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| EDITORIAL |
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| Year : 2013 | Volume
: 5
| Issue : 4 | Page : 169 |
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Silver lining and sage advise
Patrick Yesudian
President, The Hair Research Society of India, No. 10, Ritherdon Avenue, Vepery, Chennai 600 007, Tamil Nadu, India
| Date of Web Publication | 11-Apr-2014 |
Correspondence Address:
Patrick Yesudian
President, The Hair Research Society of India, No. 10, Ritherdon Avenue, Vepery, Chennai 600 007, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-7753.130384
How to cite this article:
Yesudian P. Silver lining and sage advise. Int J Trichol 2013;5:169 |
Canities praecox in darker skin types can be psychologically more devastating than premature baldness. In a dark-skinned individual, complete whitening of hairs on the scalp can give a negative photograph film look. Caucasian graying is not that contrasting. That probably could be the reason for the neglect of this condition to be treated or to be taken for research in the west.
The myth of overnight graying that we read in historical records as with Marie Antoinette on the eve of her decapitation can be explained by a diffuse alopecia areata preferentially affecting the pigmented hairs on her scalp leaving only gray ones.
But these constitute a negligible percentage and in the vast majority canities is irreversible. It has been concluded by astute researchers that canities is a threshold response to a combination of reactive oxygen species-associated damage to sensitive hair follicle melanocytes, impaired antioxidant status, and failure of melanocyte stem cell renewal (Desmond J Tobin, 2008). The silver lining (no pun intended!) to the phenomenon of canities is that graying hair may have an increased growth rate.
There are certain treatable conditions that cause premature graying like thyrotoxicosis, Addison's disease, B 12 and folic acid deficiency, phenylketonuria, and homocystinuria.
Several drugs like carbidopa, minoxidil, bromocryptine, and diazoxide have been reported to have reversed canities. Topical use of latanoprost for glaucoma has increased hair pigmentation. Biomimetic peptides mimicking the action of alpha MSH (melanocyte stimulating hormone) are the new kid in the block claiming to reverse premature and early graying with little human evidence.
Even individuals in the fifth or sixth decades of life abhor this natural ageing change of hair color and resort to dyeing. But the young with premature and early graying (graying in the first two decades) suffer social denial and emotional humiliation of being perceived as old.
The poor dark skinned and the most obvious gray folks are left with the only option of coloring, as there is not much interest or research with the focus of reversal of graying in this literally gray area of Dermato-trichology. The vegetable colors available are cumbersome to use, require frequent applications, and do not impart the desired black color.
Unfortunately, the only effective permanent dye contains the harmful chemical paraphynelene diamine (PPD) or paratoluidiene diamine (PTD), which has numerous reported cutaneous and systemic side effects.
When PPD is combined with henna, the unholy combination can be doubly devastating. The combination is reported (British Journal of Dermatology 143: 923-29, 2000) to have caused massive edema of the face and respiratory tract and few cases of death from acute tubular necrosis of the kidney. According to a report from USA (International Journal of Cancer 91: 575-79, 2001), there is a significant increase in bladder cancer in patients using permanent dyes. So it is the duty of the dermatologists to advise their older patients to age gracefully rather than resorting to inappropriate means of seeking the fountain of youth.
I am sure that hair dye-induced pigmentary disorders and allergic reactions are so common and an increasing menace in every tropical Dermato-trichology clinic. It is often a difficult task to establish and prove that the hair dye is the culprit, and in spite of a positive patch test and hour long explanation of side effects, patients resort to dyeing because graying is considered synonymous with ageing.
The Dermato-trichologist's attempt at treating early graying is all in vain with very little success in graying due to malnutritional or hormonal causes at an early age. But as an ethical Dermato-trichologist who should believe and practice "Primum non nocere" (primarily do no harm) the mandatory advice to the graying patients aspiring to color should be "Think before you dye, to save the skin and the system which is much more precious than the color of the hair."
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