Hair Aging
Author : Dr. Vrushali Rane Khan
While skin has often been considered a status symbol in most societies, the role of hair can’t be underestimated. Like an unkempt look reflects a state of mental confusion or even sadness, a change in hairstyle is often suggestive of a significant life event or to cope with it.
What is Aging? In 1991, the book Evolutionary Biology of Aging defined Aging as a persistent decline in the age-specific fitness components of an organism due to internal physiological deterioration. Gerontology is familiar to most of us as a term that captures the study of social, psychological, and biological aspects of aging. However, its derivative “gerontobiology” as applied to the hair follicle is more concerned with the latter aspect – the biology of aging in the hair follicle mini-organ.
There are some Intrinsic Protective Mechanisms of the Body to prevent/minimize oxidative Stress which are responsible for Hair Aging. They can be ENZYMATIC mechanisms such as Superoxide Dismutase, Catalase and Glutathione Peroxidase. The NON-ENZYMATIC / BIOCHEMICAL mechanism is through Vitamin C, Vitamin E, Glutathione and Ubiquinone.
Aging of Hair could be Intrinsic or Extrinsic aging.
Intrinsic / Chronological Aging – This is the chronological Aging of hair determined by genetic make-up, hormonal alterations and biochemical mechanisms.
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| Extrinsic Aging |
1. Ultraviolet Radiation
2. Smoking
3. Nutrition
4. Hair Cosmetics And Beauty Procedures
Hair aging comprises Hair Shaft aging and Aging of the Hair Follicle. The former involves weathering and photoaging of the hair shaft, while the latter manifests as decrease of melanocyte function (graying) and decrease in hair production (alopecia).
Hair Surface Aging
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| Hair Surface Changes |
It presents as reduction in the cuticular scale size,increased irregularity of cuticle, progressive abrasion to the cuticle from root to tip, loss of hair fiber lubrication/moisturization (especially in women) in the context of the “pilo-sebaceous unit” and decrease in mechanical resistance, esp wet resistance.
Hair surface aging is attributed to cystine disulfide (–SS–) content of the hair cortex, which decreases with age that further decreasesthe mechanicalresistance and progressive abrasion to the cuticle from root to tip.Additionally,reduction in ceramides and18-methyl eicosanoic acid and also in particular keratinassociatedprotein subfamilies (ultra-high sulfur proteins;high sulfur proteins; high glycine-tyrosine proteins also add to cuticular changes.
Hair Graying
Hair Graying is an enigmatic sign of aging indicating our steady decline and putative loss of power. In our vain society, even finding a new job or spouse may depend on a nicely coloured head.
Premature Graying is occurrence of Graying< 20 years in Caucasians and < 30 years in Africans.
Premature Graying could be because of autosomal dominant inheritance (familial premature graying), UV-exposure, Tobacco smoking andB 12 deficiency.
Androgenetic Alopecia / Alopecia due to Hair Aging:
The incidence of Alopecia inCaucasians is often quoted as approaching 100% moreso in the men than women.On the other hand, four times as many African-Americans retain a full head of hair than Caucasians. The reason for this racial variation is unclear, butis probably genetic because differences appear to be retained regardless of location.
Alopecia due to hair aging or Androgen mediated Alopecia is attributed to changes in the hair growth cycle causing shortening of anagen phase and increased proportion of telogen hairs. This in turn causesgradual transformation of terminal follicles that produce long, thick, pigmented hair, to smaller vellus follicles forming short, colourless, virtually invisible vellus hairs.
Ultraviolet Light and Aging
Similar to the aging of skin cause by Ultraviolet Light, it is also responsible for aging of Hair. It causes loss or hair protein, hair lipid and hair melanin changes. Additionally it causes hair anagen arrest and tellogen effluvium. Light hair is more sensitive to UV damage than dark hair except for melanin changes.
Protein loss is confined more to the cuticle than the cortex. There is oxidation at the peptide backbone carbon producing carbonyl and amide groups, which decreases the wet tensile properties of human hair. A protein,S100A3is responsible for the structural integrity to the hair. This is washed out from the cuticle after prolonged UV radiation or chemically treated hair.
Lipids confer hydrophobicity, stiffness and moisturisation to the hair.Loss of Lipid causes dryness, decreased luster, brittleness, increase in fiber porosity and loss of mechanical strength.
Premature graying is seen in UV exposed patients and is more commonly seen in dark haired patients than light haired.
UVB radiation in a bald scalp can stimulate carcinogenesis.
It is interesting to note that even Visible Light can cause Hair aging in the form of hair Lipid damage.
Tobacco and Hair Aging
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| Tobacco and Hair Aging |
The mechanism of hair aging caused by tobacco is not known exactly, but likely to be similar to the effects on the skin : constriction of cutaneous microvasculature causing reduction of vascular supply and reduced excretion of toxic substances.
Tobacco causes premature graying of hair and moderate or severe androgenetic alopecia which increases in a dose-response pattern.
Age Related General Problems affecting Hair
Old age is accompanied by a lot of deviations from the physiological state which may contribute to hair aging. Nutritional deficiency namely, Protein Energy Malnutrition, B 12, Niacin, Iron,Zinc,Copper, Selenium, Cysteine/Aminoacid deficiencies can manifest as Alopecia.
An important component of hair keratin is cysteine which constitutes 15.9% of the protein-keratin. It provides structural integrity to hair and also responsible for synthesis of glutathione which inturn prevents oxidative damage to hair. It also eliminates noxious effects of cigarette smoke.Nutritional supplementation of cysteine often shows a very good reversal of Alopecia.
Endocrinedisorders in oldagesuch as Menopause / Andropause which induce androgenetic alopecia and other disorders of Thyroid, Adrenal and pituitary can also cause Hair Loss.
Psychologicproblems, a common occurrence in the elderly,such as neurotic excoriations can also lead to alopecia.
Drug such asanticonvulsant agents, mainly valproic acid, antihypertensives such as ACE inhibitors, beta-blockers, Heparin, Warfarin, Androgens, Anabolics - Mesterolonem, Testosterone, Danazol, Nandrolone, Stanozolol, Norethisterone, Levonorgestrel, Tibolone, NSAIDS – Acetaminophen, Piroxicam, Ibuprofen, Indomethacin, AntiDepressants- Amitriptyline, Haloperidol, Desipramine, Imipramine, Doxepin can cause Tellogen Effluvium.
Treatment for Hair Graying
- Correction of Nutritional deficiencies
- Discontinuation of a offending drug
- Avoidance of Cigarette smoking
- Amino acids cysteine and L - methionine
- B-complex vitamins – especially B 12
- Calcium pantothenate 100 mg daily dose
- Hair colorants
Treatment for Hair Loss/ Androgenetic Alopecia
- Minoxidil
- Antiandrogens – Finasteride, Dutasteride
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| Care of Aging Hair |
- Minimise Manipulation of Hair – Avoidance of manipulation of hair by physical(ironing/curling) or chemical means(dyeing/coloring/perming/straightening) should be kept to a minimum. There is no such thing as a “body restoring permanent wave” or a “strengthening hair dye.” Hair spas should be avoided as their effect lasts only until the next wash but the trauma to hair is long lasting. Even activities such as repeated combing and tight braiding can traumatise the hair.
- While selecting a comb, use broadly spaced smooth toothed comb, preferably Teflon coated to reduce combing friction. Avoid reverse combing wet hairas it is more likely to fracture than dry hair. Gently detangle wet hair with fingers.
- Air dry wet Hair and avoid heat appliances such as hair dryer, curling iron, or heated curlers.
- Specifically avoid heat appliances on wet hair. When the hair is rapidly exposed to high temperatures, the water within the shaft turns to steam and exits the hair shaft by creating a loss of cuticular scale, known as “bubble hair”.
Bubble Hair - Avoid Scratching the Hair and Scalp. It is possible to remove all of cuticular scale from a hair shaft with only 45 min on continuous scratching with the fingernails. For this reason, it is important to treat itchy scalp conditions like dandruff and pediculosis(lice infestation)to preserve hair growth.
- Choosing the right shampoo - Sulfate free shampoo or atleast low sulfate shampoo will preserve the cuticular integrity.
- Using a conditioner reduces the static electricity between hair fibres and breakage. Detangling also improves manageability,imparts luster and mends split ends (temporarily).
- Hair Sunscreen - Traditional UVB sunscreen in instant conditioners, styling gels, and hair sprays are commercially available and hugely marketed but topical approach is suboptimal as it is practically difficult to cover all hair fibres. HATS ARE THE BEST OPTION !!
- There is a school of thought that promotes the use of semipermanenthairdyesthatwork as melaninsubstitutes. Some initial damage occurs to the hair fibers upon dyeing; however, as the hair is exposed to longer periods of UV radiation, the initial damaging effect is outweighed by the antioxidant effect of the color deposited on and in the hair shaft. White hair exhibits more UV-induced mechanical strength loss than semipermanently dyed hair.
Conclusion :
Hair Aging is a relatively new concept and often ignored by the academia. This is the reason why the common man reaches out to the local beautician before the dermatologist for hair care practices, most of which contribute to hair aging, as mentioned above. It is high time that we as dermatologists take active interest in Hair as much as Skin so as to impart practical and viable advice to the general public.