hair growth and disorders || natural products for hair care and treatment

Chapter

26Natural Products for Hair Care and TreatmentWilma F. Bergfeld, F. Alan Andersen

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Contents

26.1 Natural Products for Hair Care and Treatment . . . . . . . . . . . . . . . . . . . . . . . 516

26.2 Important Natural Ingredients that Possibly Promote Hair Growth . . . . . 518

26.2.1 Hair Promoters . . . . . . . . . . . . . . . . . . . . . . 51826.2.1.1 Asiasari . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51826.2.1.2 Proanthocyanidins . . . . . . . . . . . . . . . . . . . 51826.2.1.3 Ginkgo Biloba . . . . . . . . . . . . . . . . . . . . . . . 51826.2.1.4 Aloe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51826.2.1.5 Proteins . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51926.2.1.6 Bergamot . . . . . . . . . . . . . . . . . . . . . . . . . . 51926.2.1.7 Chinese Herb . . . . . . . . . . . . . . . . . . . . . . . 51926.2.1.8 Ginseng . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51926.2.1.9 Henna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51926.2.1.10 Hibiscus Extract . . . . . . . . . . . . . . . . . . . . . 51926.2.1.11 Hydrangea . . . . . . . . . . . . . . . . . . . . . . . . . . 51926.2.1.12 Illicium . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52026.2.1.13 Sorphora . . . . . . . . . . . . . . . . . . . . . . . . . . . 52026.3 Natural Hair Growth Promoters

with DHT Inhibitory Activity . . . . . . . . . 52026.3.1 Natural Fatty Acids with DHT Inhibition 52026.3.2 Saw Palmetto . . . . . . . . . . . . . . . . . . . . . . . . 520

26.4 Natural Ingredients that Retard Hair Growth . . . . . . . . . . . . . . . . . . . . . . . . 520

26.5 Natural Hair Conditioning – Repair of Damaged Hair . . . . . . . . . . . . . . 520

26.5.1 Oligosaccharides . . . . . . . . . . . . . . . . . . . . 52126.6 Natural Hair Color . . . . . . . . . . . . . . . . . . . 52126.6.1 Henna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52126.7 Natural Ingredients for the Treatment

of Seborrheic Dermatitis . . . . . . . . . . . . . 52126.7.1 Sage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52126.7.2 Rosemary . . . . . . . . . . . . . . . . . . . . . . . . . . . 52126.7.3 Thyme . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52226.7.4 Garlic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52226.7.5 Walnut . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52226.7.6 Tea Tree Oil . . . . . . . . . . . . . . . . . . . . . . . . . 52226.8 Natural Ingredients for the Treatment

of Lice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52226.9 Contact Dermatitis . . . . . . . . . . . . . . . . . . . 522

Summary for the Clinician . . . . . . . . . . . . 523

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 523

Synonyms 6phytotherapy

Key Features

• There has been an explosion in the use of natural products for hair care and treatment.

• An efficient follicular delivery system is key to en-hancing the effectiveness of these natural products.

• The industry is challenged to chemically character-ize natural constituents, understand their bioactiv-ity, and thereby assure safe and effective use.

26.1 Natural Products for Hair Care and Treatment

Natural products have become popular for the treat-ment of many ailments, and for boosting the immune system. They have also been incorporated into cosmet-ics and hair care products because of their beneficial ef-fects and as a source of chemical ingredients for specific functions. The consumer public’s interest is growing, reflected by their increased purchasing of natural prod-ucts and the explosive growth of the industry.

Some perspective on this explosion may be helpful. A good source of information on what ingredients are used is the International Cosmetic Ingredient Diction-ary and Handbook [16]. This four-volume set represents 33 years of continued effort to establish and maintain a nomenclature system for ingredients used in cosmetics. The various chemical classes of ingredients used in cos-metics are listed in Table 26.1.

Other functional cosmetic ingredients that may be used in hair care products include antidandruff agents, antistatic ingredients, fragrances, emulsion stabiliz-ers, preservatives, surfactants, and viscosity controlling agents.

Another way of looking at the explosion of products is to consider how many ingredients are used in the various product categories [16] and how many products are in each category as reported to the Food and Drug Administration [14] (Table 26.2).

The natural-based products are interpreted by the public as being safer than synthetic products. Pharma-ceutical, clinical and internet publications claim that there is an expansion of natural product uses clinically, but there are limited in vitro and in vivo studies and fewer human studies. In addition, there are no large multicenter clinical studies of the efficacy of these bio-active ingredients [43, 44, 45].

The safety of such natural chemical ingredients is un-der government regulation in most countries.

In the United States, products for hair care and treat-ment are regulated by the Food and Drug Administra-tion (FDA) under the authority of the Food, Drug and Cosmetic Act (FD&C Act) enacted in 1938 (Note: the original authority, the 1906 Pure Food and Drug Act, did not include any authority to address cosmetics.) Products claiming a medical benefit (e.g., antidandruff) are considered as drugs according to the FD&C Act and may be regulated as over-the-counter drugs or as pre-scription drugs. When a product is considered a drug, then both safety and effectiveness must be demonstrated. Products asserting improvements in appearance are generally considered cosmetics. The law requires simply that manufacturers should have data demonstrating the safety of ingredients used in cosmetics.

More specifically, the law states that a cosmetic prod-uct refers to any substance or preparation intended for application to any external surface of the human body or to the teeth or buccal mucosa, wholly for the purpose of cleaning, perfuming or protecting them, or keeping them in good condition or changing their appearance or combating body odor or perspiration except where such cleaning, perfuming, protecting, keeping, chang-ing or combating is wholly for the purpose of treating or preventing disease.

In the book A Century of Consumer Protection, for-mer FDA Chief Counsel Tom Scarlett wrote a chapter on cosmetics regulation [36] entitled “The least of FDA’s problems.” In his discussion he makes the point that, “unlike drugs and medical devices, whose therapeutic effectiveness is important to health, cosmetics have a less vital role...yet another factor is that cosmetics, un-like drugs, can be made to achieve their desired results through the use of safe ingredients...a product with more ambition than a cosmetic would require more po-tent ingredients that could have adverse effects.”

While the above asserts that cosmetics can be made with safe ingredients, it remains a wise course of action to review the data supporting that an ingredient is safe. In the United States, the Cosmetic Fragrance Toiletry Association, with the support of the FDA and the Con-sumer Federation of America, has backed a successful 30-year voluntary safety program, Cosmetic Ingredi-ent Review (CIR), which has reviewed and published in peer-reviewed journals on the safety of ingredients used in cosmetic products. The major accomplishment of the CIR has been its impact on the cosmetic industry, which strives to follow CIR’s conclusions, with the result

Table 26.1 Chemical classes of ingredients used in cosmetics

Type of cosmetic Number of ingredients

Hair colorants 293 individual ingredients

2 natural, including henna

Hair conditioning agents

1970 individual ingredients

136 natural, including ginkgo biloba

Hair fixatives 240 individual ingredients

4 natural, including rice bran extract

Hair waving/straightening agents

47 individual ingredients

6 natural, including orchid extract

516 Wilma F. Bergfeld, F. Alan Andersen

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that cosmetic products of enhanced safety are available to the consumer.

Since this discussion is focused on natural products, a word of caution based on the CIR’s experience is war-ranted. A major concern of this panel has been the lack of chemical characterization of the plant parts used, the method of extraction, the presence of contaminants, and the documentation of ingredients’ biological activ-ity on skin and hair [8].

Phytotherapy (natural) refers to novel bioactive in-gredients derived from plants. Popular ingredients in-clude Chinese herbs, vitamins, minerals, antioxidants, enzymes, hormones, and a multitude of “naturals.” Plant extracts are often poorly chemically defined because they are so complex and each part of the plant, i.e., stems, seed, flower, and fruit, contains numerous com-plex chemicals. Other factors adding to the complex-

ity of the chemical ingredients include the geographic area in which they are grown, the quality of the soil and the inherent pesticides and metals within that soil (contaminants) [47], the quality of plant collection and storage processes, and impurities related to the extrac-tion process. The natural products usually contain nu-merous chemical ingredients, such as the active ingre-dients, antioxidants, vehicles, pH adjusters, stabilizing ingredients, preservatives, fragrances, and other ingre-dients, e.g., nutrients and plant enzymes. Adding to the dilemma of chemical characterization is that it differs according to the part of the plant as well as the species. Even natural antimicrobial activity can be derived from natural ingredients and used in a cosmetic product for stabilization or as a preservative. The plant extracts differ from synthetic purified chemicals in that they are more complex mixtures of chemical ingredients. The actual

Table 26.2 Ingredients used in cosmetics

Cosmetic product category

Number of ingredients

Baby shampoos 189 individual ingredients/29 individual products

18 natural ingredients

Bleaches 108 individual ingredients/120 individual products


Color sprays 22 individual ingredients/5 individual products


Dyes and colors 598 individual ingredients/1690 individual products


Conditioners 660 individual ingredients/651 individual products


Rinses 148 individual ingredients/62 individual products


Adult shampoos 727 individual ingredients/916 individual products


Permanent waves 351 individual ingredients/260 individual products


Straighteners 108 individual ingredients/63 individual products


Hair tonics 522 individual ingredients/598 individual products


Natural Products for Hair Care and Treatment Chapter 26 517

natural hair care products contain a mixture of plant, animal, and synthetic chemicals, and share a common purpose with the regular (synthetic) hair care products.

There is continuing investigation of bioactive ingre-dients that can rejuvenate skin and hair, and promote hair growth. This chapter gives an overview of the in-gredients used in natural hair care products and their potential use.

The natural chemical ingredients are appropriately incorporated into many skin and hair care products, e.g., shampoos, conditioners, hair styling products, hair colorants, permanents and relaxers, hair promoters, and antiparasitic therapies, according to the function re-quired. Indeed, natural chemicals do provide many of these functions; for example, antioxidants, proteins, sac-charides, glycerides, acids, alcohols, saponins, alkaloids, antimicrobials, nutrients, vitamins, essential oils, sterols, flavonoids, and enzymes. The natural plant ingredients are also of therapeutic benefit in hair conditioning, hair growth stimulation, hair colorants, for scalp dermatitis such as seborrheic dermatitis and as antiparasitic and antimicrobial agents.

26.2 Important Natural Ingredients that Possibly Promote Hair Growth

There are many hair growth stimulants patented for use in hair growth or hair tonic products for the treatment and prevention of alopecia. It remains unclear how these products produce their effects, but claims suggest that hair growth is secondary to the acceleration of blood flow, activation of the anagen dermal papillae, dihy-drotestosterone inhibition, anti-inflammatory activity, and increased nutrition.

Many natural hair care and hair growth promoter products include a multitude of vitamins, antioxidants, amino acids, proteins, and fatty acids, specifically vita-min E, vitamin C, vitamin A, niacin, flavonoids, amino acids, fatty acids, and polyphenols.

26.2.1 Hair Promoters

26.2.1.1 Asiasari

An extract of Asiasari radix showed the potential for hair growth stimulation with increased protein uptake in a mouse study, and an in vitro study of human fol-licles revealed the expression of vascular endothelial growth factor (VEGF) in human dermal papillae. These results suggest the hair-promoting potential of Asiasari extracts [33]. This ingredient is not currently listed as

a cosmetic ingredient [16], and no cosmetic uses have been reported to the FDA [14].

26.2.1.2 Proanthocyanidins

Proanthocyanidins are extracted from grape seeds. In vitro, they have been shown to promote hair follicle cells and convert the telogen follicle to an anagen fol-licle [40]. The mechanism of action may be inhibition of the transforming growth factor TGF-beta1 [21]. The nomenclature of the grape seed extract used in cosmetic products is Vitis Vinifera (Grape) Seed Extract [16] and that is the name that should appear on the ingredients list in a cosmetic product. Two uses of grape seed ex-tract were reported to the FDA, neither in a hair care product [14].

26.2.1.3 Ginkgo Biloba

Ginkgo biloba leaf extract in an in vitro study promoted hair growth through effects on proliferation and inhibi-tion of apoptosis of follicular cells [23]. Ginkgo Biloba Leaf Extract is the nomenclature for this ingredient in cosmetics [16]. It is reportedly used in five cosmetic products, including three hair care products [14].

26.2.1.4 Aloe

Aloe vera L or Aloe barbadensis gel has been used tradi-tionally for the treatment of alopecia, with improvement [17]. Aloenin is the major ingredient [20]. The CIR pro-gram [12] completed a safety assessment of cosmetic in-gredients derived from the aloe plant. These ingredients function primarily as skin conditioning agents and are included in cosmetics only at low concentrations. The aloe leaf consists of pericyclic cells, found just below the plant’s skin, and the inner central area of the leaf, i.e., the gel, which is used for cosmetic products. The pericyclic cells produce bitter yellow latex containing a number of anthraquinones, phototoxic compounds which are also gastrointestinal irritants responsible for cathartic effects. The CIR concluded that anthraquinone levels in the several Aloe barbadensis/Aloe vera extracts available are well understood and can conform to the industry-established level of 50 ppm. Insufficient data were available to assess the safety of extracts from other aloe species.

The CIR also advised the industry that the total polychlorinated biphenyl (PCB)/pesticide contamina-tion of any plant-derived cosmetic ingredient should be limited.


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26.2.1.5 Proteins

Cysteine enhanced hair growth in a mouse screening study to evaluate the hair-growth-promoting effects of plant extracts. The extracts were painted on the backs of mice for 30–45 days and protein synthesis was measured using the cysteine uptake assay, using cultured murine vibrissae follicles. In addition, the immortalized human keratinocyte line and dermal papillae were evaluated us-ing thymidine incorporation assays. With this method several growth factors involved in hair growth were seen to increase [33]. Cysteine is listed as a cosmetic ingredi-ent [16] with functions that include hair conditioning and hair waving/straightening. Nine uses of cysteine are reported in cosmetics, eight of which are in hair care products [14].

26.2.1.6 Bergamot

In another mice study, bergamot and boxthorn applied topically increased the cutaneous activity of superoxide dismutase, collagen, and decreased malondialdehyde with an observable increase hair growth [38]. Citrus Au-rantium Bergamia (Bergamot) Fruit Oil and Leaf Oil are both listed as cosmetic ingredients [16], with the Fruit Oil functioning in cosmetics as a fragrance and the Leaf Oil as an astringent. Bergamot oil is reportedly used in 51 cosmetic products, two of which are hair care prod-ucts [14].

26.2.1.7 Chinese Herb

In a 6-month randomized, double-blind trial in 396 males with androgenetic alopecia the Chinese herb extract “Dabao” was applied topically and resulted in modest hair growth as compared to the placebo (42% compared to 37%) [22]. This ingredient is not currently listed as a cosmetic ingredient [16], and no cosmetic uses have been reported to the FDA [14].

26.2.1.8 Ginseng

Ginseng radix in the form of a 70% extract of red gin-seng (steamed and dried roots of Panax ginseng C.A. Meyer, a type of Ginseng Radix) showed the potential to promote hair growth on cultured mouse vibrissal hair follicles. The major extract [gensenoside-Rb (1) or G-Rb (1)] exhibited activity while other extracts are ineffective [24]. Panax Ginseng Root Extract is a cosmetic ingredient [16] that functions as a skin con-ditioning agent. Ginseng extract is reportedly used

in 344 cosmetic products, 118 of which are hair care products [14].

26.2.1.9 Henna

Henna or Lawsonia alba L. (Lythraceae) has been rec-ognized and used as a hair promoter since Egyptian times. Henna has mild anti-inflammatory activity and analgesic effects. Henna is listed as a cosmetic ingredi-ent [16] with the function of a colorant/hair colorant. There are 29 uses reported, 25 of which are in hair care products [14].

Henna use is also widespread in tattooing and while this falls outside the scope of this chapter, a note of caution is appropriate. In 2004, the CIR reaffirmed the safety of p-phenylenediamine as a hair dye ingredient; CIR did agree with FDA that other uses of this dye are unapproved. The CIR expressed particular concern over the practice of combining p-phenylenediamine with henna (so-called dark henna) for use in temporary tat-toos – p-phenylenediamine is a known sensitizer, highly inappropriate for such use as evidenced by reports of severe adverse skin reactions to dark henna temporary tattoos. The Panel urged users to report adverse reac-tions to the FDA (for more information, see http://www.cfsan.fda.gov/~dms/cos-tatt.html).

26.2.1.10 Hibiscus Extract

In vivo and in vitro studies evaluated petrolatum ether extracts of the leaves and flowers of Hibiscus rosa-sin-ensis for its potential to stimulate hair growth. Topical preparations were applied to the backs of albino rats and to cell cultures of hair follicles from albino rat neonates. From the study it was determined that, compared to the flower, the leaf extract was a more potent hair promoter [2]. Hibiscus-derived extracts (from several species) are listed as cosmetic ingredients [16] with a variety of func-tions ranging from colorant to skin conditioning agent; there is one mention of its use as a lytic agent. There are 34 uses in cosmetic products reported, 27 of which are in hair care products [14].

26.2.1.11 Hydrangea

Hydrangea macrophylla extract promotes hair growth through the suppression of TGF-beta, which delays the catagen cycle. The mechanism may be accounted for by the fact that TGF-beta is activated by caspase in the lower portion of the follicle and the outer layer of the outer root sheath. This mouse study suggests that TGF-


beta suppression could be used to treat alopecia [46]. Hydrangea-derived extracts (from several species) are listed as cosmetic ingredients [16] whose primary func-tions are skin conditioning agents. There are no reported uses in cosmetic products [14].

26.2.1.12 Illicium

Illicium anisatum has been shown to increase blood flow in a mouse model. In an in vitro study of mouse vibris-sae follicles, a water-soluble extract of Illicium anisatum leaves, fruits, and roots (shikimic acid and glycosides, and polysaccharides) produced better growth than con-trols. Similar acetone extracts inhibited the growth of hair follicles. Shikimic acid induced insulin growth fac-tor-1, keratinocyte growth factor, and VEGF in the hair follicle. The results of this study suggest that Illicium an-isatum water extract could be a useful additive to hair growth products [34]. Illicium Verum (Anise) Fruit Extract, Fruit Powder, and Oil are all listed as cosmetic ingredients, but there are no listings for extracts of Illi-cium anisatum as a cosmetic ingredient [16]. Eight uses of anise are reported in cosmetics, none of which are in hair care products [14].

26.2.1.13 Sorphora

In a mouse study, the topical application of an extract of Sophora flavescens dried root induced increases in growth factors such as insulin-like growth factor-1 (IGF-1) and keratinocyte growth factor (KGF) in dermal papillae cells and inhibited type II, 5-alpha-reductase activity. This result suggests that sorphora has potential as a natural hair growth promoter [32]. Sophora Fla-vescens Root Powder is listed as a cosmetic ingredient [16] with functions ranging from abrasive to fragrance to skin protectant. No uses in cosmetics are reported [14], although derivatives from Sophora angustifolia and Sophora japonica are currently used in cosmetics.

26.3 Natural Hair Growth Promoters with DHT Inhibitory Activity

Some of the over-the-counter botanical (natural) hair promoters incorporate minoxidil as an active ingredient. An internet search reveals that many of these products are available, such as Nioxin® Intensive Therapy Follicle Booster, and Scalp Med® Vitadil-5Aand Vitadil-2A.

The majority of plant DHT inhibitors contain saw palmetto, liposterolic extract of Serenoa repens and

beta-sitosterol, azelaic acid, zinc, B6, linoleic acid, and polyphenols. Some of these available internet products are Avacor®, ProCede®, Provillus® and Rivivogen®.

26.3.1 Natural Fatty Acids with DHT Inhibition

A number of natural ingredients have some antiandro-gen activity, primarily inhibition of 5-alpha-reductase. The active ingredients include fatty acids, for example gamma-linolenic, linoleic, palmitic, elaidic, oleic, and stearic acids. In a mouse study, an acetone extract of Boehmeria nipononivea exhibited 5-alpha-reductase in-hibition and a hair growth effect [39]. The CIR has com-pleted a review of the safety of fatty acids (oleic, lauric, palmitic, myristic, and stearic) as used in cosmetic prod-ucts [13], with the conclusion that these ingredients are safe to include in cosmetics under present practices of use and concentration. That conclusion was reaffirmed in 2005 [4].

26.3.2 Saw Palmetto

In a double-blind clinical trial, six out of ten patients with androgenetic alopecia improved when treated with Saw palmetto, a liposterolic extract of Serenoa repens, and beta-sitosterol [30].

26.4 Natural Ingredients that Retard Hair Growth

Soymilk reduces hair growth and reduces hair fiber di-ameter. Soybean trypsin inhibitor (STI) and Bowman-Birk protease inhibitor (BBI) are two serine protease in-hibitors isolated from soybeans; BBI inhibits trypsin and chymotrypsin. These inhibitors reduced hair growth, hair diameter, and pigmentation in a mouse model and in human studies [37].

26.5 Natural Hair Conditioning – Repair of Damaged Hair

Sage is known as a healing herb. There are over 500 spe-cies of Salvia from which sage is extracted. The type of sage used for cooking and skin and hair care is Salvia officinalis L. It is known as common sage, true sage or garden sage. It is used as a hair conditioner and is noted to enhance hair’s appearance. The major ingredients of


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sage extract are tannins, saponins, borneol, and cam-phor [9].

26.5.1 Oligosaccharides

Cotton honeydew extract is composed of a combination of oligosaccharides such as fructose, glucose, l-inositol, melezitose, saccharose, trehalose and trehalulose. These ingredients are protective of the hair fiber, by smooth-ing the cuticle scales. In controlled studies cotton 1% honeydew was superior to placebo [27].

In comparison studies, coconut oil is superior to mineral oil and sunflower oil in reducing protein loss from hair. Coconut oil is composed of triglyceride (lau-ric acid, a fatty acid) that has an affinity for hair pro-teins. Because of its low molecular weight and straight linear chain, it is able to penetrate the hair. In contrast, mineral oil, a hydrocarbon, has no affinity for hair while sunflower oil, a triglyceride (linoleic acid), is double bonded and does not penetrate the hair [31].

The essential oils from plants impart a pleasant aroma, shine, and conditioning effects, emolliency and they also improve the elasticity of skin [1].

26.6 Natural Hair Color

26.6.1 Henna

Henna or Lawsonia alba L. (Lythraceae) has been recog-nized and used as a hair promoter since Egyptian times. Henna has mild anti-inflammatory activity and analge-sic effects [3, 48].

Vegetable dyes are natural colors that basically coat the hair fiber with minimal penetration and are con-sidered to be non-oxidizing dyes. These hair dyes have been used for centuries. In the past there were problems with the stability of natural hair dyes, which easily oxi-dize causing the color to fade. This has been remedied with the addition of some synthetic stabilizers. The pri-mary vegetable dyes are henna and walnut. The differ-ent shades of color are achieved by adding other plant leaves.

The henna dye (lawsone) is obtained from the leaves of Lawsonia inermis and imparts a reddish color. The dye binds strongly to the hair, probably due to the bind-ing of thiol groups to keratin [3]. The variations of color are achieved by adding the dyes from other plants as well. Onion (Allium cepa) imparts a copper color; api-genin, a flavonoid from many plants (chamomile flow-ers), imparts a yellow color; curcumin, from the spice turmeric, gives a range of color from yellow to deep or-

ange [11, 42]; red sorrel, Hibiscus sabdariffa, gives a red color. These dyes [26] and the henna dyes [15] have low allergic potential.

26.7 Natural Ingredients for the Treatment of Seborrheic Dermatitis

Seborrheic dermatitis is an inflammatory disorder which presents as erythematous and scaling dermatitis of seborrheic areas, including the scalp, mid-face trunk and intertriginous areas. It commonly has associated superficial folliculitis with a yellow greasy scale or only erythema and fine scaling. A Wood’s light examination (blue UVA light) will identify colonization of Pityspo-rium organisms, which fluoresce orange under the light due to porphyrins from the organism. This disorder is commonly treated with antidandruff shampoos, which are obtainable as an over-the-counter item or as a pre-scription drug. Important synthetic ingredients are zinc pyrithione, ketoconazole, imidazoles, ciclopirox olamine, and low potency corticosteroids, selenium sul-phide, and tar. These ingredients have several, e.g., anti-inflammatory, antifungal, and exfoliative, activities [1].

Effective phytotherapeutic agents include extracts of sage, rosemary, thyme, garlic, and walnut.

26.7.1 Sage

Sage (Salvia officinalis L.) is an old favorite, and the ex-tract is massaged into the scalp to control dandruff and to treat alopecia. Sage contains vitamins A, C, and B-complex, and high amounts of calcium and potassium. Salvia Officinalis (Sage) Extract, Flower/Leaf/Stem Ex-tract, and Leaf Extract are listed as cosmetic ingredients [16] with functions as fragrances, skin conditioning agents, and oral care agents. There are 139 uses in cos-metic products reported, 70 of which are in hair care products [14].

26.7.2 Rosemary

Rosemary (Rosmarinus officinalis) is used as a tonic or rinse to remove oil (seborrhea), and to add volume and shine to the hair. Rosmarinus Officinalis (Rosemary) Extract, Flower Extract, Flower/Leaf/Stem Extract, and Leaf Extract are listed as cosmetic ingredients [16], with functions that include antioxidant, deodorant, skin con-ditioning agent, fragrance, and antimicrobial. There are 339 uses in cosmetic products reported, 166 of which are hair care products [14].


26.7.3 Thyme

Thyme (Thymus vulgaris L.) is also used to treat dan-druff and as a hair growth promoter. It is again used in rinses and tonics and frequently mixed with sage and rosemary. Thymus Vulgaris (Thyme) Flower/Leaf Ex-tract and Leaf Extract are listed as cosmetic ingredients [16] with functions that include fragrance, skin condi-tioning agent, and skin protectant. There are 27 uses in cosmetic products reported, 14 of which are hair care products [14].

26.7.4 Garlic

Garlic (Allium sativum L. Liliaceae) has been used for centuries for its antiseptic, antioxidant, anti-inflamma-tory [7], antibacterial, and antifungal effects [6]. When garlic is placed directly on the skin it induces an irritant reaction and occasionally a contact allergy. It is diluted in hair products as a lotion, which is applied to the scalp to reduce seborrheic dermatitis. Allium Sativum (Gar-lic) Bulb Extract and Oil are listed as cosmetic ingre-dients [16] with functions as skin conditioning agents, flavorings, and fragrances.

There are 13 uses in cosmetic products, with 10 of those in hair care products [14].

26.7.5 Walnut

Walnut (Juglans regia L. Juglandaceae) leaves have been used to treat skin rashes, acne, alopecia, scalp derma-titis, and seborrheic dermatitis. In an emollient it has been used for its antipruritic action and as a protective barrier. Black walnut (Juglans nigra) is used primarily for seborrheic dermatitis [10]. Juglans Regia (Walnut) Leaf Extract is listed as a cosmetic ingredient [16] with fragrance and skin conditioning functions. There are ten reported uses, all in hair care products [14].

26.7.6 Tea Tree Oil

Tea tree oil (melaleuca oil) is an essential oil extracted primarily from the leaves of Melaleuca alternifolia, a scrub-like tree in Australia. It is composed of mixture of hydrocarbons and terpenes, consisting of almost 100 ingredients. It has antimicrobial activity against Pitysporum ovale. In a double-blind study of patients with seborrheic dermatitis, 5% tea tree oil shampoo was as equally effective as ketoconazole shampoo. A recent report by Henley et al. [18] linked prepubertal gyneco-mastia in three boys to topical application of products

containing lavender and tea tree oils. Melaleuca Alterni-folia (Tea Tree) Leaf Oil is listed as a cosmetic ingredient [16] with antioxidant and fragrance functions. There are 52 uses reported in cosmetic products, 11 of which are in hair care products [14].

26.8 Natural Ingredients for the Treatment of Lice

The development of botanical lice-removal shampoo containing 0.05% paw paw, thymol, and tea tree oil effectively removed all lice and nits in a small study (n=21) [25]. These three ingredients inhibit adenosine triphosphate (ATP) production and lead to depletion of ATP stores, and ultimately they are anti-sarcoptic, anti-microbial, and antifungal.

Paw (Asimina triloba Dunal) has been shown to be effective against pesticide-resistant head lice. The active ingredients of paw are asimicin and trilobacin; thymol is the major component of the essential oil of Thymus vulgaris, whereas 1-terpinen-4-ol is the major active in-gredient in tea tree oil from Melaleuca alternifolia. All three of these chemical ingredients are antimicrobial, antifungal, and anti-sarcoptic agents that have been shown to be safe and effective; they are now available in one product, called Paw Paw Lice Remover shampoo, from Nature’s Sunshine Products (Rovo, Utah) [25, 35].

CIR’s safety assessment of thymol as a cosmetic in-gredient determined that it is safe for use in cosmetics at concentrations up to 0.5% [5]. Thymol is reportedly used in 14 cosmetic products, 3 of which are hair care products [14].

Custard apple from Annona squamosa Linn. is a tra-ditional folk medicine for lice. It is prepared as a 20% w/w oil in water cream and was found to be an effective ingredient that cleared >99% of lice in 3 h [41].

26.9 Contact Dermatitis

Botanical contact dermatitis is poorly documented but with the rising use of botanicals in skin and hair care products, more contact dermatitis, irritant or allergic, can be anticipated. Those botanicals used in hair care products that have been linked with contact dermatitis are: aloes, cucumber, rosemary, sage, and tea tree oil. Natural fragrances have caused contact dermatitis and because of growing indices the more common antigens have been added to patch test screening trays. The fra-grance mix contains jasmine absolute, ylang-ylang, nar-cissus absolute, sandalwood absolute, and spearmint oil.


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If a product is clinically suspected, whole products can be used in patch testing [28, 29].

Summary for the Clinician

Plant and animal sources of chemicals offer a wide range of possible active and basic chemical ingredi-ents that are needed to manufacture skin and hair cosmetics. The cosmetics industry is challenged to chemically characterize these plant and animal constituents, to remove the contaminants, and to understand these bioactive chemicals and find a safe use for them. The bioactive activities in der-matitis, hair growth, hair retardation, and coloring, and the phytotherapies for lice continue to be active areas of research. For the bioactive chemicals, an ef-ficient follicular delivery system is needed [19, 45] that would enhance their effects. The greatest need however is to create a safe product whose thera-peutic and cosmetic claims are founded on a good scientific basis.

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hair growth and disorders || natural products for hair care and treatment

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