Scalp Issues And Hair Care Tips

I continue to get email questions regarding hair care and scalp issues.

Here are some tips.

1. If you have a serious scalp issue of any kind have it checked out by a qualified medical doctor, or dermatologist. Doing so is to eliminate or treat an underlying medical condition and determine whether your scalp condition requires medical treatment.

2. Do not use too much product to clean your hair and scalp. One lather with any cleansing product is usually sufficient to clean both.

3. Do not clarify your hair too often. Clarifying products, like baking soda at the right strength, or a commercial shampoo are strong cleansing products and can be harsh and drying if overused. While baking soda or sodium bicarbonate has been shown to have antibacterial properties, high concentrations of it used for cleansing skin or hair are very drying.

4. Sulfate-free shampoos can be strong cleansing products too. Avoid multiple cleansers in a shampoo if you want a milder one to use regularly. Read the label to see if it is formulated to deep clean, if there is only one cleanser.

5. Vegetable oils and butters (because of their fatty acids) may make scalp issues or conditions worse. See this blog post, this one, and this one.

6. Do wash your scalp and hair often enough with cleansing products like shampoo, soap or washing herbs, to remove bacteria that can cause scalp issues. "Often enough" is determined by your scalp's response to extended time not washing with any of them.

7. Vinegar is not a clarifying product, or a scalp or hair cleansing product substitute.

8. I was asked in an email if I thought ethnic hair needs to be treated differently, than the recommendations for hair care in this blog. The answer I gave was this. It is not about hair ethnicity. It is about the condition of the hair. A product that adds moisture or to be precise, helps keep moisture in the hair and by extension can affect the scalp, will do so for any type of hair.

The key questions are for how long and how does it affect the scalp and hair otherwise? Typical ethnic hair care products tend to be filled with ingredients that cause: build-up, the hair to be greasy and heavy, or all of that. See this blog post, this one and regarding build-up causing the appearance of dandruff, this one.

Update in response to email inquires about vegetable oil use on the scalp
1. While scalp issues are present, consider avoiding vegetable oils and butters in shampoos, conditioners, treatments, styling products and as grooming aids. The same applies to emu oil because of its saturated and unsaturated fatty acids and like vegetable oils, it can become rancid.

2. You can still use coconut and argan oils as a pre-treatment, once a month or so before conventional dyeing or lightening, or the use of natural henna, to assist dye uptake. See number 3. The oil(s) do not need to be left on the hair and scalp for too long. They are removed at the end of the processes by washing out the products used.

3. It is not a good idea to dye or lighten your hair, until you have fully recovered from a scalp condition flare-up. Conventional dyes and lightening products are not recommended on their labels, to be applied to broken or irritated skin. See all cautions and directions on the labels and paper inserts. Specific warnings are government regulated.

See Also
FDA, "Cosmetic Labeling and Label Claims", updated 2014
The International Academy of Cosmetic Dermatology, "PETROLATUM, GREASE, AND ACNE"
The International Academy of Cosmetic Dermatology, "WHAT IS COSMETIC DERMATOLOGY?"
The American Shea Butter Institute, "Frequently Asked Questions", 2013
This blog post
And this research study, 2013

Can Scalp Massage With Vegetable Oils Worsen Excessive Hair Fall Or Shedding? Possibly.

Much hype has been made about certain essential oils diluted in vegetable carrier oils, as a treatment for hair loss or to promote hair growth. Scientific research on the subject although promising is limited, or lacking.

While one hyped study indicated success with essential oils used to help treat alopecia areata, the condition can reverse without any treatment. Hypnotherapy worked best in another, somewhat questionable study, discussed in the link.

I wrote about scientific research on vegetable oils being ill advised used under certain conditions, here and in another post linked in that one.

I received emails from someone who had excessive shedding and had regularly been using vegetable oils for scalp massage and as a remedy, between hair washes. They live in a country of high climatic temperatures and humidity. One of the oils is an ayurvedic recipe in sesame and coconut oils and the other is pure coconut oil. Both oils were stored well before and after opening. There was no dandruff, or underlying medical causes for the excessive hair fall. Since this person has stopped the vegetable oil scalp massages and is using mineral oil baby oil for the moisturizing and conditioning of their hair, shedding has been significantly reduced.

Excessive shedding can be caused by a number of factors including: diet, hormone levels and stress. Scalp massage can result in more hair shedding than simple hair grooming because the scalp is manipulated, similar to the way it can be during hair washing. Such shedding is usually not excessive. In this case, scalp manipulation during massage was considered and not overly done. The scalp in question is on the dry side of normal and only a small amount of either vegetable oil was used.

There were no allergic reactions or sensitivity to the oils otherwise observed. I think that in degrading while on the scalp in the usually hot, humid climate, the vegetable oils caused the hair fall to worsen.

See Also
PubMed Health for "Alopecia areata", 2012
And this blog post

Lipoid Pneumonia And Oils: Important Health Information

Lipoid pneumonia is sometimes referred to online as a reason for not using cosmetic or food grade USP/BP mineral oil. I have extensively researched scientific literature on the subject and here are the results.

I first wrote about the topic in this blog post.
"Of the types of oils that can be aspirated, animal oil causes more problems than vegetable oil, which causes more than mineral oil."  
More details on oils and lipoid pneumonia can be found here. 

The abstract for the lip gloss reference, dated 1984, in other study references can be found here. While there is a second reference here for ChapStick, dated 1972, neither the full text nor an abstract for it is available online. The use of any formulation of lip balm, lipstick or lip gloss on a regular basis has not been reported in recent case studies in research articles, that I have seen for lipoid pneumonia. Here is an overview of lipoid pneumonia, dated 2010, that contains details not in the other links. It does not take the following into account.

This article dated 2005, this one dated 2008, this one, dated 2009, and this one dated 2010. They further illustrate that in a number of cultures, while mineral oil may be recognized to be a cause of lipoid pneumonia because it has been more publicized and studied more rigorously, vegetable and animal oils are still considered to be safe used as remedies for a number of conditions and traditional practices. That is simply not true and the evidence supports this fact.

Mineral oil like any other oil needs to be used with safety in mind. The fact is that any oil can be aspirated or taken into the lungs, by those with an impaired or temporarily impaired swallow response. Giving an oil by mouth, or by other methods to the very young, or the use of one by older individuals, the two most vulnerable categories for such a response can have serious medical consequences. However, the causes of lipoid pneumonia are not restricted to taking oils by mouth directly, or the other methods described in the links above.

Lipoid pneumonia caused by silicone injection for cosmetic enhancement: 2006

Lipoid pnemonia caused by silicon injection to the breast: 2010

Surprising Research On The Topical Use of Cosmetic Mineral Oil Versus Vegetable Oils

I will be adding to this post.

This research article, dated 2012 is an easy read, very well referenced and contains some surprising to me, information. Aside from vegetable oils feeding yeasts, See this blog post, their degradation once on skin can be a potentially serious issue. This information makes cosmetic mineral oil use for hair and skin even more of a better choice and again, its moisturization properties are highlighted.

While the thrust of the article concerns infants, there is information that olive oil for example can and has been reported to cause contact dermatitis. I am constantly reading about and hearing from people with scalp issues. The causes of some of those problems may in fact be the results of products used, they may not have connected to the problems. For any dandruff or suspected dandruff or other scalp conditions that cause severe symptoms, like extreme itching or worse, consulting a doctor or dermatologist is best. I do not give advice when medical intervention is required, except to recommend that if you are unhappy with your doctor or dermatologist, seek another medically qualified opinion. I like the fact that a number of the article reference abstracts are linked and can be easily viewed.

Highlights From The Above Linked Research Article Text
"Not all vegetable oils are appropriate for use on skin [118]. Vegetable oils can vary in composition ... the ratio of linoleic to oleic acid. Some vegetable oils, including certain olive, soybean, and mustard oils, can be detrimental to the integrity of the skin barrier [119]. Some unsaturated free fatty acids can act as permeation enhancers [120], an effect that may cause contact dermatitis in adults [121–124]. 

In addition, many vegetable oils are unstable and degrade by hydrolysis and oxidation. Degradation can increase the likelihood of microbial growth and spoilage, especially in hot, humid environments. Cutaneous Propionibacterium acnes and Propionibacterium granulosum secrete lipases, enzymes that hydrolyze sebum triglycerides to free fatty acids [125]. By extension, Propionibacterium acnes, Propionibacterium granulosum, and possibly other cutaneous bacteria may hydrolyze vegetable oils present in topicals into free fatty acids, accelerating the degradation of vegetable oils on the skin surface. ... 

Emollients that contain inert, stable ingredients such as mineral oil are preferable for use on the maturing infant skin. Mineral oil, a semiocclusive ingredient that penetrates the upper layers of the SC [126] ... is noncomedogenic [127], has a long record of safe use [128] ... unlikely to go rancid even in hot, humid climates. Mineral oil helps to enhance the skin barrier as shown by a reduction in TEWL following topical application of the oil [126]."

Properly preserved cosmetics are crucial to skin and scalp health.
"Several studies have found very high concentrations ... of microbial contaminants in consumer products that are poorly preserved or preservative-free [135, 136]."  

"Eczema (Atopic Dermatitis)Treatment Skin Care at Home", 2016, bolding added by me, @NIAIDNews
http://www.niaid.nih.gov/topics/eczema/Pages/treatment.aspx
"Lubricate or moisturize the skin two to three times a day using ointments such as petroleum jelly. Moisturizers should be free of alcohol, scents, dyes, fragrances, and other skin-irritating chemicals. A humidifier in the home also can help."  

"Patient information: Atopic dermatitis (eczema) (Beyond the Basics)"
Keep the skin hydrated", 2016, bolding added by me
https://shar.es/129nJY via @sharethis   

"best emollients ... for atopic dermatitis ... Eucerin, Cetaphil ... Nutraderm or ointments ... petroleum jelly, Aquaphor, and Vaseline"

"Systematic review ... What are the effects of different models of delivery for improving maternal and infant health outcomes for poor people in urban areas in low income and lower middle income countries?", 2012 color and bolding added by me
http://r4d.dfid.gov.uk/PDF/Outputs/SystematicReviews/Health_outcomes_2012Coast_report.pdf 
"the use of sunflower seed oil (albeit not as effective as Aquaphor) is likely to be more sustainable as treatments costs are at a level that is much more affordable to people in Bangladesh paying out of pocket for medicine – $1.55 per month compared with $29 per month for Aquaphor (the average monthly salary is $39). There is a strong case, however, for public funding of Aquaphor, given the highly favourable cost-effectiveness ratio." 

Further reading on infant mortality rates and the use of Aquaphor and sunflower seed oil: Aquaphor use resulted in a lower infant mortality rate.

World Health Organization International Bulletin 2010, bolding added by me 
"The 26% reduction in mortality with SSO ... translated to 19 deaths averted per 100 neonates" SSO is "sunflower seed oil" ... "Aquaphor reduced mortality by 32% ... 23 deaths averted ... per 100 neonates"

See Also 
“Vegetable Oils and Animal Fats | Emergency Response | US EPA", 2016, @EPA
http://www2.epa.gov/emergency-resp
"Like petroleum oils, vegetable oils and animal fats and their constituents can:
Cause devastating physical effects, such as coating animals and plants with oil and suffocating them by oxygen depletion; Be toxic and form toxic products; ... Form products that linger in the environment for many years." 

And this blog post

Mineral Oil And Dandruff Update 2012

I wrote about mineral oil (cosmetic or USP/BP) being recommended for cradle cap previously. Now there may be another reason to use it, to not exacerbate dandruff. The same way mineral oil does not support bacterial growth and go rancid, it cannot feed the yeasts that cause dandruff, like vegetable and other organic oils are able to do.

This research article that made the news in August of this year, makes sense to me.

Using a dandruff shampoo or treatment and then oiling the hair from root to tip with a vegetable oil to deep condition it, or as an addition after conditioning may also be counterproductive, given this evidence. The same would apply to using any products containing vegetable oils to condition or style hair, while such dandruff or other scalp problems are present. It is about the saturated and unsaturated fatty acids in the oils.

Update in reply to recent blog emails: Any oil that is overused, lightweight or otherwise, can make hair greasy, in spite of marketing claims to the contrary. Mineral oil is harder to overuse than vegetable oils because it spreads so easily and usually does not need reapplication between washes. Mineral oil can need reapplication to make up the difference if enough has not been used the first time (on areas of hair that have been missed). It has proven superior longer lasting moisturizing effectiveness, compared to silicone and vegetable oils. I added a reference regarding this topic, specific to vegetable oils.

Using a product as often as every day on hair between washes to keep it moisturized and oiling, accelerates build-up on the hair and that is counterproductive to hair being moisturized. Using a drying oil on its own that frequently, creates build-up that usually requires clarifying out of the hair.

References

http://www.akamaiuniversity.us/PJST10_2_927.pdf

http://www.cossma.com/fileadmin/all/cossma/Archiv/SciencArtic/COS1202_26_ScientHauserOil.pdf
See Also

http://ktanihairsense.blogspot.ca/2011/12/understanding-drying-capacity-of-oils.html