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DOI: https://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20214930
Review Article
1
Department of Dermatology, Marsleeva Medicity, Pala, Kerala, India
2
Department of Dermatology, Sri Siddhartha Medical college, Tumkur, Karnataka, India
*Correspondence:
Dr. Neethu Mary George,
E-mail: [email protected]
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Modern shampoos are much more than just cleansing agents. With rising demands for new milder and ‘greener’
products, the developments in the field of shampoo and conditioners are moving at a faster pace than ever before.
Soaps were initially used to clean scalp but are not recommended for hair cleansing because they leave behind a soap
scum when mixed with hard water that is difficult to rinse from the hair and scalp. There are different types of
shampoos. Besides “normal” cleaning shampoo, there are “specific” shampoos that have additional ingredients
targeting some hair problems. Dermatologists most frequently prescribe shampoos but little is taught in medical
schools about the hair cosmetics. Most of the prescriptions are based only on the treatment of the scalp and usually
disregards the hair fibre health. Hence it is imperative for dermatologists to known about the mechanism of
shampoos, different surfactants and where to choose which shampoo.
INTRODUCTION rough, dull, and prone to get tangled, is not well accepted
by the consumer.
Shampoos are liquid cleansers and the word “shampoo”
is derived from the Hindi word meaning “to massage”. CONTENTS
Shampoos are intended to rid the hair of sebum, sweat,
desquamated cells, styling products, and environmental Shampoo usually contains a mix of primary and
dirt. It is desirable that whatever may the disease or scalp secondary surfactants for cleaning, viscosity builders,
condition be, the shampoo must preserve the softness, solvents, conditioning agents, pH adjusters and other
health and shine of the hair shaft. Shampoos are not only components such as fragrance, colour for commercial
scalp cleaners, because they also act on the hair shaft.1 appeal.2 Sometimes they contain special additives like
Unfortunately, a thoroughly cleaned hair, which is harsh, sunscreen (Table 1).
Table 1: Contents in a shampoo and their examples.
Category Examples
Sodium lauryl sulfate, ammonium lauryl sulfate, ammonium laureth sulfate, alpha olefin
Surfactants
sulfonate
Thickeners Electrolytes, cellulose derivatives, natural gums
Sequestering agents EDTA
Others (for product appeal) Fragrance, dyes, menthol, perfume oils, liquid crystal concentrate
Continued.
International Journal of Research in Dermatology | January-February 2022 | Vol 8 | Issue 1 Page 185
George NM et al. Int J Res Dermatol. 2022 Jan;8(1):185-191
Category Examples
Additives Viscosity control agents(polyacrylate), foam stabilizers, dispersing agents
Humectant Propylene glycol, polyethylene glycol, glycerin, sorbitol
Moisturizers Alkanolamides, natural oils
Preservatives Parabens
UV absorbers Benzophenones
Buffers Sodium citrate
Anti-dandruff agents Selenium disulfide, zinc pyrithione, ciclopirox olamine, ketoconazole, piroctone olamine
Sarcosines: Do not remove sebum well from the hair. Cocamidopropyl betaine: It is an amphoteric surfactant
However, they are excellent conditioners. Sarcosines are which is frequently used in cosmetic products especially
used in conditioning shampoos and dry hair shampoos. baby shampoos. Cases of contact allergy due to it are
They include lauryl sarcosine and sodium lauryl reported by Groot et al.5
sarcosinate.
Non-ionic: They are often plant derived- glucosides,
Sulfosuccinates: They are a class of strong detergents citrates, sulfosuccinates and hydrolysates proteins and do
useful for oily hair. Examples are disodium oleamine not exhibit electric charge in aqueous solution. They can
sulfosuccinate and sodium dioctyl sulfosuccinate. be formulated within a wide range of pH values and do
not cause much irritation, and still have a cleansing effect
Cationic: Cationic surfactants are quaternary ammonium but only with a small amount of foam. They do not
compounds with a positively charged hydrophilic end and possess a charged polar group and are hence compatible
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George NM et al. Int J Res Dermatol. 2022 Jan;8(1):185-191
with all other surfactants. They make good cleansers with neutralize this effect, there is the interference of the
dispersion and emulsification properties. They serve to shampoo pH, which can increase the static electricity.7
enhance tolerability in very mild cleansers such as baby Topically applied surfactant solutions can also swell
shampoos, in combining with amphoteric surfactants. corneocyte proteins, which results in the removal of
Examples of nonionic surfactants are fatty alcohol natural moisturizing factors and enhances penetration of
ethoxylates, sorbitan ether esters, and alkanolamides. irritant chemicals into the viable epidermis.8
Many long chain alcohols like fatty alcohols, cetyl
alcohol, stearyl alcohol, and cetostearyl alcohol, and oleyl HAIR KERATIN AND pH OF SHAMPOO
alcohol exhibit some surfactant property. Some sugar
esters that area biodegradable like lauryl glucoside, coco The scalp pH is 5.5 and the hair shaft pH is 3.67. The pH
glucoside, decyl glucoside, and caprylyl/capryl glucoside at which a protein or particle does not migrate (moment
are also found in many shampoos. of charge neutrality) in an electric field is the isoelectric
point (3.67 pH). The pH of which a protein or particle has
Natural detergents: Natural surfactants come from plants an equivalent number of total positive and negative
such as sarsaparilla, soapwort, soap bark, and ivy agave. charges is called the isoionic point (pH-5.6). A protein
These have excellent lathering capabilities, but are poor that is in a pH region below its isoelectric point will be
cleansers and hence combined with other synthetic positively charged, and vice versa. Any product applied
detergents. on hair that has pH higher than 3.67 may increase the
negative electrical net charge of the hair fibre surface
Sequestering agent: The function of sequestering agents and, therefore, increase the friction between the fibres
is to chelate magnesium and calcium ions preventing the increasing the damage to the A‐layer and the epicuticle of
formation of insoluble soaps, known as ‘scum’ which the hair fibre.6,9
forms a film on hair surface and scalp which can cause
dull hair, seborrheic dermatitis and scalp pruritus, as and Rinsing hair with water (pH-7), increases negativity,
when bar soap is used for cleansing the hair. creates frizz. Water penetrates the scales that open,
hydrating the strand and breaking the hydrogen bonds of
Preservatives like organic acids and their derivatives, the keratin molecule. Keratin is a spiral molecule that
e.g., parahydroxybenzoic acid ester, salicylic and sorbic keeps itself in that shape due to chemical bonds. To
acid; methylparaben are used to avoid bacterial growth. tackle the effects of shampoo with a high pH, it is
necessary to choose a shampoo with a pH lower than 5.5
Foaming agents promote foaming of the shampoo. by using a ‘pH balancing’ shampoo with the addition of
an acidic substance such as glycolic acid, adding cationic
pH adjusters and buffers: Damaged hair can swell with ingredients to shampoo or by using a conditioner after
alkaline detergents. Hence, when formulating suitable shampoo. A conditioner of low‐pH neutralizes electric
shampoos for such hair, an acidic pH adjustment is done. charge, reduce the frizz effect and close cuticular cells.10
The substances used include citric acid, lactic acid and A high pH shampoo, will have a positive effect in oily
phosphate buffers. and thin hair, as it can add volume to the hair post
shampoo because of the increase in static electricity.
Additives: UV absorbers to protect oxidation-sensitive However, a pH higher than 5.5 may cause irritation of the
oils or dyes against light (benzophenone derivatives), scalp.
anti-dandruff agents, antioxidants to protect oxidation-
sensitive substances (ascorbic acid, tocopherols, butyl TYPES
hydroxyanisole), fragrances, moisturizers and humectants
(propylene glycol, polyethylene glycol, glycerine, Shampoo with conditioner (2 in 1 shampoo)
sorbitol, natural oils, fatty acid esters, and alkanolamides.
‘2-in-1’ shampoos means that conditioning agents
MECHANISM OF ACTION incorporated into shampoos (conditioning shampoos).
Amphoteric detergents are commonly found in 2-in-1
Scalp gets accumulated with residue that does not cleansers.
dissolve with water. To remove this, surfactant form
micelle. They have a hydrophobic end which bind with Baby shampoo
the fat and a hydrophilic end that bind with water. This
micelle can be rinsed with water easily. Hair fibres are Baby shampoos are mild cleansers and are non-irritating
negatively charged which will repel the negative charge to the eyes. It usually contains ingredients that are
of micelle. However, the result is an increase of the pre- harmless to the scalp, hair, as well as less irritating to the
existing negativity of the strands increasing the repulsion eyes. Most of the paediatric shampoos focus on “no
between the strands due to excessive static electricity. tears” concept rather than conditioning the hair fibre.
Cationic, amphoteric and non‐ionic surfactants are added They mostly have a higher pH, a pH closer to the tear
to some shampoos to reduce the effects caused by the physiological pH. These shampoos use detergents from
anionic surfactants.6 Although the cationic agents try to the amphoteric group, such as the betaines.11 The
International Journal of Research in Dermatology | January-February 2022 | Vol 8 | Issue 1 Page 187
George NM et al. Int J Res Dermatol. 2022 Jan;8(1):185-191
detergent prevent stinging, but can still cause eye damage acidic professional shampoos used after bleaching to
if the baby shampoo is accidentally introduced into the neutralize residual alkalinity and prepare the hair for
eye, but the injury is not painful. Hence it is subsequent dyeing; cationic, acidic shampoos used after
recommended that adults especially with dyed hairs colouring e. g., ‘colour revival shampoos’.
should not use paediatric shampoos to cleanse their hair.10
Colour protect shampoo
Sulphate free shampoo
Cationic detergents, also known as quaternaries or
Sulfate-free shampoos are cleansers without anionic quaternary ammonium compounds or quats, neutralize
surfactants and switched with surfactants of less static electricity based on the negative (anionic) charge of
detergency. Their cleansing action is relatively milder processed or damaged hair thus improving manageability.
and it focuses more on hair fibre health. These qualities make them an excellent cleanser of choice
in patients with permanently dyed or permanently waved
Dry shampoo hair.
They are used without water. The alcohol or starch in the Medicated shampoos
product soaks excess oil and grease on the hair. It is
available as powder and aerosol spray. They include shampoos that are intended for certain
conditions like seborrheic dermatitis, scalp psoriasis etc.
Shampoo bars
Shampoos for different types of hair
It looks like regular soap but is usually infused with oils
and lathers well. Because they eliminate water in the final For normal hair/chemically naive hair, shampoos
product, the preservatives amount is relatively less. containing SDS (named also sodium lauryl sulfate) as the
main detergent, provides a good cleaning of the scalp.
All-natural shampoo For dry hair/chemically treated hair, amphoteric and
anionic detergents are preferred. Anionic surfactants may
“Herbal”, “botanical”, “organic” are all labels used for have a positive effect in extremely greasy and thin
natural shampoo. Herbal shampoos mainly use straight hair, of adding volume to the hair. Medicated
soapnut/reetha, amla, and dried pods of sheekakai, that shampoo use should be limited to scalp especially in
have been traditionally used in India for centuries to wash those with dry damaged hair.
hair. Due to high amount of saponins, reetha and
sheekakai ingredients produce a rich lather when shaken NEWER CONCEPTS AND TRENDS
with water.12 Reetha is said to have antimicrobial
properties. Furthermore, it makes hair shine, restoring the Lo-poo shampoo
natural hair texture.13 Sheekakai retain natural oils of
hair, reduces hair loss, adds volume, gives hair strength, Low poo shampoos are sulfate-free shampoos. This trend
and is a powerful antidandruff and conditioning agent.13 is becoming highly popular and is of use in those with
Other common herbal ingredients used for shampoo dry, damaged and chemically treated hair.
formulation are: Azadirachta indica (Neem), Ocimum
sanctum (Tulsi), aloe vera (aloe), Terminalia chebula No-poo method
(harda, haritaki) and Terminalia bellirica (bahera).
Though “natural”/ “herbal” shampoos claim themselves It refers to the avoidance of commercial shampoos and
to be fully natural, most of them contain chemical use other methods of cleansing the hair, such as baking
surfactants in addition to the ‘natural’ products. soda, apple cider vinegar [ACV] or treating the scalp with
tea tree oil, or simply rinsing the hair with water. They
Everyday shampoo claim to have healthier hair, retain natural oils, and less
exposure to chemicals in shampoo.
They generally contain mild detergents. They typically do
not incorporate the conditioners found in the dry or “Co-washing” or “conditioner washing” is a method of
damaged hair shampoos, and an instant conditioner can cleansing the hair with only conditioner.14 Here, a
be used in combination with these products. nonionic surfactant, such as cetyl alcohol, is used as the
main surfactant or may also contain cationic surfactants
Professional shampoo and oils.15 They claim to prevent hair breakage and
reduce the overproduction of sebum and dryness that
There are shampoos those intended for hair washing prior follow the deep cleansing. But there are no scientific data
to cutting and those intended to precede or follow a to prove it. Silicones, mineral oil or petrolatum products
chemical process. Though most of the salon shampoos are not preferred as it may cause a build-up. However,
have similar formulation as that of over-the-counter- co-washing doesn’t provide any cleansing to scalp.
varieties, some of them serve specific function: anionic,
International Journal of Research in Dermatology | January-February 2022 | Vol 8 | Issue 1 Page 188
George NM et al. Int J Res Dermatol. 2022 Jan;8(1):185-191
Hair-care market is developing with new formulations The film-forming conditioners are used as coating fibres
coming in every day. Specific shampoos for each with a thin polymer layer. Protein-derived substances are
indication are in market. Shampoos are also currently popular conditioners for damaged hair, as they can
being developed that are enriched with amino acids. temporarily mend split ends (trichoptilosis). Protein is
attracted to the keratin, and holds the cortex fragments
SIDE EFFECTS together until the next shampooing occurs. Protein that
penetrates the hair shaft during conditioning will exit the
A simple process like shampooing can be associated with hair shaft during the next shampoo, requiring
many side effects. It is important for a clinician to know reapplication. Proteins can also coat the hair shaft,
the possible adverse effects of shampoo and adopt temporarily increasing its thickness (“hair- thickening”
measures to take care of those. conditioners).20 Silicones add lubricity, reduce friction,
aid detangling and combing, add shine and act as anti-
Hair damage frizz agents. Silicones are classified as water-soluble and
non-soluble. Dimethicone, the most widely used silicone
Surface lipids within the 18-methyl eicosanoic acid (18- and the main ingredient of the two-in-one shampoos.
MEA) lipid layers of hair are removed during
shampooing.16 Though internal lipids stay unaffected Types of conditioners
initially, repeated shampooing can affect them.
Rinses or instant conditioners: They are applied to
Acute felting washed hair especially post shampoo, left on for few
minutes, and rinsed off. They improve the combability of
Damaged hair or hair that has undergone certain chemical the hair.
treatments is particularly prone to sudden entanglement.
The raised cuticle cells and electric charge of the Leave on conditioner: They are applied to towel-dried
damaged hair can lead the hair become tangled. Certain hair. They basically contain cationic surfactants like
methods like use of a conditioner, hair serum, smooth polyquaternarium-10, cetrimonium chloride and
combing and detangling of hair and use of the prescribed stearalkonium chloride; long- chain fatty alcohol, lipid
shampoo can reduce the above-mentioned effect. components (cetyl alcohol, stearyl alcohol), silicones
such as dimethicone etc. applied to washed and dried
Environmental safety hair, and remain on till the next shampoo. They smoothen
down the cuticle and protect the hair from weathering.
Certain chemicals like silicones are not biodegradable
and hence found to accumulate in environment and water Leave in conditioner: These are products used for curly
bodies and adversely affect the ecosystem. or unmanageable hair prior to styling or blow drying and
on hair that has been damaged by chemical processes.
They are designed to stay on the hair shaft until removal
Skin allergies
by the next shampooing. These film-forming conditioners
apply a thin layer of polymer, such as
Given that shampoos are diluted by water, have a short
polyvinylpyrrolidone (PVP), over the hair shaft which
contact time, and are rinsed off, the risk of sensitization is
fills hair-shaft defects, creating a smooth surface while
highly unlikely.7 Nevertheless, in patients who are
eliminating static electricity. This coating gives a false
already sensitized, exposure could trigger eczema. ‘thickening’ of hair shaft.
Common allergens in shampoos are: Cocamidopropyl
betaine, methyl chloroisothiazolinone, formaldehyde- Deep conditioner: It is popular as parlour procedure
releasing preservatives, propylene glycol, vitamin E which is applied and left on for 20-30 minutes, with or
(tocopherol), parabens and benzophenones.18,19 without a steamer and then rinsed off. This contains
conditioning agents and proteins. The extended
CONDITIONERS application time and heat causes hair-shaft swelling and
allows increased conditioner penetration.
Conditioners prevent static electricity, improve shine and
increase hair protection. Conditioning agents mainly OILS
belong to four categories: film formers (polymers),
protein containing (hydrolysed proteins), cationic Use of oil on scalp is highly prevalent among certain
detergents (quarternary ammonium compounds), silicone areas of the country. Most of the times, dermatologist
(dimethicone, ciclomethicone). Conditioners seal the forbid the use of oils on scalp in view of conditions like
cuticular gap which gets lifted after the shampoo wash. seborrheic dermatitis and folliculitis. However, oils play
This prevents exposure of cortex to environmental a role in protecting hair shaft from damage. Certain oils
damage. can penetrate the hair and reduce the amount of water
absorbed in the hair, leading to a lowering of swelling.21
International Journal of Research in Dermatology | January-February 2022 | Vol 8 | Issue 1 Page 189
George NM et al. Int J Res Dermatol. 2022 Jan;8(1):185-191
The oil can fill the gap between the cuticle cells and 7. Rushton H, Gummer CL, Flasch H. 2‐in‐1 shampoo
prevent the penetration of the aggressive substances such technology: State‐of‐the‐art shampoo and conditioner
as surfactants into the follicle. Among coconut, sunflower in one. Skin Pharmacol. 1994;7:78‐83.
and mineral oil, coconut oil was the only oil found to 8. Paye M. Mechanism of skin irritation by surfactants
reduce the protein loss for both undamaged and damaged and anti-irritants for surfactant-based products. In:
hair when used as a pre-wash and post-wash grooming Handbook of Cosmetic Science and Technology
product.22 Coconut oil, because of its low molecular (Barel AO, Paye M, Maibach HI ed., 3rd ed. Informa
weight and straight linear chain, is able to penetrate Healthcare USA Inc, New York, USA. 1990;455-69.
inside the hair shaft. The mineral oil and the sunflower 9. Sinclair RD. Healthy hair: What is it? J Investig
oil may have a film effect and adsorb to the surface of the Dermatol Symp Proc. 2007;12:2‐5.
cuticle enhancing shine and diminishing friction. Mineral 10. Gavazzoni Dias MR, De Almeida AM, Cecato P,
oil has no affinity to hair’s proteins and is not able to Adriano AR, Pichler J. The shampoo pH can affect
diffuse in the fibre.23 the hair: Myth or Reality? Int J Trichol 2014;6:95-9.
11. Wilkinson JB, Moore RJ. Harry’s Cosmeticology.
Morrocan argan oil (Argania spinosa kernel oil) has New York: Chemical Publishing. 1982;457-8.
become very popular as an ingredient in hair cosmetics. 12. Chen YF, Yang CH, Chang MS, Ciou YP, Foam
The oil is rich in tocopherols and polyphenols which are Huang YC. Foam properties and detergent abilities
powerful antioxidants. The two main fatty acids found in of the saponins from Camellia oleifera. Int J Mol Sci.
Argania spinosa kernel oil are oleic acid (46-48%) and 2010;11:4417-25.
linoleic acid (31-35%), a monounsaturated and di- 13. Utane R, Deo S, Itankar P. Preparation of herbal
unsaturated fatty acid, respectively.24 It was also found shampoo (HS) by green method and their
that Argania spinosa kernel oil in hair care formulation characterization. Int J Res Soc Sci Inf Stud.
statistically reduced the protein loss when compared to 2017;5:254-8.
basic conditioner components in coloured hair.25 14. McMichael AJ, Hordinsky M. Hair Diseases:
Medical, Surgical, and Cosmetic Treatments. New
CONCLUSION York (NY): Taylor and Francis. 2008;59-72.
15. Cline A, Uwakwe LN, McMichael AJ. No sulfates,
Shampoos form an inevitable part of everyone’s hair care no parabens, and the “no-poo” method: a new patient
routine whether they have a scalp or hair disease. This perspective on common shampoo ingredients. Cutis.
article aims to enlighten dermatologists about hair 2018;101(1):22-6.
washing, shampoos and conditioners, their basic action 16. Robbins CR. Chemical and Physical Behavior of
and effects on hair and scalp thereby helping them to Human Hair 4th ed. New York: Springer. 2013.
choose the ideal shampoo for patients depending on their 17. Fewings J, Menné T. An update of the risk
scalp/hair disease without compromising their hair shaft assessment for methylchloroisothiazolinone/
health. methylisothiazolinone (MCI/MI) with focus on rinse-
off products. Contact Dermatitis. 1999;41:1-13.
Funding: No funding sources 18. Trüeb RM. Shampoo. Ther Umsch. 2002;59:256-61.
Conflict of interest: None declared 19. Trüeb RM. Shampoos: Composition and clinical
Ethical approval: Not required applications. Hautarzt. 1998;49:895-901.
20. Draelos ZD. Shampoos, conditioners, and
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