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Itchy Scalp Problems: A Complete Dermatologist Guide

April 16, 2022

Are you facing itchy scalp problems? That scalp is the most important part of your hair. This is because the health of your scalp determines how healthy your hair grows out. Dr Teo Wan Lin, accredited Singapore dermatologist and author of the Haircare Bible: Dermatologist’s Tips for Haircare and Hair Loss, explains the latest research on scalp physiology.

Haircare Bible
Dr. Teo Wan Lin is an accredited dermatologist in Singapore, specializing in hair and scalp disorders including female pattern hair loss, seborrheic dermatitis, male pattern baldness as well as other medical causes of hair loss. 

Dermatologist Talks: Scientific updates on the scalp microbiome

The Skin and the Scalp Ecosystem encompassing the microbiome

A key area of interest is the skin and scalp microbiome. My white paper on maskne published in the Journal of the American Academy of Dermatology in October 2020 sets the stage for microbiome research. 

In the dermatology research arena, the skin microclimate affects the development of skin diseases.  These dermatological conditions are distinctly caused by microbiome imbalance. This is also know as dysbiosis. 

Microbiome and dermatological treatment

We understand more about the skin and scalp microbiome now than before. Dermatologists are moving away from treating skin and scalp conditions with topical or oral antibiotics. Antibiotic resistance itself can lead to greater harm and doesn’t always solve the problem at hand.

Itchy scalp problems are the commonest scalp and hair problem. Understanding the scalp microbiome is of interest. The incidence of seborrheic  dermatitis is increasing.

Also known as dandruff, this flaky scalp problem is common in the tropics. Scalp microbiome research is relevant. Flaky itchy scalp problems due to seborrheic dermatitis occurs becuase of overgrowth of a yeast known as Malassezia.  

The scalp microbiome is an important area of research that has advanced in the last five years. Dermatologists have determined that an imbalance of scalp bacteria and fungi can directly contribute to scalp disease. Untreated itchy scalp problems accelerates the hair cycle. Ultimately this leads to increased hair fall and poor quality of hair.

We hope you learnt something about the scalp microbiome and itchy scalp problems. 

Here are some of the common problems affecting your scalp, explained by board certified dermatologist Dr. Teo Wan Lin. 

Can I have scalp problems without knowing it?

Scalp problems can be without symptoms in early stages. By the time you observe symptoms, it is at least medium severity. Some of scalp symptoms tend to be mild and not noticeable. You may not have itchy scalp for example.

Usually by the time you observe itchy scalp symptoms, your condition has been going on for a while. 

Itchy scalp problem caused by dandruff

Dandruff is the commonest scalp problem observed.  Flaky scalp is embarrassing and irritating. For example,  flakes are visible on dark clothing.

Why does dandruff occur?  It is an increase in skin shedding. We know this is due to an imbalance in the scalp microbiome. The scalp microbiome, much like the skin microbiome, refers to bacteria and fungi. In dermatology, there is a condition known as seborrheic dermatitis. Seborrheic dermatitis is the term dermatologista use for dandruff.

What causes seborrheic dermatitis?

Malassezia FurFur is a type of fungus which lives on everybody’s skin. However, under the right conditions it overgrows. Itchy scalp problems is more common in individuals who produce a certain type of oil. Especially individuals who produce more oil than others. Hence the term seborrhea in seborrheic, meaning excess production of oil. 

Itchy dandruff on the scalp: is it eczema or seborrheic dermatitis?

Dermatitis is the term for eczema or flaking. Scalp “eczema” is often due to seborrheic dermatitis but can be due to true eczema. If you have a personal or family history of eczema, you can get itchy scalp problems due to eczema. 

Dermatitis describes flaking of the scalp. Dermatologists in Singapore often observe it is associated with an oily type of dandruff. This means that while the scalp appears dry and flaky, even together with an itchy scalp, it is not due to dryness. Rather there is an oily dandruff problem known as seborrheic dermatitis, caused by an imbalance.

Can Itchy scalp problems due to dandruff spread?

Dermatologists stress that dandruff is not contagious. This fungus lives on everyone’s skin. However, it only causes problems in certain individuals. There could be a genetic tendency such as a family history. It could also be due to tropical environments. If you live in Singapore where it’s hot and humid, you may be prone to develop itchy scalp problems. 

There is an increased risk of developing seborrheic dermatitis when you sweat more and produce oil. Thus, itchy scalp problems due to dandruff tends to affect teenagers rather than children. Seborrheic dermatitis is the most common itchy scalp problem diagnosed after puberty. 

Itchy scalp problems in babies and children 

There is a special form of dandruff that affects babies and infants. This is also known as cradle cap. Cradle cap affects infants in the first six months. Itchy scalp problems in an infant shows as greasy yellow crusts on the scalp. It may look quite alarming. Usually, before the child turns one years one year old, it will clear up. Olive oil to remove the crusts may be sufficient.

Pityriasis amiantacea in children and teenagers 

This is a type of thick dandruff that affects older children and sometimes adults. We do not know why it happens. However, it appears as localised area of thick scales on scalp. It may be associated with hair loss. Treatment is with medicated shampoos and lotions. 

Itchy scalp problems in children

The other common type of scalp problem is head lice. Head lice is contagious and can be spread amongst school children. Head lice is treated with medicated lotions and using a fine tooth comb. Medicated solutions such as those containing permethrin are prescribed by dermatologists. 

How does head lice cause itchy scalp problems?

 Lice feed on blood and the females will lay their eggs on their hair it is important to prevent this common scalp problem in children after completing treatment. This prevents recurrence.  Ensure that there is complete eradication in the surrounding furniture and bedding. 

Itchy scalp problem due to ringworm

Another type of scalp problem is actually ringworm. Ringworm can be spread amongst children. Sometimes it can be caught from an infected animal such as a dog or cat. It leaves scaly round patches of hair loss on the scalp. Oral medication is required to kill the fungus. Oral antifungals are usually taken for a period of three months for treatment of ringworm of the scalp.

Scalp psoriasis: an immune genetic cause of itchy scalp problems

Scalp psoriasis is another type of scalp problem that can cause scalp redness and flaking. What is the difference with dandruff? In scalp psoriasis, flakesis are thicker and bigger scales with underlying redness. It also affects the hairline. 

Psoriasis is immune-genetic condition. This means that it occurs in individuals who have a family history. If you have a family member who has psoriasis, you have a higher chance of developing psoriasis. 

Itchy scalp pimples due to scalp folliculitis

Scalp folliculitis is another type of scalp problem. It presents as pimples on the scalp. Scalp folliculitis can cause scratching and squeezing, causing secondary infections. When folliculitis is severe it can lead to a type of hair loss known as scarring alopecia. If you suspect you have scalp folliculitis, seek the care of an accredited dermatologist because it requires oral medications for treatment. Scalp pimples could also be the early sign of a more serious condition known as folliculitis decalvans and are dissecting cellulitis of the scalp. Both of which causes serious permanent hair loss and scarring. If you have a scalp problem, it is important to get diagnosed by a board certified dermatologist. 

How to treat itchy scalp problems 

The treatment for scalp problems such as seborrheic dermatitis can be via over the counter shampoos that contain medicated active ingredients. Itchy scalp problems due to excess growth of fungus, known as malessezia furfur, is treated with antifungal shampoos. Salicylic acid can help to increase shedding of dead skin cells so medicated solutions can penetrate the scalp better. Antifungal agents such as zinc pyrithone is from our Deep Cleanse Shampoo range by our dermatology pharmacy helps. You can also use hair oils with natural antifungal and antibacterial properties to help improve the scalp microbiome. If it is more severe, you may get a prescription ketoconazole shampoo when you visit a dermatologist. 

Hair Serums for Healthy Hair Growth
The LipiSeries Hair Serums encompass unique physicochemical properties for the scalp: inhibits 5a-reductase and promotes hair growth, and hair shaft: coats and penetrates hair cuticles to repair hair damage and reduce breakage.

Regular scalp cleansing to treat and prevent itchy scalp problems 

If you live in Singapore, you should shampoo daily. Compared to temperate climates, your scalp will produce more oil and encounter a change in bacteria balance in tropical climates. Daily shampooing in tropical climates is recommended to maintain a healthy balance of the scalp microbiome.  Our skincare pharmacy carries a range of over the counter haircare, serums and shampoo to treat itchy scalp problems.

Treatment for Itchy Scalp Problems
This 3 step Sensitive/Oily Scalp Treatment is used in our dermatology practice to relieve symptoms of scalp sensitivity with a combination of scalp balancing ingredients to help stabilise the scalp microbiome.

If your itchy scalp problem does not improve with over the counter remedies, visit an accredited dermatologist. If you are looking for a dermatologist in Singapore, always check the doctor’s accreditation on the system. If you’re living in Singapore, you can always check the Dermatological Society of Singapore’s list of dermatologists to look for a board certified dermatologist. 

Teenage Acne 101: Complete Guide on How Puberty Affects Skin & Hair

February 6, 2022

Many teens or pre-teens start getting acne during puberty. In this article, we explain teenage acne forms, and how puberty affects the skin and hair, including excerpts from Acne Care Bible: Dermatologist’s Tips For Acne Treatment & Prevention by Dr. Teo Wan Lin, dermatologist at TWL Specialist Skin & Laser Centre.

Acne Care Bible - Find out the causes and treatment of teenage acne
The Acne Care Bible is written for sufferers of adult acne, teenagers, as well as parents of teenagers who may want to equip themselves with knowledge on how to prepare their children for the start of puberty. 

We will start from a medical perspective, explaining the changes that occur physiologically that result in the external body changes observed in teenagers as they transition to adulthood. Thereafter, we will cover the specific skin and hair changes caused by puberty, like teenage acne.

Firstly, when does puberty occur? 

Between the ages of 10 to 14, both boys and girls start to secrete sex hormones. 

What happens to the body during puberty?

Puberty is marked by the secretion of sex hormones. For boys, they start to produce the male hormone testosterone whilst for girls, they start to produce both estrogen (which is the feminine hormone) as well as testosterone. In boys, they will observe that their voice may change, as well as growing a more toned and muscular physique, along with genital enlargement. All these are the effects of testosterone. 

Girls will experience breast and nipple enlargement in the early stages of puberty. The onset of puberty in girls is marked by the start of their period or the menstruation cycle. 

The influence of sex hormones on skin

Puberty is determined by the onset of the secretion of sex hormones, the timing of which varies slightly between individuals and may occur in stages over a period of several years. Where the skin is concerned, we shall now zoom in specifically on the influence of sex hormones on overall skin texture, appearance and function.

Did you know that testosterone is responsible for the production of oil? This is the cause of teens developing greasier skin and teenage acne as a result. Sex hormones are chemicals which trigger off the activity of oil glands, which are also known as the sebaceous glands because they produce sebum. Estrogens in females specifically help the skin to attain a smooth and soft appearance. This explains why women, in general, have smoother and softer skin than men.

influence of hormones on teenage acne

The same process occurs on one’s scalp as well. The scalp, face, chest and back form an area termed as the “seborrheic areas”, which really refer to areas that produce more oil. During this time, teenagers and young adults may also observe the development of teenage acne or acne-like rashes over the chest and back area. This can be due to acne itself and/or a type of skin rash induced by a fungus.

Colloquially termed as fungal acne, it is a misnomer because this is not true acne. Rather, it is inflammation of the follicles caused by a yeast known as Malessezia Furfur, a condition known as Pityosporum folliculitis. Both are related to the overproduction of oil, increased sweating such as during sports, and is especially common in individuals living in humid climates.

Effects of puberty on skin

If you are experiencing any of these symptoms, know that this is part of adolescence. A lot of hormones are being released into your body during puberty. These actively act on areas such as your scalp, your hair, and skin during your transformation to adulthood. 

What’s happening to my skin? 

1. Greasier skin that cause teenage acne

Have you noticed your skin becoming greasier over your forehead, nose, and chin? Don’t be alarmed! This is a common phenomenon known as T-Zone oiliness. The oil glands are concentrated over these areas. Oil glands are also known as sebaceous glands which are associated with hair follicles. Every area of your body has hair follicles other than your palms and your soles. Seborrheic areas are areas where the hair follicles are associated with oil glands. These would be the T-Zone of the face, the scalp, The central ‘V’ of the chest as well as on the back. 

Teenage acne appear on the forehead and T-zone

2. Enlarged pores with blackheads and whiteheads

What you may see as black dots appearing over your nose and chin are actually not “dirt” that you should try to pick and squeeze out, but rather blackheads or open comedones, which are a form of teenage acne. If you observe an increase in the size of the pores of your skin, this is related to the increased activity of the sebaceous glands, which are responsible for producing oil.

What’s happening to my hair? Teenage Acne on the Scalp?
Changes in hair and scalp

If you’ve noticed your scalp getting greasier recently and even experience pimples on the scalp, do not worry, this is part of puberty and teenage acne. The oil glands that are active on your skin are also active on the scalp. They form a primary role of providing lubrication to the hair shaft to facilitate development of thicker, denser luscious hair.

Causes of greasy scalp and dry hair

The hair is made up of three distinct components. You have the roots of the head where the hair is embedded in your scalp; this is where it is associated with the sebaceous glands that produce oil (sebum). The second part of your hair you should know about is the hair shaft. The hair shaft is composed of dead material, this is known as keratin. The part that is “alive” is the follicle growing on your scalp.

Finally, your hair ends. You may have heard about split ends. It is due to damage at the end of the hair shaft, often caused by grooming practices. It is possible to have both greasy scalp and dry hair ends if you are using the wrong types of shampoo. Certain commercial shampoos for dry hair ends are not suitable for individuals with greasy scalps, whilst others cater for oily scalps contain high amounts of drying ingredients (known as astringents) which can cause the hair shaft to be excessively dry. 

Do I have dandruff? What is dandruff?

The teenage years are when one starts to observe changes in the scalp such as scalp flaking. Otherwise known as dandruff, but more accurately, as seborrheic dermatitis in medical terms. Many adult patients recall having their first episodes of having dandruff in teenage years. Dandruff is a layperson term for a medical condition known as seborrheic dermatitis. The term “seborrheic” derives from the root word sebum, referring to oil production. By now you would be familiar with the term seborrhea. Hence it is a condition related to an oily scalp. 

Deep Cleanse Shampoo to treat teenage acne and dandruff
The Copper Peptide Deep Cleanse Shampoo is a degreasing shampoo that contains amino acid surfactant for a gentle cleansing action on sensitive scalps, as well as Zinc Pyrithione to treat dandruff, ideal for teens with oilier scalps.

What causes dandruff to form? 

Seborrheic dermatitis is caused by a yeast that grows on everyone’s scalp and skin. That’s right, so even in healthy, young, and old individuals, the yeast is a healthy commensal. The name of this disease is Malassezia furfur. It tends to overgrow in individuals who produce more oil than others and in warm humid climates like Singapore and the tropics. Combined with sweat, this is the optimal environment for the overgrowth of this yeast. Overgrowth of the yeast then leads to inflammation of the skin as well as the scalp.

On the skin, this may appear as whitehead-like bumps that people often mistake for teenage acne. In reality, it is actually fungal acne and is found commonly over the hairline and the jawline. When over the scalp, it develops into dandruff. Specifically, people who suffer from seborrheic dermatitis may also complain of scalp sensitivity as well as discomfort. If you find that your scalp is feeling greasy at the end of every day or when you wake up in the morning, then very likely you produce more oil than normal. 

Are there any individuals who enter into puberty and do not have these symptoms? 

Yes. However, most individuals will observe these changes in their skin including the scalp as they become teenagers, and experience teenage acne. However, the key feature here would be genetics. So if any of your parents had suffered from oily scalp, oily skin and teenage acne when they were teenagers, you will likely have the same symptoms. 

@drteowanlin New book launch @amazon @drtwlderma #acnecare #healthy #skincare #pimpletreatment #fyp #foryou #foryourpagechallenge ♬ Say So (Instrumental Version) [Originally Performed by Doja Cat] – Elliot Van Coup

Hair Regrowth Treatments: A Comprehensive Guide

December 24, 2021
Dermatologist Haircare Bible
Dermatologist Dr Teo Wan Lin is the author of Haircare Bible: Dermatologist’s Tips on Cosmeceutical Haircare, which also includes tips on using cosmeceuticals to thicken the ageing, thinning hair shaft.


Are you looking for effective hair regrowth treatments in Singapore? 

First, understand why your hair is falling out.

The above forms an important basis for understanding how scalp stimulation therapies work. This article goes through the commonest causes of hair loss and which hair regrowth treatments are suitable. Also, strategies to reduce hair breakage are included.

Hair regrowth treatments are for those who suffer from hair loss. They are also for all who seek to have healthy and beautiful hair as they age. Successful treatment options are those that ensure long term sustainable results. 

The scalp and hair care industry is one of the biggest industries in the cosmetic market. This encompasses nutraceuticals, in the form of supplements as well as cosmeceuticals. Hair regrowth treatments can also be technologies or devices used in dermatologist clinics and home use devices. 

Which hair regrowth treatments actually work?

Topical applications that stimulate hair growth form a sizeable market share of the hair care industry. Hair loss shampoos, conditioners, serums and oils are various modes of application of hair care products. Most over the counter remedies have limited efficacy. It is best to use what is recommended by your dermatologist.

Red Light Therapy for Hair Regrowth Treatments
Low level laser therapy that uses red light (wavelength 630-670 nanometers) has been demonstrated to be effective in patter balding hair loss treatments.

LED light therapy treatments¹ are offered at TWL Specialist Skin and Laser Centre as an effective measure to increase hair density and hair regrowth rates.

Visit a dermatologist for advice on hair regrowth treatments

Dermatologists are the accredited specialists who are able to advise on scalp and hair treatments. Firstly, causes of treatable hair loss must be investigated. Other than pattern hair loss, autoimmune and systemic disease can cause hair loss. Telogen effluvium, which is hair loss caused by stress, can be due to post pregnancy states. The condition can also be attributed to prolonged illnesses. Alopecia areata is a reversible autoimmune disease that attacks the hair follicles. Traditional hair regrowth treatments will not work for this. A dermatologist will be able to diagnose this sort of non-scarring hair loss quickly. Injected steroids are usually required. Oral steroids are necessary for rapidly spreading autoimmune hair loss. 

Hair regrowth treatments should be comprehensive and not based on one modality alone. Non invasive, non surgical treatment methods are preferred over hair transplant. This is because transplantation is not readily available, and may not be sustainable for those who are unable to afford these treatments. Examples of non-invasive therapies are Laser diode treatments that can be delivered in a clinic setting. However, with the COVID-19 pandemic, it is far more convenient to use home devices such as hair regrowth combs. These devices utilise radio frequency as well as laser diode to stimulate your hair follicles.

An intensive regimen may not be as effective as a sustainable one

it is important to understand that hair regrowth treatments have to be a comprehensive regimen rather than an intensive one. This is important because focusing only on one method, for example intensive clinic treatments, will see the hair fall returning once treatments are stopped. Also, one has to understand that many may not have time or the budget for frequent in-clinic treatments. The evidence for hair regrowth treatments is more towards a well rounded treatment regimen rather than a one-modality method.

Hair Regrowth Mask Bar
The Hair Mask Bar System is developed with a focus on environmentally conscious, science-backed botanical ingredients for a deep-conditioning home hair spa treatment. The haircare formulation delivers salon-results, without the toxic chemical runoff associated with the traditional haircare industry.

A home hair care regimen can be helpful to maintain a heathy scalp microbiome to treat scalp disorders such as dandruff and scalp pimples which can exacerbate hair fall. For example, application of hair regrowth serums alone is not going to deliver the same results as if you were to utilize the entire range of hair regrowth treatments available. Also, if there is an underlying cause of hair loss, one should focus on treatment of the medical condition first. For example, hormonal hair loss due to underlying polycystic ovarian syndrome can cause raised testosterone levels which can accelerate pattern hair loss.

LED therapy is an effective form of hair regrowth treatment. It stimulates hair regrowth after completion of at least 6-12 sessions. LED light therapy for hair follicle stimulation has been shown in scientific studies¹ to stimulate the hair follicles to grow. It can also cause thickening of the hair shaft so hair appears more voluminous. This can be via stimulation of the stem cells of the hair follicles from the LED lights. Red and yellow LED light therapy is performed usually on a weekly basis as part of a intensive hair regrowth treatment regimen at our dermatology practice over 6-12 weeks before tapering off on home care alone.

At TWL Specialist Skin & Laser center, every patient has a thorough analysis of their hair and the scalp before a treatment regimen is recommended to them. Red and yellow light therapy is an effective way to increase hair growth in the short to medium term. Laser diode therapy is delivered via a home use device which combines radio frequency treatment.

Hair regrowth treatment shampoos and serums

The other important part of hair follicle stimulation is actually application of  shampoos and topical serums to maintain a healthy scalp. The purpose of scalp cleansing must not be forgotten. The scalp is exposed to a constantly humid environment in Singapore. This means that residual dirt and grime can mix with scalp oils to form an unhealthy scalp microbiome. Increased hair loss can occur from an unhealthy scalp environment. Also, male and female pattern hair loss means that you have thinner hair strands on the scalp. This can make your scalp feel greasier as there are less hair strands to moisturise.

Treating Scalp pimples and flaking can benefit hair regrowth 

If you suffer from folliculitis which refers to pimples on the scalp or dandruff, your hair fall problem can be accelerated by this inflammation. What is necessary then is to treat the underlying inflammation before initiating an aggressive hair regrowth therapy session. The reason is because hair is part of a complex cycle. This cycle means that your hair goes through a few stages of cycling. Approximately 70 to 90% of your hair should be in the growth phase and 5 to 10% in the shedding phase. What this means is if there is an imbalance in the cycling, more hair goes into the shedding phase.

As a result, you are going to develop thinning hair. We ideally want more hair in the growing phase or the anagen phase. Effective hair regrowth treatments are supposed to help that. However, if you cannot stop your hair from cycling fast to the falling out phase, then there will still be an imbalance. This can make your hair regrowth treatments ineffective. 

Scalp folliculitis is treated with oral medications such as oral antibiotics for three to six months. If you suffer from folliculitis or seborrheic dermatitis (the medical name for scalp dandruff), it is beneficial for you to consult a dermatologist. An accredited dermatologist will assess your risk factors of developing hair loss, and underlying health conditions that can cause hair loss. Your dermatologist will then recommend a regimen for you to improve your hair condition. An effective hair regrowth treatment regimen encompasses the following: improvement of hair density and treatment of any underlying inflammation.

Medicated shampoos can be part of an effective hair regrowth regimen

Shampoos containing antifungal active ingredients such as ketoconazole and zinc pyrithone / salicylic acid are very often necessary for those who suffer from severe seborrheic dermatitis. 

Ketoconazole² shampoo is also sometimes used off label for treatment of pattern hair loss. The reason is because it has an anti-testosterone effect. The basis of increased hair fall in men and women who suffer from pattern hair loss has to do with the receptors on the scalp being particularly sensitive to the circulating levels of male hormones. In women who have polycystic ovarian syndrome, this can also accelerate pattern hair loss symptoms. Symptoms of polycystic ovarian syndrome also include excess hair growth on the face and body, irregular menstrual cycles and infertility.

A sustainable home hair care regimen is equally important 

It is critical that we focus on home maintenance therapy for hair regrowth treatments. In particular, for androgenetic alopecia, also known as male and female pattern hair loss. This is because it is a very slowly progressive condition that eventually causes hair loss over decades. Once the diagnosis has been established, your dermatologist will be able to customise a sustainable hair care regimen for you long term according to your budget. Our focus at TWL Specialist Skin & Laser Centre is to encourage cost effective sustainable home hair care regimens tailored for the individual’s hair and scalp concern. 

Oral therapies are of limited value. Finasteride³ (also known by its trade name Propecia) are suitable for short to medium term treatment for men who suffer from androgenetic alopecia. Oral spironolactone for women can be of value for female pattern hair loss. However, treatment is usually accompanied by laboratory test monitoring which some may find inconvenient. 

While LED light treatments are effective, they are usually only prescribed over a period of two up to six months in the clinic setting. It can only deliver a certain level of results and it is best to include a comprehensive range of hair regrowth treatments in order to have a sustainable result. Topical serums such as those made based off minoxidil⁴ can increase hair growth. However, topical minoxidil can also cause scalp irritation. 

What is used in our dermatology practice is copper peptide serum⁵ which is a proprietary formulation containing an antioxidant that stimulates hair regrowth. It can also be used with micro needling to enhance absorption. 

Your hair regrowth treatment regimen must include care of the hair shaft. 

However, it is important after you have done all of these things, to ensure that the quality of your hair shaft is equally healthy. Hair regrowth treatments should not just focus on the scalp, but also on the hair shaft. The reason is because if your hair shaft is unmanageable, there will be a lot of breakage and it will lead to even more hair loss. Hair loss due to breakage is far more common than we imagine.

Grooming practices play a part for the aging scalp. It is important to highlight gentle hair grooming practices. These gentle hair grooming practices are best inculcated from youth. This means using a wooden brush instead of plastic or metal combs. Wooden brushes reduced static and also do not tear hair out. Flexible bristles such as those made from bamboo are preferred over stiff combs. The use of appropriate hair conditioner is important. Many hair volumizers exists in the market. However, it is important to look for active ingredients that actually help to thicken your hair. The use of hydrolyzed proteins in hair treatment masks and conditioners rather than silicone is preferred for individuals who suffer from thinning hair.

The Hair Thickening Mask, containing hydrolysed proteins, is Dermatologist-formulated designed to increase hair volume and stimulate hair growth.

Hydrolyzed proteins do not weigh hair down. While silicones can smoothen and moisturize the hair shaft, it can cause hair to appear limp without volume. An important hair regrowth treatment strategy besides increasing hair density, is to increase individual hair thickness and volume. This means that your hair can appear more voluminous. 

Scalp hygiene is an important part of hair regrowth treatment

Washing your hair on a daily basis is an important part of your hair regrowth treatment. This is especially if you live in a tropical humid climates like Singapore where the heat and humidity encourages sebaceous glands to produce more sebum. According to our dermatologist Dr. Teo Wan Lin, this is because if your scalp is greasy, your scalp microbiome will be abnormal. This increases the risk of one developing the above mentioned scalp disorders such as scalp folliculitis and seborrheic dermatitis. These scalp disorders can cause itching, sensitivity and ultimately increase the rate of hair fall. Consequently, it can worsen the underlying genetic or hormonal related hair fall 

Hair shaft cosmeceuticals as part of hair regrowth treatments to increase strength and thickness of hair 

Finally, there are other methods to improve the quality of your hair shaft. The use of plant based oils is a method to strengthen the hair shaft. Selected plant seed oils have close physico-chemical properties with healthy hair shaft. The way to measure your hair shaft’s elasticity is also by doing a stretch test. This means that if you pull your wet hair, it should readily return to its original length. Hair with good elasticity also does not break so easily when wet. 

@drteowanlin

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Why is it important to visit a dermatologist for hair regrowth treatments?

Dr. Teo Wan Lin is a dermatologist accredited by the Specialist Accreditation Board, Ministry of Health Singapore, and specialises in both medical and cosmetic dermatology.

An accredited dermatologist is able to advise you comprehensively on your scalp health as well as rule out underlying causes of your hair loss. 

Summary of causes of hair loss and hair regrowth treatment options 

Finally, if you are looking for thicker, fuller and more voluminous shiny hair it is important for you first to ensure you do not have an underlying health condition that may actually cause hair fall. This is to make sure that any dangerous conditions are ruled out before hair regrowth treatments are started. If you would like to start on an anti-aging regimen for hair, it is important for you to learn about the ways to strengthen your hair shaft and this can be done with home treatments.

How to maintain healthy shiny hair as part of aging gracefully 

The treatable causes of hair loss can be mainly divided into the following. Pattern related hair loss, which in males is known as male pattern hair loss and in females, female pattern hair loss. This is the biggest category of patients who will benefit from hair regrowth treatment. The reason is because pattern hair loss is driven by hormonal and genetic influences. It is a slowly progressive condition that will ultimately lead to hair shaft miniaturization which means that your hair follicles shrink in size over many decades. 

The purpose of hair regrowth treatments in patients with pattern hair loss is twofold. Firstly, it slows down the process of hair miniaturization, which is a big problem in patients with androgenetic alopecia. Secondly, it induces the growth of new hair, which is important. Most patients who need hair regrowth treatments belong to the mid 20s onwards group. This is because of the process of biological aging.

Biological aging leads to cell death. This process known as cellular senescence also affects the hair quality. In terms of age alone, it can affect the amount as well as the quality of hair that an individual has. Hair regrowth treatments are hence suitable for those who are concerned about thinning hair associated with aging as well. The important non-invasive hair regrowth treatments are readily available to patients in the comfort of their own homes. 

These hair regrowth treatment options are applicable only when more serious causes of hair loss, such as scarring alopecia, or hair loss due to systemic disease are excluded. For example, autoimmune disease. Thyroid disorders are also important medical conditions that can cause hair loss.

Consequently, it is important that if you are diagnosed with any one of the above conditions, that you seek medical treatment by an accredited specialist before embarking on hair regrowth treatments only. This is the reason why consultation with an accredited dermatologist is key. The roots of the hair are affected by your nutritional status as well. If you are suffering from nutritional deficiency, it is possible that you would suffer from poor hair quality as well as increased hair loss.

In terms of self-care, hair regrowth treatments are important if you wish to maintain a healthy head of hair as you are aging. Much has been spoken about aging of the skin but it is important for us to address aging of the scalp as well. This is where hair regrowth treatments are both science based and an important part of your anti aging regime. 

Book an appointment with Dr. Teo Wan Lin to commence on your scalp care and discuss hair regrowth treatment options.

References:

  1. Zarei M, Wikramanayake TC, Falto-Aizpurua L, Schachner LA, Jimenez JJ. Low level laser therapy and hair regrowth: an evidence-based review. Lasers Med Sci. 2016 Feb;31(2):363-71. doi: 10.1007/s10103-015-1818-2. Epub 2015 Dec 21. PMID: 26690359.
  2. Fields JR, Vonu PM, Monir RL, Schoch JJ. Topical ketoconazole for the treatment of androgenetic alopecia: A systematic review. Dermatol Ther. 2020 Jan;33(1):e13202. doi: 10.1111/dth.13202. Epub 2020 Jan 2. PMID: 31858672.
  3. McClellan KJ, Markham A. Finasteride: a review of its use in male pattern hair loss. Drugs. 1999 Jan;57(1):111-26. doi: 10.2165/00003495-199957010-00014. PMID: 9951956.
  4. Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. 2019 Aug 9;13:2777-2786. doi: 10.2147/DDDT.S214907. Erratum in: Drug Des Devel Ther. 2020 Feb 10;14:575. PMID: 31496654; PMCID: PMC6691938.
  5. Pickart L, Margolina A. Regenerative and Protective Actions of the GHK-Cu Peptide in the Light of the New Gene Data. Int J Mol Sci. 2018 Jul 7;19(7):1987. doi: 10.3390/ijms19071987. PMID: 29986520; PMCID: PMC6073405

Itchy Scalp? The Microbiome May be the Cause

January 15, 2021

An itchy scalp, or scalp pruritus, is a common problem that can lead to symptoms such as frequent scratching or discomfort, scabbed or flaking skin, or redness on the scalp. 

In this article, we’ll cover everything you need to know about itchy scalp and its links to the scalp microbiome, including excerpts from accredited dermatologist, Dr. Teo Wan Lin. We’ll also cover how the scalp microbiome can lead to various hair conditions, and how to keep the scalp microbiome healthy.

What causes itchy scalp?

The cause of an itchy scalp is inflammation. Is it possible that itchy scalp leads to hair loss? The short answer is no. But the long answer is that if your itchy scalp is due to an underlying scalp condition such as seborrheic dermatitis, this can in the medium to long term, disrupt your hair cycle and cause more hair to fall our faster, and hair to grow at a slower rate due to the underlying inflammation. Associated scalp symptoms can include redness, sensitivity. Some individuals experience pain when they’re tying up their hair. All that has to do with increased activity of the immune cells around the area where there is inflammation.

Seborrheic dermatitis

The commonest cause of scalp inflammation in this part of the world, in tropical Singapore, is seborrheic dermatitis. Seborrheic dermatitis is due to an overgrowth of yeast organisms that are otherwise normal commensals, meaning that they are part of the healthy scalp microbiome. What happens in seborrheic dermatitis is that the scalp inflammation leads to symptoms of itch, flaking, redness, sensitivity.

Over a period of several months, or years, this can cause disruption in the hair cycle. 90% of our hair should be in the growing phase known as the anagen phase. When there is active inflammation such as in the case of seborrheic dermatitis, psoriasis, or eczema, the hair cycle may be disrupted and as a result, more hairs may enter into the telogen phase. This expedites the hair cycle process, leading to more hair that is falling out, and comparatively, less hair that is growing back to compensate for the amount of hair that’s falling out. 

Itchy Scalp? Copper Peptide Hair Regrowth Serum

The Copper Peptide Hair Regrowth Serum contains Copper tripeptide, a novel molecule that stimulates hair growth. Copper tripeptide is a potent antioxidant with minimal to zero risk of scalp irritation. It helps to maintain healthy, immunological function of the scalp, promoting beneficial scalp microbiome.

What is the scalp microbiome? 

The scalp is one of the thickest parts of the skin on the body, with on average about 100,000 hairs growing on it at a given time. It high production of vitamin-rich sebum (oil) and an unusually humid environment, which gives rise to microbes and microorganisms that aren’t found on any other part of the body. 

A microbiome is a community of microorganisms that exist in one habitat, like your gut, skin and scalp. In order for a microbiome to function efficiently, it must maintain a balance of diverse microorganisms, with each contributing to the productivity of the habitat. The scalp microbiome is the balance of healthy microorganisms that work together and contribute to our scalp health. Just like our skin microbiome, if the delicate microbiome is thrown off balance, skin conditions can develop, causing symptoms of flaking, itching, and irritation.

How does the scalp microbiome affect hair conditions?

Research in the scalp microbiome has intensified in the last 3 years. In 2017 in a paper submitted to Experimental Dermatology, a group of researchers stated that there was a difference in the scalp microbiome in terms of the bacterial and yeast flora in individuals who suffered from dandruff, also known as seborrheic dermatitis, compared to individuals with healthy scalps. What that really means that there is a definite role in the balance that microorganisms play in our skin, and now our scalp, in order to maintain scalp homeostasis. Homeostasis is the state of balance that is required for our organs to function at their optimal states.

A disturbance in the scalp microbiome can be influenced by the environment, one’s personal genetics as well as hormonally influenced oil production on the scalp. In this situation, we should zoom in on the specific problems that are brought about by the imbalances of the microorganisms living on one’s scalp.

Dandruff

Dandruff is one of the most common scalp complaints. Flaking on the scalp and white scales found on one’s clothes are one of the first symptoms of dandruff. The term dandruff is lay speak for any form of scalp inflammation that causes the cell turnover rate on the scalp to increase abnormally. There are several medical conditions that can result in this, the commonest being the following: scalp psoriasis, seborrheic dermatitis and scalp eczema. 

Dandruff and Seborrheic dermatitis 

We have spoken about seborrheic dermatitis earlier, and how it can lead to itchy scalp and scalp inflammation. Additionally, seborrheic dermatitis could also be the cause of your recent dandruff outbreak. It mainly affects the sebaceous, gland-rich regions of the scalp, face, and trunk. Seborrhea or seborrheic dermatitis is a common, chronic or relapsing form of eczema/dermatitis. 

Dandruff, also known as pityriasis capitis, is considered to be an uninflamed form of seborrhoeic dermatitis. Scattering within hair-bearing areas of the scalp, dandruff of such presents as itself as bran-like scaly patches. 

The cause of seborrheic dermatitis is associated with the proliferative species of the fungus Malassezia. Its metabolites (such as fatty acids oleic acid, malassezia, and indole-3-carbaldehyde) may cause an inflammatory reaction. Therefore, there is a link between dandruff and the bacteria and fungi that grow on the scalp. 

The Copper Peptide Deep Cleanse Shampoo can help to overcome itchy scalp

The Copper Peptide Deep Cleanse Shampoo contains amino acid surfactant for gentle cleansing of sensitive scalps,  zinc pyrithione that has anti-dandruff properties, and copper peptide that helps to promote healthy hair growth. 

Scalp folliculitis

Scalp folliculitis is an inflammatory disorder of the hair follicles in the scalp, also known as “acne necrotica miliaris” or “Proprionibacterium folliculitis”.

It is characterised by small, very itchy pustules on the scalp, often most troublesome on the frontal hairline. Depending on the severity, there may be only a small number or may appear as very numerous lesions. Due to the itch, they are hard to leave alone and overtime often become sore and crusted. 

Causes of scalp folliculitis

The cause of scalp folliculitis is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include:

●  Bacteria (especially Cutibacterium acnes, but in severe cases, also Staphylococcus aureus)

●  Mites (Demodex folliculorum)

●  Yeasts (Malassezia species)

An imbalance in these microorganisms can lead to an inflammatory reaction on the scalp, causing scalp folliculitis. 

To explain, Malassezia is the causative yeast organism belonging to the family of fungi that colonizes the scalp of individuals who suffer from seborrheic dermatitis. Chronic inflammation of the scalp’s follicles can lead to pimple-like lesions that can be painful, lead to deeper cysts, and even abscesses in a more serious type of scalp folliculitis known as dissecting folliculitis. These are typically associated with imbalances in the bacterial flora of the scalp. Research shows a link between scalp folliculitis and scalp sensitivity, as well as the sebum and bacterial imbalances. The microorganisms interact with environmental factors such as increased temperature, humidity, the presence of sweat in a genetically predisposed individual to create chronic inflammation. 

Keeping the scalp microbiome healthy

Shampoo

Research has shown that zinc pyrithione medicated shampoo is a safe and effective way to treat dandruff. Fighting off Malassezia can help to restore the health of your scalp microbiome. 

Hair serum

Use of antioxidants serums on the scalp can encourage healthy cell talk between the immune cells, and improve the ability of the scalp to fight off disease-causing bacteria and fungus. This also helps to maintain regular sebum production. Copper tripeptide is a potent antioxidant with minimal to zero risk of scalp irritation. It helps to maintain healthy, immunological function of the scalp, promoting beneficial scalp microbiome.

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What to Look For in a Hair Loss Shampoo

January 11, 2021

What ingredients are in a good hair loss shampoo? How should a shampoo function? In this article we’ll go through everything you should look for in a hair loss shampoo, including excerpts from Haircare Bible: A Dermatologist’s Tips on Haircare and Hair Loss by Dr. Teo Wan Lin, Dermatologist at TWL Specialist Skin & Laser Centre.

How Does Shampoo Work?

What constitutes a good hair loss shampoo?

Caring for one’s hair is just as important as caring for one’s face, but often gets less attention. Understanding what constitutes a good hair loss shampoo is an important part of making sure your hair stays healthy and voluminous. To help you navigate the world of shampoo products, we introduce you to the basics you need to know.

How should a hair loss shampoo function?

A shampoo is a viscous liquid (liquid with texture that tends to be thick). Its primary purpose is cleansing the scalp and hair of dirt, sebum, sweat, dead skin cells and environmental pollutants. It does so by dissolving oil-soluble dirt, which is water-insoluble and hence, cannot be removed by solely rinsing with water. A shampoo should also remove greasy residues from hair care products such as oils, gels and sprays. The overall effect is that of cleansing to maintain a good hygiene level to reduce the chance of scalp irritation, inflammation and odour.

While most shampoos can accomplish a thorough cleanse, the real challenge lies in removing just enough sebum to allow the hair to be clean without drying it out.

This explains why most shampoo formulations have a secondary function of smoothing the hair’s surface and imparting lustre, smoothness, buoyancy and volume. Certain types of shampoos also treat the scalp with medicated ingredients, such as those targeting dandruff, a common scalp disorder caused by a yeast known as Malassezia.

Hair Loss Shampoo: Copper Peptide Deep Cleanse Hair Regrowth Shampoo

The Copper Peptide Hair Regrowth Shampoo is a hair loss shampoo formulated for hair loss and sensitive scalps. It contains amino acid surfactant that performs gentle action for sensitive scalps, is pH-Adjusted for deep-cleansing. It also includes actives such as zinc pyrithione for anti-dandruff, and copper peptide for healthy hair growth.

Ingredients In A Shampoo

Typical shampoos contain 10 to 30 ingredients. These include: cleansing agents (surfactants), conditioning agents, special care ingredients, and additives. Surfactants essentially cause a lathering effect via a process known as emulsification. For example, a surfactant emulsifies sebum and grime on the hair and scalp which can then be easily rinsed off with water. They are responsible for cleansing hair while the conditioners and other ingredients do the rest.

Types of surfactants

A surfactant is often amphiphilic, meaning its molecules contain both lipophilic (oil-attracting) and hydrophilic (water-attracting) parts. The oil-attracting parts bind to sebum while the water-loving sites parts to water. Such a mechanism allows sebum to be removed when in contact with water.

The type of surfactants used in hair loss shampoos is classified according to their hydrophilic polar group. The four common categories of shampoo surfactants are anionics, cationics, non-ionics and amphoterics. Most shampoo formulas rely on two types of surfactants.

The surfactant listed first in a shampoo’s ingredient list denotes the primary cleanser and also the ingredient in the highest concentration. The surfactant listed second is the secondary cleanser; this is often added to offset the weaknesses of the first surfactant.

Anionic surfactants

Anionic surfactants are named for their negatively charged hydrophilic (water-loving) parts. Derived from fatty alcohols, they are good at removing sebum from the scalp. However, excessive cleansing with anionic surfactants leaves the hair harsh, rough, dull, frizzy and prone to tangling. Examples include sodium laureth sulfate, ammonium laureth sulfate, sodium lauryl sulfate, and ammonium lauryl sulfate.

Cationic surfactants

In contrast to anionic surfactants, cationic surfactants have a positively charged element. Cationic surfactants are poor cleansers and do not lather well. They are also not compatible with anionic surfactants. However, they are excellent at keeping chemically damaged hair soft and manageable. As a result, shampoos for damaged or coloured hair often include cationic surfactants. Examples include long-chain amino esters, ammonioesters, and cetyltrimethylammonium chloride.

Amphoteric surfactants

With both positively and negatively charged groups, amphoteric surfactants foam well and condition the hair. They help with the formation of micellar emulsion, improving the lathering ability of the shampoo, resulting in a thick liquid which is efficient to use. In addition, they do not cause stinging in the eyes and are gentle on the skin/scalp barrier, making them ideal for mild shampoos. Examples are cocamidopropyl betaine, sulfonate betaine, amphoteric acetate/diacetate.

Nonionic surfactants

Nonionic surfactants do not have a charged group and hence are compatible with any surfactant. Nonionic surfactants are the mildest type of surfactant. Such surfactants are often used in baby shampoos. Examples are fatty alcohol ethoxylates, cocamide MEA, sorbitan ether esters, and alkyl polyglucosides.

Conditioners In Shampoo

The purpose of conditioning is to increase hair manageability by smoothening and softening the hair shaft and to enable easy detangling. Shampoo formulations tend to add hair-conditioning ingredients to impart manageability, gloss and antistatic properties to the hair. Many are noted as ‘2 in 1’ to indicate the presence of both cleansing and conditioning benefits.

What are 2 in 1 shampoos?

They are conditioning shampoos that can wash off dirt and at the same time disperse conditioners onto the hair shaft. Examples of conditioning ingredients are fatty substances such as vegetable oils, wax, lecithin and lanolin derivatives, protein by-products (collagen, silk, animal proteins) and silicones.

What is the technology behind 2 in 1 shampoo?

Silicones and conditioning oils help smoothen out the hair shaft. They need to be regularly dispersed upon application to the hair shaft to condition the hair. Silicones add lubricity to the hair and reduce friction that arises from combing. They make it easier to comb through and detangle strands and prevent them from becoming frizzy.
Protein substances found in conditioners function by temporarily mending split ends and holding the hair fragments together until the next shampooing takes place.
The lathering components help to cleanse off the oil, dirt and dead skin cells of the scalp.

What is the science behind wet and dry hair conditioning?

The science behind conditioning hair while wet is based on a compound known as coacervate. It is best understood as something with positive and negative ions reacting in the presence of water.

On the other hand, the end goal of dry hair conditioning is to deposit smoothening silicones and hair conditioning oils on the hair surface. The commonest hair oils contain silicones such as dimethicone, dimethiconol, and amodimethicone.

Why should we avoid silicone-containing hair conditioners?

Scientific studies show that when the hair shaft surface is coated with silicone it becomes instantly smoother and it is covered with a protective layer. However, this is merely a temporary illusion of healthy hair. Silicone continues to build up layer by layer and eventually your hair gets weighed down. Instead of appearing smooth and shiny, hair may appear greasy and dull.

What are the other alternatives available?

In my development of the hair mask bar system for my patients with dry, brittle and unmanageable hair, I have incorporated natural proteins such as hydrolysed wheat, silk and milk proteins that directly penetrate and repair the hair shaft. These natural proteins are effective cuticle moisturizers that ensure detangled, well-nourished locks.

The Hair Mask Vials Bundle includes the Keratin Hair Mask for hair strengthening, the Silk Hair Mask for hair smoothness and frizz, and the Milk Hair Mask for hair softness.

Another important way to smoothen and condition your hair is through the use of plant oils. The bioactive substances present in plant oils contribute to their moisturizing, conditioning, anti-inflammatory and antioxidant properties.

The LipiGro Serum is enriched with 5a-reductase inhibitor to reverse hormonal hair loss, and the purified seed oil of ethanolic extract of Carthamus tinctorius.

The LipiShine Serum should be used with the CutisCool™ Biological Gel Hair Cap in the Hot Oil Treatment. Enriched with Oleic acid that acts as a cuticle softener, Linoleic acid that smooths hair, and the Purified seed oil of ethanolic extract of Carthamus tinctorius.

The LipiSilk Serum is used to treat damaged hair, chemically treated hair, and split ends. It contains actives such as Linoleic acid for deep repair of the hair shaft, Vitamin E, a bioactive antioxidant, and purified seed oil of Hippophae rhanoides (Sea Buckthorn Oil).

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Hair Loss Shampoo

Sensitive Scalp: Can it Cause Hair Loss?

December 29, 2020

Do you feel itching, tingling, pain and redness on your scalp? Does your scalp feel tight and itchy? If yes, you may have a sensitive scalp.

In this article, we’ll take you through the signs of sensitive scalp, and hair and scalp conditions linked to it, including excerpts from Haircare Bible: A Dermatologist’s Tips on Haircare and Hair Loss by Dr. Teo Wan Lin, Dermatologist at TWL Specialist Skin & Laser Centre.

Do I have a sensitive scalp or is it a symptom of another condition?

Do you have an itch, redness or pain on your scalp? You may have an undiagnosed inflammatory scalp disease. Scalp “sensitivity” without any underlying scalp condition is a very rare condition attributed to abnormal nerve sensations known as scalp dysaesthesia.

It is far more common to have an underlying cause such as seborrheic dermatitis, which is due to proliferation of a yeast known as malassezia furfur in an individual with excess production of oil. It is also more common in tropical and humid climates such as Singapore, as such climates encourage this yeast to grow. Otherwise, malassezia is an ordinary inhabitant of one’s skin and scalp.

Under normal conditions, it does not cause any issues. However, under humid and sweaty environments, this yeast can proliferate to cause scalp inflammation and flaking. If you have scalp flaking which does not respond to over the counter anti-dandruff shampoos, usually contain zinc pyrithione as an antifungal agent, promptly seek the care of an accredited dermatologist rather than self medicate or DIY.

Other causes of scalp inflammation would be scalp eczema due to excessively dry scalp/skin conditions, scalp psoriasis which may be the case especially if one has a family history of psoriasis or rashes on one’s body. If you have been in contact with a ringworm infected cat or dog, do have your scalp and skin checked by a dermatologist as these infections are contagious. They could also cause a form of scalp inflammation presenting as a red, scaly and itchy patches with hair loss.

The CUTISCOOL Hair Cap has specifically engineered thermal and cold therapy capacities that allows comfortable home use of effective heat treatment for sensitive scalps. When heated, it can increase absorption of cosmeceuticals. When chilled, the Hair Cap has an anti-inflammatory effect on the scalp.

Is my sensitive scalp causing hair loss?

Most cases of scalp inflammation due to eczema, seborrheic dermatitis, scalp folliculitis or psoriasis should not cause hair loss. However, severe inflammation can push the hair growth cycle into a stage of telogen effluvium which is when hair reaches the end of its cycle and falls out, similar to hair loss that occurs after a major illness or post-pregnancy. In addition, if one picks and peels off crusted areas over the scalp, this can also cause damage to the hair root and lead to hair loss.

The ORZAT4 InfusionTreatment Comb is impregnated with Sandalore® which has been scientifically proven to stimulate hair regrowth. This comb is designed to stimulate and support vigorous, healthy hair growth when used regularly.

There are other causes of hair loss such as alopecia areata, which is an autoimmune disorder causing one’s immune system to attack hair follicles, leading to hair loss. This usually has no symptoms other than the appearance of round patches of hair loss over one’s scalp. Scarring causes of hair loss include folliculitis decalvans, which is the end-stage of a type of scalp folliculitis, whereby the hair follicles themselves are constantly inflamed and infected. Children may be more susceptible to tinea capitis, which is a fungal scalp infection that can lead to scarring hair loss if untreated.

Copper peptide serum for sensitive scalp hair loss.

The Copper Peptide Hair Regrowth Serum contains copper tripeptide for hair regrowth, root strengthening, and hair shaft thickening.

Scalp Folliculitis

Suspect suffering from a hair inflammatory disorder; scalp folliculitis?
Scalp folliculitis is an inflammatory disorder of the hair follicles in the scalp, also known as “acne necrotica miliaris” or “Proprionibacterium folliculitis”.

It is characterised by small, very itchy pustules on the scalp, often most troublesome on the frontal hairline. Depending on the severity, there may be only a small number or may appear as very numerous lesions. Due to the itch, they are hard to leave alone and overtime often become sore and crusted.

Causes of Scalp Folliculitis

Although the cause of scalp folliculitis is not well understood, it is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include:

●  Bacteria (especially Cutibacterium acnes, but in severe cases, also Staphylococcus aureus)

●  Mites (Demodex folliculorum)

●  Yeasts (Malassezia species)

Treatment for Scalp Folliculitis

Treatment plan includes washing the folliculitis affected scalp with a mild normal shampoo as often as desired. In some cases, antidandruff shampoos containing anti-fungal agents such as ketoconazole or ciclopirox are helpful in mitigating scalp folliculitis. If patients desire, hair conditioner can be used.

Copper peptide shampoo for sensitive scalp

The Copper Peptide Hair Regrowth Shampoo contains Zinc Pyrithione – an anti-fungal and anti-dandruff agent. It is dermatologist-formulated for sensitive scalps and hair loss.

The following medications may be helpful for scalp folliculitis:

●  Topical antibiotics eg fusidic acid gel, clindamycin solution, erythromycin solution

●  Mild topical steroid lotions or creams

●  Oral antihistamines

●  Oral antibiotics, such as the consumption of tetracycline in the long-term

●  Oral isotretinoin, as a long-term, low dose treatment option

Severe Forms of Scalp Folliculitis

One such severe form of scalp folliculitis is acne necrotica. It is also known as “acne varioliformis” or “acne frontalis”. In this condition, first, the larger follicular spots (papules) become inflamed then secondly they tend to develop blackened crusts, finally leaving permanent pox-like scars. It is to be noted that acne necrotica may affect the face, scalp or other areas.

Another rare and severe form of scalp folliculitis, sometimes associated with hidradenitis suppurativa, acne conglobata and spinal arthritis (spondyloarthropathy), is perifolliculitis capitis abscedens et suffodiens. It is also known as “dissecting cellulitis” or folliculitis, or “perifolliculitis capitis”. It rarely occurs in white-skinned individuals, females and children and most often affects black adult men. In this case, large nodules and cysts accompany smaller follicular papules and pustules, from which purulent material can be expressed. Temporary hair loss over the lesions eventually results in permanent scarring and bald patches.

Because dissecting cellulitis is very resistant to treatment, the severity of the condition can be reduced with oral treatment such as isotretinoin, antibiotics, dapsone and injectables such as systemic steroids. If you have been diagnosed with dissecting cellulitis, you will need to be on long term treatment and followup with an accredited dermatologist to prevent scarring.

The Raser™ Hair Regrowth Comb is a multi-functional 5 in 1 comb that incorporates Diode Laser + Radiofrequency+ Red Photon + EMS + Massage with Ozone Sterilization. It is beneficial for hair follicle stimulation, hair regrowth, scalp serum absorption, and increases hair elasticity/anti-frizz/shine.

Hair Loss Shampoo for the Scalp Microbiome

December 10, 2020

Hair loss (alopecia) can be a major source of distress and is a common problem.

In this article, we’ll go through common causes of hair loss, including facts about the hair cycle, what constitutes a good hair loss shampoo, and all about the scalp microbiome. We will also share an excerpt from Haircare Bible: A Dermatologist’s Tips on Haircare and Hair Loss by Dr. Teo Wan Lin, Dermatologist at TWL Specialist Skin & Laser Centre

The Hair Cycle

Normal hair grows through a hair cycle that has three stages. The growth phase, or anagen phase, is the longest phase of the hair cycle, with 80 to 90% of the hair on our scalp in this phase. In the next stage called the catagen phase, the hair bulb detaches from the blood supply and is pushed from the scalp. In the last stage, the telogen phase, shedding occurs as the hair is released, leaving behind an empty follicle.

Each hair follicle is independent, going through the cycle at different stages as the other hairs. Hair problems occur when there is a disruption in the hair cycle.

What are the causes of hair loss?

Hair loss can be caused either by an isolated problem or a combination of factors including genetics, chronic medical diseases such as a thyroid problem or underlying anemia (low blood count), poor nutrition, etc.
Chemical treatments performed in hair salons, such as hair dyes, bleaching, perming and rebonding hair, can cause a form of hair loss from breakage of the hair shaft.

In the hospital setting, patients undergoing chemotherapy usually suffer from a form of temporary hair loss, caused by the hair follicles entering into the resting phase whereby they are shed.

Namely, as our hair growth cycle goes through 3 main phases — active growth caused by anagen, transitional growth caused by catagen and inactive growth and shedding caused by telogen — an impact in any of these stages caused by the abovementioned factors can lead to loss in hair density due to less hair on the scalp present in the growth or anagen phase.

Hair loss shampoo

What constitutes a good shampoo?

Caring for one’s hair is just as important as caring for one’s face, but often gets less attention. Understanding what constitutes a good hair loss shampoo is an important part of making sure your hair stays healthy and voluminous.

To help you navigate the world of shampoo products, we introduce you to the basics you need to know.

How should a shampoo function?

A shampoo is a viscous liquid (liquid with texture that tends to be thick). Its primary purpose is cleansing the scalp and hair of dirt, sebum, sweat, dead skin cells and environmental pollutants. It does so by dissolving oil-soluble dirt, which is water-insoluble and hence, cannot be removed by solely rinsing with water. A hair loss shampoo should also remove greasy residues from hair care products such as oils, gels and sprays. The overall effect is that of cleansing to maintain a good hygiene level to reduce the chance of scalp irritation, inflammation and odour.

While most shampoos can accomplish a thorough cleanse, the real challenge lies in removing just enough sebum to allow the hair to be clean without drying it out.

This explains why most shampoo formulations have a secondary function of smoothing the hair’s surface and imparting lustre, smoothness, buoyancy and volume.

Certain types of hair loss shampoos also treat the scalp with medicated ingredients, such as those targeting dandruff, a common scalp disorder caused by a yeast known as Malassezia.

Hair loss shampoo: Copper Peptide Hair regrowth deep cleanse shampoo

The Copper Peptide Hair Regrowth Deep Cleanse Shampoo is formulated for hair loss and sensitive scalps. It has degreasing, soothing, and anti-hairloss effects. It also contains amino acid surfactant for sensitive scalps, zinc pyrithione for anti-dandruff action, and copper peptide for healthy hair growth.

Types of surfactants

A surfactant is often amphiphilic, meaning its molecules contain both lipophilic (oil-attracting) and hydrophilic (water-attracting) parts. The oil-attracting parts bind to sebum while the water-loving sites parts to water. Such a mechanism allows sebum to be removed when in contact with water.

The type of surfactants used in hair loss shampoos is classified according to their hydrophilic polar group. The four common categories of shampoo surfactants are anionics, cationics, non-ionics and amphoterics. Most shampoo formulas rely on two types of surfactants.

The surfactant listed first in a shampoo’s ingredient list denotes the primary cleanser and also the ingredient in the highest concentration. The surfactant listed second is the secondary cleanser; this is often added to offset the weaknesses of the first surfactant.

Anionic surfactants
Anionic surfactants are named for their negatively charged hydrophilic (water-loving) parts. Derived from fatty alcohols, they are good at removing sebum from the scalp. However, excessive cleansing with anionic surfactants leaves the hair harsh, rough, dull, frizzy and prone to tangling. Examples include sodium laureth sulfate, ammonium laureth sulfate, sodium lauryl sulfate, and ammonium lauryl sulfate.

Cationic surfactants
In contrast to anionic surfactants, cationic surfactants have a positively charged element. Cationic surfactants are poor cleansers and do not lather well. They are also not compatible with anionic surfactants. However, they are excellent at keeping chemically damaged hair soft and manageable. As a result, shampoos for damaged or coloured hair often include cationic surfactants. Examples include long-chain amino esters, ammonioesters, and cetyltrimethylammonium chloride.

Amphoteric surfactants
With both positively and negatively charged groups, amphoteric surfactants foam well and condition the hair. They help with the formation of micellar emulsion, improving the lathering ability of the shampoo, resulting in a thick liquid which is efficient to use. In addition, they do not cause stinging in the eyes and are gentle on the skin/scalp barrier, making them ideal for mild shampoos. Examples are cocamidopropyl betaine, sulfonate betaine, amphoteric acetate/diacetate.

Nonionic surfactants
Nonionic surfactants do not have a charged group and hence are compatible with any surfactant. Nonionic surfactants are the mildest type of surfactant. Such surfactants are often used in baby shampoos. Examples are fatty alcohol ethoxylates, cocamide MEA, sorbitan ether esters, and alkyl polyglucosides.

The Scalp Microbiome

The scalp is one of the thickest parts of the skin on the body, with on average about 100,000 hairs growing on it at a given time. It high production of vitamin-rich sebum (oil) and an unusually humid environment, which gives rise to microbes and microorganisms that aren’t found on any other part of the body. 

The scalp microbiome is the balance of healthy microorganisms that work together and contribute to our scalp health. Just like our skin microbiome, if the delicate microbiome is thrown off balance, skin conditions can develop, causing symptoms of flaking, itching, and irritation.

Keeping the scalp microbiome health: Shampoo 

Research has shown that zinc pyrithione medicated shampoo is a safe and effective way to treat dandruff. By fighting off Malassezia, it is a beneficial way to restore the health of your scalp microbiome. 

The Copper Peptide Deep Cleanse Shampoo contains amino acid surfactant for gentle cleansing of sensitive scalps,  zinc pyrithione that has anti-dandruff properties, and copper peptide that helps to promote healthy hair growth.

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Home Hair Treatments for Damaged Hair

December 1, 2020

Does your hair get easily tangled? Is your hair frizzy? Is the texture of your hair rough? Does your hair break when you comb? If you answered yes to any of these questions, your hair may be showing signs of damage.

In this article, we’ll walk through home hair treatments for damaged hair, the botanical ingredients you should look out for, and the science behind how it can benefit your hair shaft. We’ll also include excerpts from Haircare Bible: A Dermatologist’s Tips on Haircare and Hair Loss by Dr. Teo Wan Lin, dermatologist at TWL Specialist Skin & Laser Centre.

What is hair elasticity and how is it measured?

Hair elasticity is measured by how much the hair will stretch before it returns to a normal state. Healthy hair, when wet stretches up to 50% of its original length and returns to its normal shape without breaking. Dry hair will stretch about 20%.

How to test your hair elasticity:

After you wash your hair, try these steps to check your hair elasticity:

  • Take a strand of hair, hold it at mid-length or at the roots (this will prevent pulling at the root), and gently stretch the strand of hair.

After a gentle tug, if the hair doesn’t fall back into shape or if it breaks, hair elasticity is low.

What can be used to increase hair elasticity?

Protein and oils can be incorporated into the hair shaft

What are proteins? Why are they important for healthy hair?

Proteins are large molecules consisting of amino acids, the building blocks of proteins, that our body’s cells need to function properly.

Amino acids play an integral role in the body’s processes for healthy skin and hair. Amino acid proteins are necessary for the strong and resilient growth of the hair shaft — reducing the incidence of breakage due to brittleness. It can also increase hair shine and elasticity, and features prominently in thick, healthy shiny virgin hair.

Hair Mask bar as home hair treatments for damaged hair

The 360° Conscious Mask Bar for Hair is developed with a focus on environmentally conscious, science-backed botanical ingredients for a deep-conditioning home hair spa treatment. 

Why are topical formulations of proteins important and how do you get amino acids into your hair?

Proteins like keratin and collagen are too large to be directly used on the hair shaft for a beneficial effect. They need to be broken down via a process performed in the laboratory, known as hydrolysis in order to be absorbed by hair.

What is hydrolysis and how does it affect the ability of proteins to be absorbed by the hair shaft?

Hydrolysis is a chemical reaction involving reactants that will create at least two products via a decomposition reaction. “Hydro” is derived from water — hydrolysis means a reaction with water. The hydrolysis process means this – a larger molecule is split into two or more parts by the addition of a water molecule.

Large proteins are too large and bulky to be absorbed by the hair. What Hydrolysis does is that it allows the hair shaft, which is made of keratin material to readily “absorb” and hang on to proteins by breaking them to smaller molecules.”

What are the types of proteins that can benefit the hair shaft in home hair treatments?

Wheat, Silk, Milk, Soy, Keratin, and Collagen proteins. The hydrolysed state of these proteins have all been proven to directly penetrate the hair shaft and repair it.

How do these proteins work to help heal the hair shaft?

Hydrolyzed Wheat Protein
Hydrolysed wheat proteins are considered reparative and conditioning agents for the hair due to the active peptides that are present. While it does not prevent hair loss, wheat proteins work to bring existing hair follicles to optimal health. It functions primarily by the following methods:  First of all it moisturises the hair cuticle, the part of the hair that is responsible for keeping the hair smooth and shiny looking. In addition, it forms a coating around the hair shaft hence easily doubling the volume of the hair shaft, consequently working as a hair shaft volumiser. Finally, it helps to seal up the cuticle and functions as a smoothener to enhance hair shine in home hair treatments.

Place LipiShine, LipiSilk serums and Gel Cap in Mask Bar on “HOT” 30 min for the hot oil treatment. Apply the serum on the hair shaft, and wear the Gel Cap for 5 minutes. Rinse off thoroughly with cool water. Repeat this home hair treatment monthly.

Hydrolyzed Silk Protein
Silk is one of the strongest natural fibers in the world. It offers crystalline protection, ensuring hair elasticity and resiliency against breakage. At the same time, hydrolyzed silk protein acts as a barrier to improve shine by guarding the hair against moisture loss.

Hydrolyzed Milk Protein
A perfect fix for dry, limp and tangled hair. Hair tangles are more common when there is cuticle damage. Smooth, closed cuticles are less likely to encounter snags which are the primary cause of tangles and knots. Hydrolysed milk protein acts as an effective cuticle moisturizer ensuring detangled, well-nourished locks.

Hydrolyzed Soy Protein
Derived from the soybean plant, hydrolyzed soy protein is water soluble and can strengthen hair while repairing the shaft. It increases the natural ability of hair to retain moisture while adding shine and smoothness. Soy protein also functions as a humectant to trap moisture under the hair cuticle in home hair treatments.

Hydrolyzed Keratin Protein
Keratin is a fibrous protein that makes up the structure of our hair and is part of the natural protective layer of hair. It renders strength and returns elasticity to hair strands. As a protective barrier, it greatly reduces damages to the hair from harsh chemicals.

Hydrolyzed Collagen Protein
Sourced from bovine bone and cartilage, this protein temporarily bonds to the hair and increases its resistance to breakage under tension.

Hair Mask Vial bundle for at home hair treatment of damaged hair

The Hair Mask Vial Bundles includes 3 customized masque applicators that thicken the hair shaft after each treatment. It includes the Keratin Hair Mask for hair strengthening, the Milk Hair Mask for hair softening, and the Silk Hair Mask for smoothing frizzy hair.

Plant oils and its benefits for hair

Plant oils have been known for centuries to help improve hair conditions in home hair treatments. Bioactive substances in plant oils have functional properties such as moisturizing, conditioning, anti-inflammatory and antioxidant activity. These substances are mainly found in the non-saponifiable (non-soaping forming) lipid (NSL) of plant oils. The effectiveness of plant oils are significantly reduced after undergoing chemical refinement methods in manufacturing but are still widely used and purported to be effective in many cosmetic hair care products.

The LipiSilk™ Serum is enriched with Linoleic acid for deep repair of hair shaft and purified seed oil of Hippophae rhanoides (Sea Buckthorn Oil). It coats and penetrates hair cuticles to repair hair damage and reduce breakage.

Synthetic Sandalwood found to stimulate hair growth in studies

The interesting finding of synthetic sandalwood stimulating human hair growth was first published in the prestigious journal Nature in 2016, as it appears to bind to the scalp’s olfactory (sense of smell) receptors. This did not occur with the actual sandalwood extract, rather the synthetic version made under trade name Sandalore.

This has implications in the realm of hair cosmeceuticals for hair regrowth. Firstly, is it viable to apply this as an oil directly to the scalp? There is a single commercially available preparation at the time of publication of this book, marketed as a hair growth tonic. While this is promising, there needs to be further clinical studies performed on the safety and efficacy of a topically applied synthetic oil directly on the scalp in home hair treatments.

Based on this study, my team and I have developed an alternative method of impregnating the fully porous natural material of a wooden comb with Sandalore, as a means of exposing the oil to the scalp receptors without direct contact with the scalp. I deem this a safer method of application in the absence of clinical studies, and will be looking towards a controlled study of such an intervention.

The ORZAT4 Infusion Treatment Comb is impregnated with Sandalore® which has been scientifically proven to stimulate hair regrowth in home hair treatments.

Dandruff & Itchy Oily Scalp – Best Dermatologist Treatments

August 30, 2020
Oily scalp treatment by dermatologist

Does itchy oily scalp cause hair loss? How about dandruff? It is pertinent to recognise the condition of your scalp to effectively treat and prevent hair loss.

What causes dandruff and scalp inflammation? 

Dandruff is a lay person’s term for a medical condition called seborrheic dermatitis. The term dermatitis itself was first to an inflammatory scalp disease. In this case, it is a combination of excess sebum or oily scalp, as well as the overgrowth of a yeast organism known as Malassezia furfur that is otherwise a commensal of the scalp. So healthy people also have Malassezia furfur on their skin and scalp, but in individuals who develop dandruff, there usually is an overgrowth of these organisms that leads to an imbalance of the microbiome, which is the balance of good bacteria, pathogenic bacteria, and the various yeast organisms. 

What are the symptoms of dandruff?

1. Excess production of oil or oily scalp. If you do not wash their hair, say for more than 24 hours, there can be significant itch associated with dandruff.

2. Scalp sensitivity and redness. Individuals who have dandruff, as well as scalp pimples, may actually have a concomitant disease known as scalp folliculitis. Scalp folliculitis can be caused by the same yeast organism Malassezia, or it can be due to secondary bacterial infections as well.

What factors can exacerbate dandruff?

  1. Excess sebum production, i.e. oily scalp
  2. The proliferation of Malassezia, a yeast that causes seborrheic dermatitis. There are specific genetic differences in the oil content. An individual who is prone to getting seborrheic dermatitis may have a slightly different what we call a physiochemical composition of their sebum, which seems to be more favorable for the yeast to proliferate.
  3. High humidity. In terms of environment, it is also very critical to appreciate that tropical climate, such as Singapore where you have high humidity, there is a predisposition to the development of seborrheic dermatitis. The reason is because of increased moisture such as from sweating, as well as raised temperatures from heat. These factors increase the growth of microorganisms, which includes yeast.
  4. Excessive sun exposure, exposure to environmental pollutants, and in the case of a poor diet and lifestyle can increase the amount of free radical damage that occurs on the scalp, and that leads to inflammatory processes. 

What causes oily scalp, beyond genetics? What role does diet, lifestyle play?

One’s diet has not been proven definitively to influence the development of seborrheic dermatitis. What we do know in acne is if you are taking high-fat diets, in terms of trans-fat for example, such as taking a lot of deep-fried saturated fats in your diet, it increases your production of sebum and exacerbates oily scalp conditions. If we were to postulate that the same process could be happening for the scalp, then certainly this is also a valid statement. What’s more important to appreciate is the role of a poor diet, as well as a sedentary lifestyle, in terms of one’s physiology.

The skin and the scalp have to deal with a lot of inflammation on a daily basis because it is exposed to the external environment. Sun exposure, UV exposure which is considered an immunosuppressant and environmental pollutant can cause free radical damage to the scalp. In an individual who is consuming a lot of antioxidants in their diet which tend to be plant-derived, versus an individual who does not incorporate antioxidant-rich food in their diet, the former will be better equipped to fight off these external aggressors. 

Can oily scalp lead to hair loss? 

Oily scalp on its own does not cause hair loss. However, oily scalp is often in association with seborrheic dermatitis. In seborrheic dermatitis, the process of inflammation in the scalp does cause a disruption in the hair cycle. The hair cycle can be broadly thought of as having a growth phase, which is specifically known as the anagen phase, and the falling out phase, which is the telogen phase.

When you have active inflammation on your scalp, you are accelerating the cycles. Consequently, you may be having more hair in the falling out phase, as opposed to the growing phase. This, in turn, can lead to an imbalance in the amount of hair fall, so you probably have less hair growing and more hair falling out. In that situation, you may also experience hair thinning.

Do you have male or female pattern hair loss?

In a second scenario where you get oily scalp, it is because you are already having hair fall. This is very specific to individuals who are suffering from male or female pattern hair loss. If you have seen images of men who have the classical male pattern hair loss, you notice that the scalp has a little bit of a shiny tone to that. The reason is not that their hair follicles are dead, they are alive. However, the hair follicles over time have become miniature, in a process we call miniaturization.

The hair follicles are associated with oil glands. While the hair shaft itself is now very tiny and almost invisible towards the end stage of male pattern hair loss, the oil glands are still equally active. Hence, the original amount of oil that the body was producing in order to lubricate the hair shaft is now in excess because there is hardly any hair left for the oil to lubricate. That can lead to a phenomenon where you have excess oil production and hence the oily scalp.

Does nutrient deficiency lead to hair loss?

Whether one can eat your way to a healthy scalp, I think it’s important to address firstly, does nutrient deficiency lead to hair loss? It is extremely rare in the developed world that one’s diet is specifically lacking in what we call micronutrients. As it is, hair loss supplements are actually not evidence-based, unless there is a documented deficiency.

Right now, supplementation folic acid and vitamin D are only recommended for high-risk groups, such as during pregnancy or in infancy. However, it is a very widespread practice for many dermatologists and non-dermatologist doctors who are treating hair loss to prescribe supplements. The important thing to note here is that there is really no solid evidence that micronutrient deficiency is in a large proportion of our cases of hair loss. If you’re talking about scalp disease, there is no evidence at all.

Can you eat your way to a healthier scalp?

Our skin and scalp are very much dependent on, first of all, your biological age, as well as external environmental effects that cause this chronological aging. Having a diet that’s rich in antioxidants can help to combat and slow down this aging process. If you do suffer from a scalp disease or have hair fall, modifying your diet is not going to help. For patients who are thinking of taking biotin supplements or other natural supplements in hope of achieving some remedy for the scalp and their hair problems, it’s very important to note that while generally supplements are considered harmless, HSA and in the U.S. the FDA, are often not involved in reviewing supplements for either safety or efficacy.

There have also been reports of inadequate active ingredients, bacterial contamination, heavy metal, and toxin contamination of supplements. It is important to highlight that one should not be focusing on a dietary modification to achieve a healthy scalp and healthy hair, but it is certainly important to include antioxidant-rich food in your diet for purposes of general wellbeing, as well as organ function. 

What are the common scalp problems in Singapore/Malaysia?

People living in the tropics tend to suffer from seborrheic dermatitis, and scalp folliculitis, which is essentially pimples on the scalp. Scalp folliculitis can be caused by the same yeast organism Malassezia, or it can be due to bacteria on the surface of the scalp. The common scalp problems seen in Singapore and Malaysia are due to our climate. Our climate is tropical, which means that it creates a very specific skin and scalp microenvironment.

There is increased retention of sweat because of the low evaporation rates owing to the environmental humidity. Young people who tend to be more active or say athletes or individuals involved in outdoor work may find that they sweat more. For scalp problems or the conditions associated with microorganism growth, these are much more prevalent in tropical regions and in susceptible individuals.

What would you recommend for individuals who are living in the tropics for healthy scalp and hair?

What I would recommend is to wash their hair daily. Scalp hygiene isn’t about going to a spa or having a hair treatment. But it’s really on a daily basis, you need an efficient way to cleanse your scalp. So the function of a cleanser is to emulsify dirt, oil, grime on the surface of your skin, on your scalp in this case, and physically rinse it off with water. Individuals or high-risk groups who are prone to scalp conditions include, for example, athletes, manual laborers who are working outdoors in the humidity. For them, it may be wise to incorporate active ingredients that prevent fungal or bacterial infections in their shampoo.

In the treatment of seborrheic dermatitis, we often use the active ingredients zinc pyrithione, salicylic acid in over the counter antidandruff shampoos. The concentration of active ingredients is also very important for efficacy. For individuals who have a history of recurrent seborrheic dermatitis, prescription shampoo that contains an antifungal agent, such as ketoconazole, may be required for longterm use and maintenance. 

© 2020 TWL Specialist Skin & Laser Centre. All rights reserved.

Excessive Hair Fall – 5 Alluring Myths Dermatologist-Debunked

August 7, 2020

In this article, we shall dispel some common myths about excessive hair fall or hair loss. Below, we use an excerpt from the Haircare Bible which talks about the common misconceptions about hair fall. Stay tuned for more in this series.

Excessive Hair Fall Haircare Bible Dermatologist's Tips
Haircare Bible – Dermatologist’s Tips on Haircare and Hair Loss 

Dr. Teo Wan Lin is one of Singapore’s prominent dermatologists and is also an expert in cosmeceutical research and development, having written the Skincare Bible – Dermatologist Tips for Cosmeceutical Skincare. She is the founder of Dr.TWL Dermaceuticals, one of the top dermatologist-formulated cosmeceutical skincare and haircare lines in Asia. As an expert in cosmeceutical formulation and with her background in dermatological research, Dr. Teo is widely consulted as an expert medical and cosmetic dermatologist for various media collaborations.

Dr. Teo’s second book, the Haircare Bible is catered to both beauty aficionados as well as sufferers of hair conditions such as hair loss, sensitive scalp, and dandruff for tips on home hair and scalp care. Chemists who seek to understand the perspective of a dermatologist in haircare formulas and individuals with an interest in hair care formulations will also find this a thorough and helpful read. Hair cosmeceuticals – for both the scalp and hair shaft, as well as best grooming practices are shared in a friendly FAQ format. 

Myth #1: I have just moved to a different country and I think my hair loss started only after that. I suspect it is the water that I use to shampoo my hair with!

Potable water compliant with international guidelines for drinking water will not influence hair growth. It is sometimes a red herring, as a major move to a different country can cause a certain amount of mental and emotional stress, which will manifest 2-3 months after the move, as a form of hair loss known as telogen effluvium. It could also be the change in the climate, for example from a temperate climate to tropical weather, which causes the scalp to get inflamed. A common scenario is a flare-up of the condition seborrheic dermatitis, known to laypersons as dandruff. Seborrheic dermatitis is worsened by humid weather and can cause some hair shedding to occur as it triggers off scalp inflammation.

Myth #2: I just changed my shampoo before having excessive hair fall, could this be the culprit?

The answer is no, there is usually no impact of change in shampoo on hair fall. However, if you suffer from dandruff, start to use an over the counter anti-dandruff shampoo containing active ingredients such as selenium sulfide, zinc pyrithone and salicylic acid, your condition should improve.

Myth #3: Since developing hair loss, I switched to organic mild shampoo, that should help?

There is no such thing as organic shampoo, by way of classification via the FDA or Singapore’s HSA. Organic refers to food produce grown without pesticides, and as shampoo is not ingested, it does not apply. The key features of an effective shampoo is to be able to perform the following functions: removing oil, dirt and hair products from the scalp and hair shaft and be gentle enough on the scalp so as not to trigger off dryness and sensitivity.

Lastly, it should contain active ingredients that can help stimulate hair growth, such as a copper peptide. The differences between the lathering abilities of different types of shampoos can be traced back to the type of surfactant used. Specifically, a shampoo that lathers strongly is likely to be high in laureth sulfates, and this can cause scalp dryness as well.

Myth #4: Can I see a trichologist or an aesthetic doctor instead of a dermatologist for my hair loss?

Excessive hair fall can be indicative of medical conditions such as autoimmune disease, thyroid or anemia — these can be serious health conditions if ignored. A trichologist is not legally recognized as a medical practitioner, neither can they be held accountable in any way for your health.

Aesthetic doctors are general practitioners with a medical license. They are not specialists in skin hair or scalp as recognized by the governing medical bodies. Only accredited dermatologists (check your doctor’s license at your local Ministry of Health or board accreditation facility – it should explicitly state specialist qualifications) are legally recognized as the correct specialist to treat your scalp and hair problem.

Myth #5: Do herbal scalp treatments for unclogging scalp pores work?

Here’s the dealbreaker, those machines used by trichologists to scan your scalp? These are all marketing gimmicks and are not used in dermatologists’ offices as they offer no clue to the diagnosis. When the clinical examination is insufficient, dermatologists will order scalp biopsies to rule out rare causes of hair loss which are scarring, such as frontal fibrosing alopecia.

The scalp does not have “clogged pores” per se. If you notice bumps on your scalp, this is not a sign of clogging. It is an inflammatory condition known as scalp folliculitis, which can be due to bacteria or a yeast infection. These will not respond to herbal or deep cleansing treatments and will require oral medication in combination with a medicated shampoo for effective treatment.

Treatment – What can I do to prevent excessive hair fall?

If you are in the early to moderate stages of hair loss and thinning, or have a family history of hair loss, get started on a home-based hair diode laser/radiofrequency device such as the Raser™ Hair Comb.

How does laser light therapy prevent excessive hair fall?

The Raser™ Hair Comb diode laser treatments work through the process of photobiostimulation, delivering low-level laser light to your hair follicles. This helps to activate them for stronger hair growth. In addition, the boost of nourishing light energizes hair follicles at a cellular level to stimulate growth factors.

As a result, it becomes possible to reverse hair thinning, and restore your hair’s natural growth cycle. This will help your hair grow fuller, denser, longer, and stronger. Laser light therapy is recommended by dermatologists to their patients with hereditary hair loss. The comb is also FDA Approved for laser device usage in the fields of dermatology and hair restoration. 

What is a radiofrequency device?

Radiofrequency devices are used on the scalp to produce the rejuvenating effect of the wound healing process. Hair follicles undergo the same process of wound healing in order to stimulate hair growth. Hence, using radio frequency technology can help in treatment of hair loss. This is especially relevant for hair loss due to genetic causes such as female pattern and male pattern hair loss. This strengthens the hair follicles, preventing excessive hair fall and promoting hair growth. 

The  Raser Hair Regrowth Comb is most effective for people in early to moderate stages of hair loss and thinning. This comb is a multi-functional 5 in 1 comb, encompassing diode laser, radiofrequency, red photon, electric muscle stimulation, and massage with ozone sterilization. These functions are helpful in the prevention of excessive hair fall as it addresses the causes of hair loss holistically and stimulates the hair follicle via 4 main modalities – Laser diodes, radiofrequency, red photon light therapy as well as scalp massage which stimulate blood flow to the hair follicles. The teeth and shape of the Raser™ Hair Regrowth Comb help to separate the hair parting to efficiently deliver light energy to scalp follicles for optimal results.

Overall, light therapy/radiofrequency devices are recommended as part of comprehensive hair loss treatment. The Raser™ Hair Regrowth Comb, in particular, stimulates hair follicles, enhances absorption of hair growth serums by the scalp, restores hair elasticity, and add shine to the hair shaft with anti-frizz features.

© 2020 TWL Specialist Skin & Laser Centre. All rights reserved.

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