What’s causing my Hair Loss?
Join Singapore dermatologist Dr. Teo Wan Lin as she weighs in on common scalp conditions that cause hair loss and also home treatment options.
This series “In the classroom with Dr.TWL” is the masterclass that you have been waiting for. This is the first of a series of masterclasses on hair care and scalp care by accredited dermatologist Dr Teo Wan Lin, director of TWL Specialist Skin & Laser Centre and founder of Dr.TWL Dermaceuticals.
Beautiful hair starts from the scalp
The scalp is home to a complex microbiome, consisting of bacteria and yeast, each of which play a role in preventing pathological inflammation or disease, which can cause scalp irritation.
If you suffer from dandruff scalp pimples, this masterclass will help you understand what you may have. If you suffer from hair loss, this dermatologist created series covers the commonest causes of hair loss and treatments. This masterclass aims to educate the public on important aspects of scalp and hair care right out of a dermatologist’s office. Join Dr.TWL’s classroom today to learn about important active ingredients that can help you in your haircare and scalp care journey.
Hair Loss & Scalp Care – according to a Singapore Dermatologist
How to achieve healthy and beautiful looking hair starting from the scalp. Now, the scalp is uniquely supplied by many sebaceous glands. These are the oil glands that produce sebum, which helps to moisturize your hair shaft so that it looks glossy and smooth, preserving the health of the cuticle. However, there are certain conditions that can occur on the scalp that can affect both the quality as well as the quantity of your hair.
0:54 Male and female pattern hair loss
What is the commonest cause of hair loss?
You may have heard of the term androgenetic alopecia or AGA for short. It is also known as female pattern hair loss in women and male pattern hair loss in men. Now, how does this relate to the oil glands, you may wonder. Well, what actually occurs in AGA is that over time, miniaturization of the hair follicles occur. This is predominantly due to genetics. If you have a family member with a history of pattern hair loss, you may be at higher risk of acquiring that later on in your life as well. Hair miniaturization is the process whereby hair strands that grow out from follicles over decades become finer and finer. This carries on until they are what we call miniature.
The phenomenon is really relevant, because while you have less hair on your scalp, you still have the same number of sebaceous glands. This is responsible for individuals who find that their scalp actually gets greasier with age. It could be that they are experiencing some form of hair loss, hence there is increased sebum that is left on the scalp. These sebum previously would be regularly distributed across all the hair follicles and hair strands.
2:40 Function of sebum for the scalp
Is excess sebum bad for my scalp?
So the question is if sebum is actually good or bad for the scalp? The answer is that an appropriate amount of sebum is actually necessary for the scalp to maintain a healthy microbiome.
2:59 Seborrheic dermatitis and the hair cycle
Can dandruff cause hair loss?
Seborrheic dermatitis itself doesn’t cause hair loss. What is troubling is that it can disrupt the hair cycle. This means that because of chronic inflammation, more hairs are pushed into the falling out phase, the telogen phase. The hairs in the anagen phase, which is the growing phase, may not be able to catch up. That way, when there is a negative balance, you’ll find that you have overall thinning of the hair observed.
3:39 Causes of scalp eczema
What are the other causes of scalp problems?
That is the commonest scalp condition that I see in my dermatology practice. We should also touch briefly on other types of scalp disorders that may deserve our attention as well. I want to also share about a certain type of scalp eczema that is due to excessive dryness that can be caused, most of the time, by the use of inappropriately harsh shampoos. Chemical treatments in salons, such as with the use of hair dyes, can trigger off scalp eczema due to an allergic reaction to a hair dye. When that happens, you sometimes see associated breakage of hair at the roots where the chemical was in contact with the scalp.
It is far more common though, for us to see a type of scalp eczema that is related to atopic eczema. This is a type of endogenous eczema. These individuals are actually born with a certain susceptibility to dry skin and usually have a family history of it. There may be a personal history of sensitive skin, allergic rhinitis, having sinus problems, and also asthma. That is what we call atopic triad. The key here is to avoid astringent shampoos, which dehydrate the scalp. It can result in flaking and increase susceptibility to external allergens. These make your scalp more sensitive, resulting in uncomfortable sensations.
5:39 Best shampoo for a healthy scalp microbiome
What type of shampoo is the best for the scalp microbiome?
Now for the big ticket question, do amino acid cleansers cleanse as well? This is especially when it comes to the scalp. The scalp has thicker skin versus the rest of our body and contains more sebaceous glands where having oily scalp problems is actually pretty common. The answer is a resounding yes.
6:10 Amino acid surfactant based shampoos
Are amino acid surfactant based shampoos more effective?
In many consumer studies, the cosmetic acceptability of a product and especially cleansers, is an important aspect that is considered. Amino acid surfactants – whether used in facial cleansers or in shampoos, are actually very effective in terms of performing a degreasing effect on the scalp and it leaves the user feeling cleansed and refreshed. Apart from that, it is important to consider other active ingredients that are present in your shampoo that can help to minimise your chances of developing any of these scalp disorders. Most importantly, we want to maintain a healthy scalp microbiome. As we mentioned before, it has to do with the balance of microorganisms on your scalp.
7:17 Effective dandruff treatment
How does zinc pyrithione work?
Zinc pyrithione is an active ingredient that has been very well studied in terms of its ability to inhibit dandruff. That is because it is fungistatic, meaning that it reduces the growth of the fungal organisms. On top of that, it also has sebum regulation properties. This also brings me to the point of using an appropriate, gentle yet effective cleanser for your scalp even if you have oily scalp problems. Conversely, if a very astringent cleanser is used, the scalp, just like your skin, may be prone to a condition known as reactive seborrhea. This is where excessive paradoxical production of oil can occur when you strip the skin or the scalp completely dry.
8:18 The science behind copper peptide shampoo
How does the degreasing copper peptide shampoo work?
The copper peptide shampoo has actually been formulated to address many of these common scalp conditions. It has, first of all, a unique lathering base, which is based on amino acids. Amino acid surfactants are far gentler than the traditional laureth sulfate counterparts. If you look at ingredient lists of your shampoos, 95% of commercially available shampoos contain laureth sulfates. These are actually safe for use on the skin on the scalp, but really depending on how high the concentration is. If it has been listed as the top ingredient or the top few ingredients in your cleanser, then you can be certain that it is present in a rather high concentration.
9:27 Lathering agent in shampoos
Expensive vs cheap shampoo? Is there a difference?
Many people have asked me if an expensive shampoo is different from one that is cheaper. The honest answer is that it is very likely due to the ingredients that are being used to form the cleansing base. Laureth sulfates are essentially forms of detergent. Anything that foams up from your dish washing liquid to your body soap, all contain some form of a lathering agent. The lather is very important when you are cleansing because you want the foam in order to grab excess grease, dirt and grime off surfaces before physically rinsing it off with water.
Cosmetic formulas have obviously advanced, but it is still the most common lathering agent that we find in cleansers and it is the same for shampoos. Amino acid surfactants are far more pH balanced and are definitely tested to be gentler on the scalp and on the skin,. This is also very relevant if you are suffering from facial eczema. Sometimes it could be your shampoo that is exacerbating the facial eczema. All these are some important points to consider. It is also relevant that it produces an equivalent amount of foam whilst leaving your scalp and your skin feeling cleansed.
This sums up the first installment of my masterclass on hair. We have covered the basics of scalp health. Starting with the roots of your scalp, and also in terms of maintaining and understanding your scalp microbiome.