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Thinning scalp hair in Indian + sub-continent Women (+Men)

Throughout the world, Women of Indian heritage have long been admired for their luxurious, true black hair that shines like polished ebony. The scalp hair is strong, coarse and possesses a gentle, rolling wave that flows as they walk.  Most can grow their hair ‘Rapunzel-like’ down past the small of their back, which means the hair follicle has an extended anagen (growing) phase – up to eight years rather than the usual 2-4 years.

Sometimes though dietary and religious observances – even the structured social status of unique Indian culture – may combine to gradually diminish the quality, texture and density of scalp hair for which sub-continent Women are generally renowned.

  1. Religious and dietary considerations: the Indian diet is profoundly influenced by religious – Hinduism predominantly – as well as numerous other cultural choices and traditions. In the 2011 National Censes an overwhelming 79.8% of the Indian population identified as ‘Hindu’ in Faith, with Islam the next closest at 14.2%.

Most Hindus consume a lacto-vegetarian diet; no animal-derived meats or proteins (such as eggs), but milk consumption is encouraged as a gift from ‘The Mother’ – the much revered Indian cow. The Brahmin social class restricts how their food is prepared; by whom as well as how it may be stored. More orthodox Hindus may also exclude some Allium, Brassica and Fungi (mushrooms) vegetables as part of their religious devotion.

In some areas of India non-vegetarian Hindus consume small portions of meat with rice or bread.

‘Jainism’ is one of the most ancient religions in India but represents less than 0.5% of practiced faiths at the 201 census. Jains consume a similar diet to Hindus except all root vegetables are forbidden and they do not eat after sunset.

  1. How Hindu and Jain diets affect the hair: lacto-vegetarian or ‘fruitarian’ diets tend to be meagre in proteins or some essential nutrients – particularly Iron and Vitamin B12. The hair is 98% (matrix) protein – but as a non-essential tissue in nutrient-metabolic priorities – receives adequate supply only when the vital organs, tissues and body systems have been sustained.

The mineral Iron is arguably the most important nutrient to the body’s functioning as very little is activated within the body without sufficient iron; iron effectively ‘switches-on’ all other body systems (Lee: 2006). Vitamin B12 (Cyanocobalamin) is an essential B-complex for DNA synthesis, the formation of red blood cells and fatty acid metabolism. Iron deficiency or Pernicious anaemia may result from a dietary deficit of these nutrients, with deteriorating scalp hair quality and density an initial sign.

It’s anecdotally recognised the higher Indian social classes prefer to avoid prolonged sun exposure wherever possible – enhanced by ‘full covering’ forms of dress. Vitamin D deficiency is therefore another common health concern found in many Indian and sub-continent people.

Goswami, R. et al (2009) found the average Vitamin D levels among Indian people was only 17.5nmol/L. Less than 51 nmol/L is deemed deficient, and Vitamin D should ideally be at least 100 nmol/L to optimise thyroid function and hair follicle maturation (Van Zanden:2012).

Chronic Vitamin D deficiency is linked to a plethora of health conditions (www.vitamindcouncil.org) from hypothyroidism, autoimmune disease, neurological disorders*, multiple sclerosis (MS) through to pregnancy miscarriage in women.

Vitiligo is held to be an autoimmune skin condition where one’s own immune system attacks and obliterates the skin melanocytes (colour pigment). Vitiligo predisposes to familial incidence, and although it seemingly affects all races and both sexes equally – the devastating visual and psychological impact are most evident in those of darker skin tones.

The various forms of hair loss experienced by sub-continent men and women is consistent with most other alopecia conditions seen throughout the world. Sub-continent people are at greater incidence of pigment-related disorders – Alopecia areata being one example. Male androgenic thinning is of similar prevalence to Caucasians, often intensified by nutrient-metabolic disturbance as previously outlined. ‘Pattern’ hair loss in women would conceptually tend to be of higher incidence and can differ slightly in presentation to their Caucasian sisters**

  1. Positive aspects to dietary or other customs: as with any nationality, racial or ethnic population, Indian people are more ‘at risk’ to some health conditions but less of others. Vegetarians tend to have reduced incidence of cardiovascular disease (including hypertension), cholesterol***, some cancers or gout, obesity, diabetes (mellitus) ****, psoriasis, and many numerous health conditions.

Everyday cooking spices such as Turmeric, Ayurvedic herbs and medicines, and the preference for Besan ‘Gram’ flour (from ground Chickpea) in place of Gluten-containing grains all tend to decrease the incidence of inflammatory disease, particular skin conditions***** and problems associated with the Gut.

By providence or karma, some Ayurvedic herbs are naturally occurring Fibroblast Growth Factor-5 (FGF-5) inhibitors – believed to be beneficial in the treatment of androgenic and diffuse hair loss. In humans FGF-5 is a complex protein encoded by the FGF-5 gene. FGF-5 plays a role in follicle hair cycle regulation, where it’s believed to be one signalling initiator of follicle hair growth (anagen) to regression (catagen/telogen) transitioning of the hair follicle cycle. ******

  1. Traditional hair treatment remedies: Whilst western medical treatments and pharmaceutical drugs are now an integral part of modern India, Ayurvedic traditional medicine remains a cornerstone of treatment for many people. Ayurveda is one of civilisation’s oldest traditional health practices, and based on the conviction that balance of mind, body and spirit determine an individual’s state of health and wellness.
    1. The ‘Pitta constitution’: is Ayurvedic hormonal disturbance causing hair loss; ‘Pitta Dosha’ excess is believed due to dietary, lifestyle overindulgence******* and India’s diverse climate extremes. Ayurvedic practitioners would generally prescribe herbal medicines, general tonics and (Ayurvedic) hair cleansing mixtures to rebalance ‘Pitta’.
    2. Oiling and massage of the hair and scalp: is a long-cherished Indian tradition to promote scalp blood flow, nourish and repair the hair, treat scalp skin conditions and help stimulate hair growth. A warm oil massage (termed ‘champi’) of coconut oil (or commercial aromatherapy oil combinations) ******** before shampooing is a ritual luxury undertaken at least once per week.

It must however be appreciated if an individual has significant iron or Vitamin D deficiency, any external treatments will have limited effect until these disturbances are corrected.

  1. Skin conditions affecting the scalp: India is arguably the most populous country in the world today; economic diversity is vast and her land mass spans sub-tropical/tropical, arid and snow-covered zones. Deprivation, poverty, inconsistent access to quality medical care, nutritious diet and sanitation for the ‘majority Indians’ (Sen:2005) will often reveal itself as endemic fungal infections, infestations (such as head lice or scabies), Herpes infections (Zoster & Simplex); the various Tineas, tropical ulcerations, or the universally common Psoriasis and Seborrhoeic Dermatitis – which tend to be familiarly-inherited. Thappa (Common Skin Problems: 2002) details an in-depth list of dermatological problems common to India. Both traditional Ayurveda and western medicines are prescribed in the treatment of these conditions.

Writer’s Note: this minor article has been written purely from a ‘trichology perspective’ -and my unfamiliarity of Indian social structure or economic diversity is plain. Only by being born into this unique and venerable culture could an objective ‘citizen of sociology’ fully understand and appreciate India’s fascinating complexity, mystery and social enigmas. I truly hope none are offended by this piece, for I have a new and greater respect for India and her people from researching and writing it.

I do apologise to Indian people of Islamic Faith (who comprise 14.2% of the identified population in the 2011 India National Census) – and other religious or ethnic minority groups for omitting a paragraph or two on their nutrient-dietary customs and ‘at risk’ considerations. I promise to correct this when I revise this article.

Copyright Anthony Pearce 2017

*Parkinson’s disease, Alzheimer’s and dementia

** ‘Acquired pattern thinning’ (due to the body’s compensatory mechanisms to maintain metabolic homeostasis) rather than genetically inherited female androgenic alopecia. This is again due to religious dietary restrictions of iron-rich animal protein and social inclination to avoid lengthy sun exposure. Many sub-continent Women present with initial thinning of the scalp vertex (crown) rather than behind the frontal hairline margins seen in Caucasian women (author’s >20 year anecdotal observations only)

***Reduced cholesterolaemia can be countered by Vitamin D or iron deficiency and their influence on thyroid function. Researchers in the Colorado Thyroid Study (2000) found that even small decreases in thyroid hormone levels caused blood cholesterol levels to raise.

****Loma Linda University School of Public Health Study.

*****such as Psoriasis

******there are around 30 known factors that promote hair growth activity (anagen) and approximately 40 which inhibit or regress hair follicle activity. FgF-5 is one such promoter; FGF-2, 10 and 15 quiescent follicle activity (Chan: 2017)

*******Smoking, excess alcohol, consuming meats and overly-spiced foods

********Emami of India’s 7-oils-in-one is an aromatherapy oil combination and very effective ‘champi’ treatment that I have recommended to my partner and (young) adult daughters to alleviate scalp eczema, dryness and hair loss (all have long hair).