History

History

The use of both scalp flaps, in which a band of tissue with its original blood supply is shifted to the bald area, and free grafts dates back to the 19th century. Modern transplant techniques began in Japan in the 1930s^[1], where surgeons used small grafts, and even "follicular unit grafts" to replace damaged areas of eyebrows or lashes. They did not attempt to treat baldness per se. Their efforts did not receive worldwide attention at the time, and the traumas of World War II kept their advances isolated for another two decades.

The modern era of hair transplantation in the western world was ushered in the late 1950s, when New York dermatologist Norman Orentreich began to experiment with free donor grafts to balding areas in patients with male pattern baldness. Previously it had been thought that transplanted hair would thrive no more than the original hair at the "recipient" site. Dr. Orentreich demonstrated that such grafts were "donor dominant," as the new hairs grew and lasted just as they would have at their original home.^{[citation needed]}

Advancing the theory of donor dominance, Walter P. Unger, M.D. defined the parameters of the "Safe Donor Zone" from which the most permanent hair follicles could be extracted for hair transplantation.^[2] As transplanted hair will only grow in its new site for as long as it would have in its original one, these parameters continue to serve as the fundamental foundation for hair follicle harvesting, whether by strip method or FUE.

For the next twenty years, surgeons worked on transplanting smaller grafts, but results were only minimally successful, with 2–4 mm "plugs" leading to a doll's head-like appearance. In the 1980s, Uebel in Brazil popularized using large numbers of small grafts, while in the United States Rassman began using thousands of “micrografts” in a single session.^{[citation needed]}

In the late 1980s, Limmer introduced the use of the stereo-microscope to dissect a single donor strip into small micrografts.

The follicular unit hair transplant procedure has continued to evolve, becoming more refined and minimally invasive as the size of the graft incisions have become smaller. These smaller and less invasive incisions enable surgeons to place a larger number of follicular unit grafts into a given area. With the new "gold standard" of ultra refined follicular unit hair transplantation, over 50 grafts can be placed per square centimeter, when appropriate for the patient.^{[citation needed]}

Surgeons have also devoted more attention to the angle and orientation of the transplanted grafts. The adoption of the “lateral slit” technique in the early 2000s, enabled hair transplant surgeons to orient 2 to 4 hair follicular unit grafts so that they splay out across the scalp's surface. This enabled the transplanted hair to lie better on the scalp and provide better coverage to the bald areas. One disadvantage however, is that lateral incisions also tend to disrupt the scalp's vascularity more than sagitals. Thus sagital incisions transect less hairs and blood vessels assuming the cutting instruments are of the same size. One of the big advantages of sagitals is that they do a much better job of sliding in and around existing hairs to avoid follicle transection. This certainly makes a strong case for physicians who do not require shaving of the recipient area. The lateral incisions bisect existing hairs perpendicular (horizontal) like a T while sagital incisions run parallel (vertical) alongside and in between existing hairs. The use of perpendicular (lateral/coronal) slits versus parallel (sagital) slits, however, has been heavily debated in patient-based hair transplant communities. Many elite hair transplant surgeons typically adopt a combination of both methods based on what is best for the individual patient.^{[citation needed]}

With the latest improvements in surgical technique and especially with the FUE procedure, the recovery time is immediate and the pain negligible. There is no bed rest or hospitalization required after the hair transplant and the client can immediately get back to home after the OPD procedure. He or she can even get back to office from Day 1 after surgery.

Hair mousse

Hair mousse.

Hair mousse is a hairstyling product added to hair for extra volume and shine. It is often dispensed in an aerosol foam spray or in a cream form. Hair mousse adds volume to hair and often provides both conditioning and hold, without any clumps or buildup. Hair mousse is a purple color while in the can, but after it comes in contact with air it becomes an off-white color. One of the lighter-weight hair styling products, hair mousse is applied to wet hair before drying and styling. Hair mousse may also be referred to as styling foam. Hair mousse can be used on naturally curly or permed hair to reduce frizz and define curl.

As a versatile hair styling product, hair mousse is a popular choice for both short and long hairstyles. When hair mousse is applied to wet hair that is allowed to air dry, the hair is often left with a "wet" look that can be "crunchy" feeling, but unlike hair gel, hair mousse combs out easily for a softer look. When hair mousse is applied to wet hair that is dried with a hair dryer, it provides additional volume and hold.

There are hundreds of brands of hair mousse from professional to store brands, many delivering a quality styling product. Certain brands contain alcohol, which is fine for most hair types except dry. For dry hair, look for hair mousse that contains natural conditioners and vitamins, but no alcohol. Users might also consider checking hair mousse and other styling products for ultraviolet sun protection.

Color mousse is used to cover up grey hair and to create hair styles at the same time. Semi-permanent color mousse can be used to give toning to hair that is fading from the hair color process

Hair gel

Hair styled with hair gel

Hair gel is a hairstyling product that is used to stiffen hair into a particular hairstyle. The results it produces are usually similar to, but stronger than, those of hair spray, and weaker than those of hair glue or hair wax.

Contents

Types

Many brands of hair gel in North America and the United Kingdom come in numbered variants. Higher numbered gels maintain a greater "hold" on hair, while lower numbers do not make the hair as stiff and in some products give the hair a wet look. A category typically referred to as "ethnic" gels are designed and manufactured specifically for sculpting the hair texture common to African Americans. Ampro Industries is a common example of this category.

Some forms of hair gel include temporary hair coloring for the hair, including variants in unnatural colors associated with various subcultures, and are popular within the goth and raver subcultures.^{[citation needed]}

[edit] Cationic polymers

Cationic polymers are one of the main functional component of hair gel. The positive charges in polymer causes it to stretch, making the gel more viscous. Hair gels resist natural protein conformations and allow hair to be styled and textured. This is because the stretched-out polymer takes up more space than a coiled polymer and thus resists the flow of solvent molecules around it. The positive charges also bind the gel to the negatively charged amino acids on the surface of the keratin molecules in the hair. More complicated polymer formulas exist, e.g. a copolymer of vinylpyrrolidone, methacrylamide, and N-vinylimidazole.

Alternatives to industrial tints

Alternatives to industrial tints

Ancient civilizations dyed their hair using plants. Some of the most well known are henna, indigo, Cassia obovata, senna, turmeric and amla. Others include katam, black walnut hulls, red ochre and leeks.^[12]

Alternate based dyes are available for people sensitive to PPD, a chemical found in most hair colors.

Products that avoid the side effects of most industrial tints are available. The safer alternatives generally contain fewer potentially toxic compounds or are plant based. Temporary, semi-permanent and permanent exist with the same persistence as the industrial versions. In practice the results produced by these products often do not last as long as industrial tints.^[13] Allergic reactions are possible even from "natural" vegetable dyes.

Henna is a plant (Lawsonia inermis) used for Ayurvedic hair coloring. The orange dye is commonly used as a deposit-only hair color whose active component, lawsone, binds to keratin. It is therefore considered semi-permanent ^[14] to permanent, depending on a person's hair type. Most people will achieve a permanent color from henna, especially after the second dye. With repeated use the orange color builds up into red and then auburn. While "natural" henna is generally a red color, variations exist. These variations usually contain ingredients from other plants and even synthetic dyes.

Indigo is natural dye from a plant (Indigofera tinctoria, suffructicosa, or arrecta) that can be added to henna or layered on top of it to create brown to black colors in the hair. On the color wheel, henna is orange, and indigo is blue, so the two colors work together to create brown tones. Like henna, indigo may fade after one application, but it becomes permanent on the hair with repeated use.

Using a plant-based color such as henna can cause problems later when trying to do a perm or permanent hair color. Pure imported body art quality henna is claimed not to cause such problems, but most store-bought henna is mixed with additives which can lead to unpredictable results if the hair is later colored. Although it may not be visible on darker hair, the staining from henna will remain for several months and this may only be realized when dyeing is attempted and an unpleasant, permanent orange color results.

Hair breakage

Hair breakage

Hair that has been damaged by excessive exposure to chemicals is considered over-processed. This results in dry, rough and fragile hair. In extreme cases, the hair can be so damaged that it breaks off entirely. This is especially true for Afro-Caribbean hair, especially if used in combination with relaxers. Treatments are available but the only real solution is to stop the use of chemicals until new hair grows and the damaged hair is cut off.

It is advised that colored hair be deep conditioned regularly, and washed and conditioned with gentle products specifically designed for color-treated hair. This will help keep the hair intact and minimize color fading.

Skin discoloration

Skin and fingernails are made of the same type of keratinized protein as hair. That means that drips, slips and extra hair tint around the hairline can result in patches of discolored skin. This is more common with darker hair colors and persons with dry absorbent skin.

This discoloration will disappear as the skin naturally renews itself and the top layer of skin is removed (typically takes a few days or at most a week). A good way to prevent dye discoloration is to put a thin layer of Vaseline or any oil-based preparation around the hairline. It is recommended that latex or nitrile gloves be worn to protect the hands.

[edit] Unpredictable color results

Several factors influence the final color of the hair following the coloring process.

• For semi-permanent and demi-permanent color, the final color is a blend of the natural color of the hair and the dye color.

• Bleached hair will often require pre-pigmentation before a color application. Dyeing bleached hair brown can result in grey or very ashy (grey sheen) hair.

• Previously color treated hair can react unpredictably with subsequent color treatments.

• Previous use of shampoos which deposit a layer of plastic on the hair can block the action of the dye.

• Presence of minerals, salts, chlorine or other contaminants in the water used in the coloring process

• Certain prescription drugs can alter hair chemistry

• Coloring dark hair to achieve a desirable shade of blond requires bleaching, followed by a secondary color treatment. Bleached hair can still have a yellow or coppery shade. A violet-based color can cancel out yellow tones, and a blue-based shade will cancel out coppery orange.

Professional hair colorists have a number of products to correct or deemphasize unintended hair coloring outcomes.

[edit] Health concerns

There is ongoing debate regarding more serious health consequences that may result from use of hair coloring.

Recent publications regarding the dangers of hair tints include:

• An FDA study that found lead acetate (the active ingredient in gradual darkening products such as Grecian formula) to be potentially toxic.^[4][5]

• Articles that link the development of some forms of cancer (including leukemia, non-Hodgkin's lymphoma, bladder cancer, blood cancer, and multiple myeloma) with use of hair color.^[6][7][8] More specifically, prolonged use of permanent dark hair dyes can double a person's risk of getting various types of blood cancer.^[9]

• Recently a known human carcinogen, 4-aminobiphenyl or 4-ABP, was found in some hair dyes that you can get off the shelf.^[10] However, evidence is limited and inconsistent for the link between cancer from hair दए
  

Skin irritation and allergy

Skin irritation and allergy

In certain individuals, the use of hair coloring can result in allergic reaction and/or skin irritation.

Symptoms of these reactions can include redness, sores, itching, burning sensation and discomfort. If any of these symptoms occur, alert your hair colorist immediately so that they can remove the color. Symptoms will not always be present right at the application and processing of the tint but can also arise after hours or even a day.

To help prevent or limit allergic reactions, the majority of hair color products recommend that the client conduct a patch test before using the product. This involves mixing a small quantity of tint preparation and applying it directly to the skin for a period of 48 hours. If irritation develops, manufacturers recommend that the client not use the product. A skin patch test is advised before the use of every coloring process, since allergies can develop even after years of use with no reaction.

Adverse reactions can result from both at-home and salon hair coloring products, as similar chemicals are used in both settings .

In some cases, allergic reactions are caused by the aniline derivative and/or p-phenylenediamine (PPD) found in permanent hair color.

In some cases, if itching, burning sensation or discomfort occur and one does not alert the hair colorist immediately, it could result in hair loss.

Alternative hair colorants

Alternative hair colorants

Hair and beard colored blue.

A minority of hair coloring products are designed to create hair colors not typically found in nature. These are available in almost any color imaginable, including green or fuchsia.

These dyes are typically sold in punk-themed stores (such as comic book and music stores), with brand names like "Beyond The Zone", "Splat", "Clairol Jazzing", "Manic Panic", "Special Effects", "Punky Colour", "Stargazer", "La Riche Directions". A permanent alternative in some colors (such as bold red and dark, inky purples and blues) are available from big haircare brands. Some alternative color shades are blacklight reactive, to show up under nightclub lighting.

The chemical formulae of alternative color dyes typically contain only tint, and have no developer. This means that they will only create the bright color of the packet if they are applied to light blond hair. People with darker hair (medium brown to black) will need to use a bleaching kit prior to tint application. Some people with fair hair may benefit from prior bleaching as well. Gold, yellow and orange undertones in hair that hasn't been lightened enough can adversely affect results, especially with pinks, blues, and greens. Although alternative colors are semi-permanent in the cases of some colors, such as blue and purple, it could take several months to fully wash the colour from bleached or prelightened hair

Application techniques

Application techniques

Hair with blonde highlights

Hair color was traditionally applied to the hair as one overall color. The modern trend is to use several colors to produce streaks or gradations, either on top of the natural color or on top of a single base color. These are referred to as:

• Highlighting, where sections of hair are treated with lighteners, usually to create blond streaks.
• Lowlighting, where sections of hair are treated with darker hair color.

These can be applied by the following methods:

• Foiling, where pieces of foil or plastic film are used to separate off the hair to be colored; especially when applying more than one color.
• Cap, when a plastic cap is placed tight on the head and strands are pulled through with a hook.
• Balayage, where hair color is painted directly onto sections of the hair with no foils used to keep the color contained.

All application techniques can be used with any type of color. For highlights, the hair will usually have to be bleached before coloring.

Hair lighteners and bleaches

Hair lighteners and bleaches

Bleaching, also referred to as hair lightening or decolorizing, is a chemical process involving the diffusion of natural color pigment or artificial color from hair. Hydrogen peroxide and ammonium hydroxide are frequently used. It has the side effect of raising of the cuticle, making the hair more porous.

If the hair has been coloured, in order to go lighter it must first be cleansed or bleached. However, it is possible to lighten natural (virgin) hair with para dyes and hydrogen peroxide up to 4 levels depending on the product used

Permanent hair color

Permanent hair color

All permanent hair color products and lighteners contain a developer, or oxidizing agent, and an alkalizing agent (most often ammonia).

When the tint containing the alkalizing ingredient is combined with the developer, a chemical reaction occurs that swells the hair, permitting the tint to enter the cortex, where the melanin is located. The melanin is lightened and subsumed by the new color. The ammonia swells the cuticle of the hair to allow the color pigments to penetrate deep into the hair shaft.

Permanent color is truly permanent and will not wash out, although it may fade. New hair growth in the hair's natural color will contrast with the colored section of the hair.

Permanent hair dyes can be removed by bleaching, or stripping with a color remover. Theoretically, a color remover can return hair to its natural color if the hair has been treated with deposit-only dye, but this process may be damaging.

Semi-permanent hair color

Semi-permanent hair color

Semi-permanent hair dye has smaller molecules than temporary dyes, and is therefore able to partially penetrate the hair shaft. For this reason, the color will survive repeated washing, typically 4–5 shampoos or a few weeks. Semi-permanents contain no, or very low levels of developer, peroxide or ammonia, and are therefore safer for damaged or fragile hair. However, semi-permanents may still contain the toxic compound p-phenylenediamine or other such ingredients.

The final color of each strand of hair will depend on its original color and porosity, so there will be subtle variations in shade across the whole head. This gives a more natural result than the solid, all over color of a permanent dye. However, it also means that gray or white hairs will not dye to the same shade as the rest of the hair. If there are only a few grey/white hairs, the effect will usually be enough for them to blend in, but as the gray spreads, there will come a point where it will not be disguised as well. In this case, the move to permanent color can sometimes be delayed by using the semi-permanent as a base and adding highlights.

Semi-permanent color cannot lighten the hair.

Types of hair color

Types of hair color

The four most common classifications are temporary, semi-permanent, demi-permanent (sometimes called deposit only) and permanent.^[2]

Temporary hair color

Temporary hair color is available in various forms including rinses, shampoos, gels, sprays, and foams. Temporary hair color is typically brighter and more vibrant than semi-permanent and permanent hair color. It is most often used to color hair for special occasions such as costume parties and Halloween.

The pigment molecules in temporary hair color are large and cannot penetrate the cuticle layer. The color particles remain adsorbed (closely adherent) to the hair shaft and are easily removed with a single shampooing. Temporary hair color can persist on hair that is excessively dry or damaged in a way that allows for migration of the pigment to the interior of the hair shaft. It lasts for about a few hours to 1 day.