I have been asked many times about a report published by scientists at the Department of Dermatopathology, University of Liège in Belgium about work they carried out that shows that when certain anti-microbial substances, traditionally used to treat dandruff, are incorporated into a shampoo at elevated levels they have a significant effect in the prevention of male pattern hair loss.
This report is called: Nudging hair shedding by antidandruff shampoos.
A comparison of 1% ketoconazole, 1% piroctone olamine and 1% zinc pyrithione formulations
C. Piérard-Franchimont, V. Goffin, F. Henry, I. Uhoda, C. Braham, G. E. Piérard.
Department of Dermatopathology, University Medical Center Sart Tilman, B-4000 Liège Belgium.
International Journal of Cosmetic Science Volume 24, Issue 5, Page 249-256, Oct 2002.
The full report can be found on the website of the University of Liège Medical Centre, Department of Dermatopathology.
Below is the synopsis and conclusion from that study.
Hair shedding and hair thinning have been reported to be affected by dandruff and seborrhoeic dermatitis (a type of severe dandruff accompanied by inflammation which may encroach onto the facial skin). The present study was conducted in 150 men presenting with telogen effluvium (diffuse and general hair loss) related to androgenic alopecia associated with dandruff. They were randomly allocated to three groups receiving each one of the three shampoos in the market containing either 1% ketoconazole (KTZ), 1% piroctone olamine (PTO) or 1% zinc pyrithione (ZPT). Shampoos had to be used 2-3 times a week for 6 months. Hair shedding during shampoo was evaluated semiquantitatively (an approximation of the quantity). Hair density on the vertex (top of the head) was evaluated on photographs using a Dermaphot (a special camera lens with x10 magnification for photographing the skin) Trichograms (microscopic examination of epilated or fallen hair) were used for determining the anagen (the growing phase of the hair life cycle) hair percentage and the mean proximal hair shaft diameter using computerized image analysis. The sebum (the skin’s natural oil secreated from the sebaceous glands in the sides of the hair follicles) excretion rate (SER, g cm2 h1) was also measured using a Sebumeter©.
The three treatments cleared pruritus (itching) and dandruff rapidly. At end point, hair density was unchanged, although hair shedding was decreased (KTZ: -17.3%, PTO: -16.5%, ZPT: -10.1%) and the anagen hair percentage was increased (KTZ: 4.9%, PTO: 7.9%, ZPT: 6.8%). The effect on the mean hair shaft diameter was contrasted between the three groups of volunteers (KTZ: 5.4%, PTO: 7.7%, ZPT: -2.2%). In conclusion, telogen effluvium was controlled by KTZ, PTO and ZPT shampoos at 1% concentration. In addition, KTZ and PTO increased the mean hair shaft thickness while discretely decreasing the sebum output at the skin surface.
The present study comparing 1% KTZ,1% PTO and 1% ZPT shampoos has demonstrated that these products have some other benefits in addition to their reported antidandruff effect. The data show that these shampoos have a beneficial effect on the anagen/ telogen ratio (the proportion of hair follicles either in the hair producing phase of the hair life cycle or the resting, non-hair producing, phase) , by increasing the anagen hair percentage in subjects with dandruff. This results in a reduced hair shedding. In addition, the data show that 1% KTZ and 1% PTO, but not 1% ZPT, produce a beneficial effect on scalp seborrhoea (excess oiliness) and hair shaft diameter. The reason for such opposite effect is unknown. Finally, the data show that scalp seborrhoea is inversely correlated with hair thickness. The virtue of such a finding is its simplicity. However, the results cannot be taken at face value. There may remain debate whether reducing sebum excess on the scalp may lead to thicker hair, and whether increasing scalp seborrhoea may be accompanied by a reduction in the hair shaft diameter.
What does this really mean?
Taking into consideration the reduced number of hairs lost, the increased number of follicles in the growing phase of the hair cycle (anagen) and an increase in hair diameter, then the most effective of the substances tested was piroctone olamine. When it is incorporated into an appropriate shampoo base at 1% and used 2-3 times per week there is a reduction in hair loss by 16.5%, a 7.9% increase in the number of hair follicles in the hair producing phase, and an increase in hair diameter of 7.7%. Put together these results show a significant and meaningful improvement in the hair loss/hair growth ratio which should, in time, reflect in an improved appearance of the hair.
Another interesting finding from the study was the reduction in sebum secretion. This is important as sebum contains dihydrotestosterone (DHT), the hormone which causes male pattern hair loss. Elevated levels of DHT on the scalp are known to exacerbate hair loss when this is allowed to accumulate in the scalp tissues and possibly double-back down the hair follicles to the dermal papilla (the root of the hair). Limiting the quantity of DHT on the scalp by either washing the scalp frequently or reducing the quantity of secreted sebum is advantageous in reducing hair loss.
Juniper Mint Scalp Therapy Shampoo
Because of the findings of this study along with positive results from the subsequent use of shampoos containing 1% piroctone olamine in clinical practice, and because of many requests from people wanting to use this treatment, we have incorporated piroctone olamine in the Juniper Scalp Therapy Shampoo at 1% so allowing it to give similar results to those obtained in the University of Liège study.