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Int J Trichology. 2018 Nov-Dec;10(6):262-270. doi: 10.4103/ijt.ijt_57_18.

Scalp Condition Impacts Hair Growth and Retention via Oxidative Stress.

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Center for Dermatology and Hair Diseases, University of Zurich, Wallisellen, Switzerland.
The Procter and Gamble Company, Cincinnati, OH, USA.
Sharon Woods Innovation Center, Cincinnati, OH, USA.


Conventionally, the medical focus has been either on hair loss or the condition of the scalp in terms of specific dermatological diseases. Indeed, the proximate structural arrangement of the scalp and hair leads to an interdependent relationship between the two. While protective benefits of the hair to the scalp are obvious, the role of the scalp as an incubatory environment for the preemergent hair fiber has largely been ignored. In fact, there is a wealth of observational data on specific dermatological conditions of the scalp providing evidence for the role of the scalp condition in supporting the production of healthy hair. Oxidative stress, the inability of the body to sufficiently counteract the sources of oxidation, is prevalent in many skin conditions, including normal skin aging. On the scalp, the hair appears to be impacted prior to emergence, and oxidative stress appears to play a role in premature hair loss. The scalp commensal organism, Malassezia, has been recognized to be a source of oxidative damage. Therefore, hair care products, specifically shampoos, with active Malassezia inhibitory agents, such as zinc pyrithione, tend to reduce premature hair loss, besides the known benefits in treating specific dermatologic scalp pathologies, and therefore should represent an integral part of every treatment regimen for hair loss, even in individuals not showing symptoms of scalp pathologies.


Malassezia spp.; oxidative stress; premature hair loss; scalp pathologies; zinc pyrithione-based shampoo

Conflict of interest statement

R. M. Trüeb is an active member of the Healthy Hair and Scalp Alliance and in this function provides consulting activity for Procter and Gamble. J. R. Schwartz, M. G. Davis, and J. P. Henry are employees of Procter and Gamble. Parts of this article were orally presented by R. M. Trüeb on November 2nd 2017 on the occasion of the 10th World Congress of Hair Research Societies (WCHR) 2017 in Kyoto, Japan.

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