.
These results indicate that lipid peroxides, which can cause free radicals, induce the apoptosis of hair follicle cells, and this is followed by the early onset of the catagen phase.
Ultimately, in the context of scalp condition and its impact on the pre-emergent hair and ageing, Malassezia is a proven source of oxidative stress, with a correlation between Malassezia presence and the degree of oxidative stress.
• An unhealthy scalp leads to unhealthy hair: Healthy Scalp
There is ample evidence from data involving collections and characterization of hair samples from various unhealthy scalp conditions to help establish a link between scalp health and hair growth and quality.
As can be seen from the summary of scalp abnormalities, the most common manifestation to hair emerged from an unhealthy scalp is an altered cuticle with evidence of surface pitting, roughness, cuticle rigidity, or breakage.
In some cases, the impact is manifested as shine reduction. In addition to the physical changes, there are biochemical alterations observed in hair emerging from an unhealthy scalp, with both protein and lipid components affected, most commonly by oxidative damage.
Finally, several observations have found that premature hair loss may be caused by the poor scalp health associated with either dandruff and seborrhoeic dermatitis, or psoriasis, indicating that the effect on the pre-emergent hair fibre may alter the anchoring force of the fibre with the follicle, as evidenced by an increased proportion both of catagen and telogen, and of dysplastic anagen hairs (anagen hairs devoid of hair root sheaths) in the Trichogramma (hair pluck).
• When We Should Have Taken Medical Support? Healthy Scalp
Conventionally, the medical focus has been either on hair loss or the condition of the scalp in terms of specific dermatological diseases. Indeed, the proximate structural arrangement of the scalp and hair leads to an interdependent relationship between the two.
While protective benefits of the hair to the scalp are obvious, the role of the scalp as an incubator environment for the pre-emergent hair fibre has largely been ignored. There is a wealth of observational data on specific dermatological conditions of the scalp providing evidence for the role of the scalp condition in supporting the production of healthy hair.
Oxidative stress, the inability of the body to sufficiently counteract the sources of oxidation, is prevalent in many skin conditions, including normal skin ageing.
Therefore, hair care products, specifically shampoos, with active Malassezia inhibitory agents, such as zinc pyrithione, tend to reduce premature hair loss, besides the known benefits in treating specific dermatologic scalp pathologies and therefore should represent an integral part of every treatment regimen for hair loss, even in individuals not showing symptoms of scalp pathologies.
• HOW SCALP CARE EFFECTS ON HAIR GROWTH AND QUALITY?
Until the introduction of the first nonalkaline shampoos in 1933, soap was the only available cleanser for the hair and healthy scalp.
Today, shampoos are expected to be more than mere cleansing agents. They are expected to improve the hair cosmetically while being tailored to the needs of various hair types, age, and healthy scalp condition.
Finally, concerning product comfort, shampoos are expected to not dry out the hair. It will produce lather in hard and soft water. When it is applied to oily hair, it is non-irritating to skin and mucous membranes. Thereore, it will be chemically and physically stable, and to be biodegradable, and affordable.
Accordingly, shampoos have evolved into high-tech products consisting of ten to thirty ingredients that are combined in precise formulations to meet consumer demands.
Ultimately, shampoo treatments are the most commonly used means of managing hair and healthy scalp conditions and have proven to be effective for the treatment of dandruff and seborrhoeic dermatitis, psoriasis, and atopic dermatitis of the head-and-neck type.
Today, it is understood that scalp care products for dandruff and seborrhoeic dermatitis, psoriasis, and atopic dermatitis exert their benefits by controlling scalp Malassezia levels.
However, it is the observation that there is a great role of oxidative stress in premature hair loss. Besides, the part that Malassezia spp. play in generating oxidative stress. So it is likely that products with Malassezia control active would exert some hair loss prevention benefits.
Subsequently, Piérard-Franchimont et al. conducted a study to compare the effect of 2% ketoconazole shampoo to that of an unmedicated shampoo used in combination with or without 2% minoxidil therapy for male androgenetic alopecia.
Eventually, it’s found that hair density and size and proportion of anagen follicles were improved almost similarly by both ketoconazole and minoxidil regimens, even in the absence of dandruff.
The authors concluded that there may be a significant action of ketoconazole upon the course of androgenetic alopecia. And that Malassezia spp. play a role in the inflammatory reaction.
• Value of zinc pyrithione-based shampoo for normal hair growth and retention( Healthy Scalp)
Scientists performed a 6-month, randomized, investigator-blinded, parallel-group clinical study to assess the hair growth benefits of a 1% zinc pyrithione (ZPT)-based shampoo (Head & Shoulders®, Procter and Gamble Company) in males between the ages of 18 and 49 years exhibiting Hamilton–Norwood type III vertex or type IV baldness.
So, the efficacy of the 1% ZPT-based shampoo (used daily) was compared with that of 5% minoxidil topical solution (applied twice daily), a placebo shampoo, and a combination of the 1% ZPT-based shampoo and the 5% minoxidil topical solution.
Hair count results showed a significant net increase in total visible hair counts for the 1% ZPT shampoo, the 5% minoxidil topical solution, and the combination treatment groups relative to the placebo shampoo after 9 weeks of treatment.
Finally, a placebo-controlled treatment study with a ZPT-based shampoo (Head & Shoulders®) was published demonstrating decreased oxidative stress in both scalp and pre-emergent hair for the ZPT leg.
This provides support for the underlying mechanisms for hair loss reduction observations for the ZPT-based shampoo as well as other Malassezia-inhibiting shampoo actives.
• Treatments for scalp conditions: Healthy scalp
Treatment for scalp conditions varies depending on the diagnosis.
- Prescription medications are available to help treat hair loss. Surgical implants of hair transplants are also possible. In some cases, the underlying cause of hair loss can be treated.
2. Supplements or dietary changes can correct nutritional deficiencies.
3. Medications can treat autoimmune disorders and hormone disorders.
4. You can treat celiac disease by avoiding gluten in your diet.
5. Medicated ointments and washes that kill fungi or certain insects can cure certain infections, such as ringworm and lice.
6. You can treat seborrhoeic eczema and cradle cap with medicated shampoos.
Ito syndrome and scleroderma aren’t curable, but you can manage the symptoms with medications.
FINAL WORDS:
However, the science of hair care not only addresses the aesthetic problem of the condition of the hair fibre in terms of hair quality and colour but also the underlying biological problem of hair ageing and pathologies.
While the role of oxidative stress has been widely discussed in the skin and ageing, in comparison, little focus has been placed on its role in impacting scalp health, hair growth, and condition.
There is a wealth of observational data on specific dermatological conditions, such as dandruff and seborrhoeic dermatitis, psoriasis, and atopic dermatitis, providing evidence for the role of a healthy scalp in supporting the production of healthy hair.
Oxidative stress, the inability of the body to sufficiently counteract sources of oxidative damage, is prevalent in all of these skin conditions, just as in normal skin ageing.
On the scalp, the hair appears to be impacted before emergence, and oxidative stress appears to play a role in premature hair loss. The scalp commensal organism, Malassezia, has been recognized to be a source of oxidative damage.
Therefore, hair care products with active agents that reduce the population of Malassezia tend to reduce premature hair loss. Since Malassezia is a source of oxidative stress, its presence, even in individuals not showing symptoms of scalp pathologies, likely enhances subclinical stress that could contribute to compromised hair quality and growth.
Besides its known benefits in treating scalp pathologies, such as dandruff and seborrhoeic dermatitis, psoriasis, and atopic dermatitis of the scalp, a ZPT-based shampoo (Head & Shoulders) has demonstrated a reduction in hair loss by several assessment methods, even in the absence of scalp pathologies.
Considering the relationship between oxidative stress, Malassezia spp., and hair ageing, it is therefore conceivable that regular use may contribute to hair loss.
I think this elaborate discussion will help the readers who are interested in this subject. You may contact me here for further information: sushilrudra040@gmail.com
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Keywords: Malassezia spp., oxidative stress, premature hair loss, scalp pathologies, zinc pyrithione-based shampoo, Healthy scalp
Supported by
Ralph M Trüeb, Jim P Henry,1Mike G Davis,1 and Jim R Schwartz2Center for Dermatology and Hair Diseases, University of Zurich, Wallisellen, Switzerland1The Procter and Gamble Company, Cincinnati, Prof. Ralph M Trüeb, Center for Dermatology and Hair Diseases, Bahnhofplatz 1A, CH-8304 Wallisellen, Switzerland. International Journal of Trichology.
This is an open-access journal, and articles are distributed under the terms of Creative Commons Attribution. NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
REFERENCES
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