Causes of Dry Brittle Hair

• Excessive sun exposure can result in the decreased production of oils leaving the hair dry and brittle.
• Colder, dry environments may cause drying of the hair and scalp.
• Long term use of hair preparation such as hair relaxers (straighteners), bleaches, colorants and dyes or perm treatments can cause the hair to become dry and damaged.
• Styling products and treatments creates stress on the hair resulting in hair breakage. Excessive use of flat irons and hair dryers depletes the hair of moisture and causes heat damage.
• Dry hair can also indicate a poor nutrition or mild dehydration
• Dry, brittle hair is a symptom of hypothyroidism disorder where the body produces low amounts of thyroid hormones.
• Eating disorders such as anorexia and bulimia can result in the hair becoming dry and brittle due to a lack of vitamin and mineral intake.
• Iron-deficiency anemia may also contribute towards dry, brittle hair as well as thin hair or hair loss.
• Certain disorders of the sex hormones, particularly those resulting in an increased amount of testosterone in men and women, may contribute to dry, brittle hair.
• Dry brittle hair may be the result of the side effects of certain drugs like chemotherapy and certain diabetes medicines.

Treatment for Dry Brittle Hair

• Naturally derived oils are widely available in treatments infusing moisture into the hair. The oil adds luster and shine while providing nourishing benefitsand protects the hair from heat damage during styling.

• Products such as conditioners, repair cream and gels should be applied before the use of flat irons and hair dryers.

• Rice and corn protein are effective ingredients that penetrate the root of the hair providing strength, protection, and shine by smoothing the hair cuticles. Protein also helps to rebuild damaged hair

• Avoid the use of hair products that contain alcohol and alkaline as these ingredients can often strip the hair of its natural oils.

• Protect the hair when swimming with a swimming cap to prevent the action of chlorine, which can cause the hair to dry out.

• Hair products that contain sunscreens are effective in preventing the loss of moisture in the hair especially if you live in humid climates with a lot of sun exposure.

• Consume a well balanced healthy diet rich in proteins, vitamin and minerals.

• Vitamin and mineral supplements containing vitamin A, C, E, iron, calcium and zinc, may help in the treatment of dry brittle hair.

• Regular trimming of the hair can often help in reducing the appearance of split-ends.

• Condition the hair at least once a week to keep the hair nourished and moisturized.

Nail Development & Growth

The nail develops in the embryo as the epidermis folds to form a nail fold. At 3 months of development the fold thickens on each finger. Nail formation is completed at the fifth month of development when they reach the tips of the fingers. The growth of nails is continuous throughout life although the rate of growth varies from person to person.

With age, blood circulation at the root becomes less efficient which leads to a gradual slowing of the nail growth. The effect of ageing may be increased by nutritional deficiencies related to a poor diet as well as chronic disease. Nails become thicker and opaque resulting in a yellow to gray color and the moisture of the nails are reduced, resulting in fragile nails causing the nails to either flake in layers or develop fissures.

Internal physiological conditions such as poor circulation, anemia and psoriasis may cause disorders of the nail. Self-inflicted conditions such as misuse, accident or nail biting are also causes of nail defects. Fungal infections of the nail (onychomycosis) is common on the toenails and especially on the fingernails due to prolonged use of acrylic nails.

Brittle nails (Fragilitas unguium)

Frequent usage of detergents may lead to dehydration of the nails due to the constant removal of protective oils. Brittle nails have a decreased amount of water in the nail plate and a deficiency in blood supply of the matrix. Poor blood circulation or iron deficiency can impair nail growth leading to the thinning of the nail plate. Water is easily lost from a thin nail resulting in brittle nails.

Gelatin is recommended for brittle nails as it is a protein which helps for tissue repair. The use of cuticle cream massaged into the nail area and avoid overuse of detergents will be beneficial in preventing the nails from drying out.

Furrows and Ridges

A transverse furrow on the nail may follow after a serious illness and could also be a sign of respiratory disorders, seen in long time smokers. The lines are an interference with the nail growth and appear several weeks after the illness and may take 3 to 4 months to grow out. Furrows and ridges in smokers persist for years, even after quitting smoking.

Hang nails

A hang nail is a piece of nail growing in the nail groove separately from the main nail. This may result from injury to the nail root, nail biting or the dryness of the nail. If allowed to grow the hang nail may be pulled away from the skin resulting in an infection of the area. If inflammation occurs it should be treated with an antiseptic cream.

Ingrown nails

Onychocryptosis, commonly known as an ingrown nail, occurs when the nail plate is cut too short at the corners of the nails. This results in the nail growing into the sides of the wall causing inflammation. Toe nails are more prone than finger nails as the tips of the nail are constantly under pressure from the shoe.

Nail biting

Nail biting or onychophagy results in the distortion of the nail, most commonly seen when the nail is bitten too deep, resulting in a ragged appearance. This habit usually starts in childhood and is very difficult to break. While the habit should be stopped, a cuticle massage may improve circulation and encourage nail growth. The bitten nails should be trimmed to give a neat appearance and prevent ingrown nails.

Discoloration of the Nail

Nails may become discolored by damage of the nail bed, fungal infection, or substances that stain the nail plate. A fungal infection of the nail (ringworm) may cause the nail to become yellow, brown, or black and powdery. An antifungal application is required or the fungus will persist, spread and cause severe deformity of the nail. Nicotine and hair dyes stain the nail plate yellow and some dark red nail enamel used without a based coat may also contribute to nail staining that is not easily removed with acetone.

What are Scalp Pimples?

Pimples on the head are caused by microorganisms such as yeasts (malassezia), a form of skin fungus, mites, or bacteria. These microorganisms thrive on the dead cells of the outer layers of the scalp resulting in the outbreak of pimples. Yeasts, such as malassezia (Pityosporum ovale) often live on the scalp of healthy individuals causing no harm to the host but due to aggravating factors, like a hair dye allergy or seborrheic dermatitis, the yeast tends to grow out of control as it feeds on the dead skin cells. The hair follicle becomes inflamed and irritated. The irritation results in the skin shedding further. The dead skin cells clump up with the oil in the scalp and eventually fall off. Fatty acids are also produced in the hair follicle causing an inflammation which results in a further concentration of bacteria. This causes a break out of pimples that eventually forms a crust or a scab and may falls off spontaneously.

Causes of Itchy Scalp Pimples

Pimples on the scalp are also caused by other factors that aggravate the scalp :

• Excessive build-up of dust and plaques composed of hair product residue, oils and bacteria which accumulates in the hair root follicle.
• Sweating excessively may also lead to an increase in oil production.
• Allergic skin reactions (contact dermatitis) to hair products (hair dye allergy)
• A viral infection such chicken pox or shingles
• Skin conditions such as acne with the occurrence of cyst like formations due to blocked ducts at the site of the hair shaft.
• A deficiency in zinc intake.
• Stress can aggravate the condition as it may increase oil production.
• An irritated scalp (seborrhoeric dermatitis) can contribute to scalp pimples.
• Environmental factors such as dry and cold weather or the exposure to dust can aggravate the condition.
• A lack of hygiene where the hair is not washed frequently can cause a build up of oil resulting in pimples on the head.
• Psoriasis can cause a build up of dead skin cells which may be prone to infection.
• Eczema can aggravate the pimples on the head as it increases the shedding of normal skin cells.

Management & Treatment of Head Pimples

The condition usually subsides spontaneously if it not infected however severe cases, especially where a bacterial or fungal infection is present,  requires medical intervention.

• Improve scalp hygiene with frequent washing of the head and hair.
• Use natural or hypoallergenic shampoos as these products will reduce allergic reactions.
• It is advisable to alternate the use of two types of shampoo to prevent an oil accumulation.
• Tar shampoo and benzoyl peroxide are effective products in the management of pimples on the head but it can have a dehydrating effect if used excessively.
• If an infection occurs antibiotics is usually prescribed. Fungal infections may require antifungal hair shampoos and tablets.

It is advisable to avoid  the following :

• Scratching the scalp as it causes breaks in the skin and increasing the chance of infection
• Using hair products such such as styling gels or hair sprays.
• Hair conditioners may increase oily residue on the hair.

What is a hair dye allergy?

Initially, the allergy to a hair dye presents as skin sensitivity, with itching and burning in response to the application of a hair dye. A hair dye allergy is classified as an allergic contact dermatitis where a delayed hypersensitivity reaction occurs in response to the chemical constituents of the hair dye. While itching and burning may be noticed, at times there are no symptoms upon applying the dye and any signs of an allergy appears weeks after the hair dye application. Continued exposure to the hair dye can aggravate the allergy further.

Symptoms of a Hair Dye Allergy

• Inflammation of the affected area (mostly the head area).
• The skin has a red appearance with a presence of a rash.
• Itchy and burning sensations often accompany the allergy.
• Temporary thickening of the skin can occur.
• The skin may become dry and scaly.
• Eruption of blisters or ’scalp pimples’.
• In some cases severe swelling can occur.
• Systemic allergic reactions may occur in hypersensitive individuals.
• Secondary infection of the scalp rash or blisters will result in thick crusts, and oozing pus from the scalp.

Causes of a Hair Dye Allergy

The cause of most hair dye allergies is linked to a substance called paraphenyenediamine (PPD) which is commonly found in permanent hair dyes. PPD is banned in some European countries due to its tendency to cause hair dye allergies and severe skin irritation. Commercial hair dyes that are widely used in the retail market contain PPD along with hydrogen peroxide. PPD functions as a replacement for the color of the hair whilst hydrogen peroxide breaks down the melanin (natural pigment) of the hair. A reaction occurs with PPD and hydrogen peroxide which may result in a partial oxidation of the dye color. During this stage an allergic reaction can occur if the PPD is not completely oxidized.

Preventing a Hair Dye Allergy

• It is advisable to do an allergy sensitive test or a patch test to determine if the skin will react to the hair dye preparation.
• Apply hair dye on a small sensitive area of the skin for 5 to 10 minutes.
• Wash off the area completely with warm to cold water.
• After a waiting period of 48 to 72 hours, if a rash appears, this indicates an allergy to the hair dye. Do not use the dye if a reaction is evident.
• If no reaction occurs, the skin is unlikely to react to the hair dye preparation.
• Stop using the hair dye or reduce the frequency of application.
• Switch to a ‘non-permanent’ or a natural hair dye preparation like henna.
• Wait for the symptoms to disappear or resolve before considering another hair dye application.

Treatment of Hair Dye Allergies

• In cases where the allergy is present the use of a corticosteroid cream can be effective to reduce the itching, burning and skin rash.
• Anti-histamines may offer some short term relief for the itching.
• In acute reactions, immediately after applying the hair dye, a thorough rinsing with cold water may reduce the severity of the itching or burning. However this is unlikely to prevent the development of a rash.
• Secondary bacterial or fungal infections should be treated immediately to prevent further complications like hair loss.

The structure of the hair varies in colour, length and thickness and hair consists of a hair follicle, shaft and root. The hair structure is enclosed in the hair follicle of the skin with the hair root at the base of the hair. The visible hair that lies on the surface of the skin is called the hair shaft. The hair cycle occurs in three stages :

• Anagen stage is the active phase of hair growth which is the long ‘growing’ phase.
• Catagen stage is the transitional phase betweem anagen and telogen stages which is short term.
• Telogen stage is the resting phase of the hair. At this stage the hair tends to shed before the appearance of new hair growth.

Hair removal can be broadly divided into temporary and permanent hair removal techniques. Temporary hair removal include methods such as bleaching, waxing, shaving, threading, tweezing and the use of depilatory creams whilst permanent hair removal involves electrolysis and laser treatments.

Hair Removal Methods

Bleaching

This method uses chemicals such as hydrogen peroxide to ’strip’ the hair of its natural color. Bleaching is an effective method to disguise unwanted hair in large areas by camouflaging the hairs to blend into the skins complexion. Since the hair is not removed with the process of bleaching it provides an effective and painless method. Bleach should not be used on skin infections, cuts, blisters, sunburn, dry and flaky skin. Skin types that are prone to allergies should have bleach applied on a small area to test for skin reactions. After a period of 24 to 48 hours the area should be checked for any reactions. Long term use of bleach can result in pigmentation and skin irritation

Waxing

Waxing is a popular method of hair removal as the hair grows back soft and fine. Hair is removed from the root resulting in the regrowth starting 2-3 weeks after treatment. A wax treatment should not be done if there are cuts, bruises, infections or skin conditions such as psoriasis or eczema. Individuals who are on medication such as isotretinoin (Roaccutane is a common brand) should avoid waxing.

Shaving

Shaving is a quick, convenient and cost effective method of hair removal. This method uses a razor and shaving mediums such as foam, soap or lotion to cut the hair on the skins surface (hair shaft). While this is more popular among men for facial hair removal, shaving is also used by some women who suffer with hirsutism or hypertrichosis although this should be discouraged as it may increase the likelihood of thicker hair growth.

Shaving however can result in cuts, ingrown hairs, dry and itchy skin.

Tweezing

This method is effective in the removal of hair from small areas. Tweezing is a quick method that removes hair from the root. However if tweezing is not done properly it can result in stubble and ingrown hair pimples or folliculitis.

Threading

This method originated in India and uses a piece of thread or cotton to remove hair from the root. The re-growth of hair is fine with the possible occurrence of ingrown hairs.

Depilatory Creams

This is a painless method that uses a chemical to dissolve the hair at the root. The cream is applied to the skin and removed 5 to 15 minutes later. The side effects include skin irritation due to allergic reactions and possible pigmentation with long term use.

Laser

Laser is a permanent method of hair removal that retards hair growth by targeting skin pigments (melanin). This treatment is ideal for light skinned individuals with dark hair growth. However the procedure is costly and there is no guarantee of permanent hair removal.

Electrolysis

Electrolysis uses the insertion of a sterilized needle into the individual hair follicle. An electrical current is passed to the root of the hair resulting in the ‘burning’ of the root. Many treatments are required making this method expensive and time consuming.

What is folliculitis?

Folliculitis is a common condition involving the hair follicle. The hair in the follicle which normally grows in an upward direction curves and re-enters the skins surface resulting in the appearance of small white pimples or clusters of red bumps around the hair follicle. Bearded areas (sycosis barbae) on the facial skin are often infected with the bacteria Staphylococcus aureus , resulting in pain, swelling and redness of the skin.

Folliculitis Picture from Dartmouth College

Folliculitis is commonly referred to as an ‘ingrown hair’ and can occur anywhere on the body except areas that do not have hair follicles such as the palms of hand or soles of the feet. Follicular pustules or pimples occur in and around the hair follicle area. This condition affects individuals of all age groups but is common in people suffering with diabetes mellitus,  HIV, cancer or individuals on chemotherapy treatment. Ingrown hair is also more prevalent amongst individuals with curly or wavy hair due to the stiff structure of the hair composition which may be based on ethnic or genetic traits. The ingrown hairs are easily removed but the development of pimples may still persist.

Causes of Folliculitis

• Irritation of the hair shaft or follicle opening in the skin.
• Friction on the shaved area which is often caused by tight clothing.
• Excessive perspiration is often a common irritant to the hair follicle.
• Injury to the skin caused by cuts and nicks during shaving, leaves the skin susceptible to bacteria.
• Close or frequent shaving can result in irritation of the skin.
• Bacterial infection (staph skin infection) through skin abrasions results in folliculitis.

Preventing Folliculitis

• The use of an electric shaver may be a better option than the razor as it is more hygienic.
• If the use of the razor is essential, a new blade should be used for every shave.
• Avoid repetitive shaving over the same area to prevent the occurrence of cuts and knicks.
• Shave in the direction of the hair growth to minimize the occurrence of ingrown hair.
• Do not shave over skin that appears dry or irritated.
• Avoid the use of tight clothing for 2 to 3 days after shaving.
• Daily or frequent shaving should be avoided.
• Exfoliation of the skin can help to keep the area clean preventing the spread of bacteria.

Treatment and Management of Folliculitis

• Hydrocortisone creams are effective alleviating dry itchy skin.
• The application of an antibiotic ointment will sterilize the area preventing the spread of bacteria.
• Topical anesthetic ointments aids in the relief of pain and soreness of the ingrown hair.
• Oral antibiotics may be administered for bacterial skin infections.
• A warm moist towel should be applied twice a day to the affected area to keep the hair soft.
• Permanent hair removal such as electrolysis can aid in the prevention of ingrown hairs and pimples.
• If the condition does not rectify itself or becomes a recurrent chronic condition, seek medical advice.
• Avoid squeezing ingrown hair pimples that occur to prevent possible scarring.

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