الفهرس 
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Abstract
The process of straightening hair involves either temporarily or permanently severing the chemical connections that keep the keratin protein in its native, stiff three-dimensional shape (Abraham et al., 2009). When applied to hair, it changes the structure of the hair fibres in practically every way, making them stronger and giving them a different shape than they would be without treatment (Wolfram, 2003).
A temporary straightening using physicochemical methods like as drier, flat iron, and the old hot comb lasts just until the next wash. Pre-wetting is necessary since it temporarily opens the hair’s natural structure by breaking the keratin’s hydrogen bonds. Now the strand is perfectly straight. When using a hair dryer, drying the hair quickly keeps the strands flat. Eventually, the strand becomes polished and smooth, allowing it to reflect more light (Abraham et al., 2009).
Changing the keratin disulphide bonds results in a more long-lasting straightening of the hair (Abraham et al., 2009). Alkaline creams containing up to 3.5% sodium hydroxide (lye-based straighteners) may do this, whereas non-lye straighteners including guanidine hydroxide, potassium hydroxide, or lithium hydroxide can achieve the same result (Draelos, 2010)
Formaldehyde (solution 37%) and glutaraldehyde are two of the most widely used and potentially harmful chemical relaxers (Santos et al., 2011).
Because of its tiny size, formaldehyde is able to swiftly penetrate to the cortex and react with the keratin of human hair (Inci et al., 2013). Hydrolyzed keratin (HK) solution in the natural keratin of the hair increases its fixing ability as formaldehyde is volatilized by the heat of the dryer (Gavazzoni, 2013).
Glutaraldehyde is more poisonous than formaldehyde and very effective at creating persistent cross-links with DNA proteins (Abraham et al., 2009).
Thirty patients utilised chemical and manual hair straighteners for three months or more, while the remaining twenty-five used natural hair oils for six months. There were no male patients.
With a thorough history, scalp examination, hair card test, hair pull test, tug test, trichogram, and scalp biopsy, we want to compare the effects of hair relaxers to those of natural hair oils.
Twelve patients (40%) in group I used hair straighteners because they were convenient, whereas ten (33.3%) did so for aesthetic reasons and eight (26.6%) did so to fit in with their peers. These findings are consistent with those published by Shetty et al. (2013), who found that 35% of volunteers used hair straighteners because they were easy to maintain, whereas 30% did so for the sake of looking better, and 25% did so to fit in with society.
from a purely aesthetic standpoint, 23 patients (76.7% success rate) were pleased with chemical hair relaxers, whereas 7 (23.3% failure rate) were not.
Patients who used chemical or manual hair relaxers reported hair loss as their primary issue 83.3% of the time. As revealed by Swee et al. (2000), 90% of respondents complained that using the straightening treatments caused them to lose or damage their hair. Hair breakage is a potential side effect that happens if the hair is subjected to straighteners for a long period, if the pH is off, or if chemicals are used at extremely high concentrations (Abraham et al., 2009). (Gummer, 2002).
Additionally, our research showed that the most prevalent side effects of chemical hair relaxers were dandruff (reported by 80% of patients), frizzy hair (73.3%), premature greying (63.3%), and central scalp hair loss (53.3%). These findings corroborated those of a 2013 study by shetty et al. on the effects of hair straightening on women, which found that 67 percent of participants experienced frizzy hair, 61 percent experienced dandruff, 60 percent experienced hair loss in the central scalp, and 67 percent experienced greying of their hair.
Eighty-three percent of our patients tested positive in the hair-pull test. Use of chemicals with a high pH (9-12) causes severe damage, making hair dry and brittle and eventually causing hair loss (Dias et al., 2008).
Because chemical relaxers make hair seem straight by altering cysteine disulfide connections (Gavazzoni et al., 2015), we discovered that the tensile strength of the hair was significantly reduced in 73.3% of patients when we conducted a pull test on their hair (Khalil, 2000).
Miniaturized hairs (those with smaller calibres), broken hairs (those with sharp cutted ends), and freshly regrowing hairs (those with pointed ends) are all signs of a positive response to treatment, as determined by the hair card test (Itin and Fistarol, 2005; Mirmirani et al., 2011). Research showed that whereas 57.3% of patients had cleanly snipped limbs, 26.7% had split limbs, and 16.7% were pointed. This matched the findings of a research by Shetty et al. (2013), who found that 17% of women who straightened their hair had split ends afterwards.
The trichogram is a useful diagnostic tool for determining the cause of hair loss and classifying the various patterns of baldness since it is a microscopic, non-invasive examination of the scalp that can evaluate both the hair root and the hair cycle (Hillmann and Blume-peytavi, 2009). A trichogram revealed a telogen phase percentage distribution of 5%-25% (Mean SD: 11.2, 5.4). Gavazzoni et al2015 .’s research showed that using a hair straightener might cause psoriasiform eczema on the scalp, sometimes with pustules, which could account for these findings.
Our research also includes an examination of the hair shaft under a microscope, which revealed that 73.3% of patients had damaged hair. According to Bolduc C. and Shapiro J.’s (2001) research, all chemical strengtheners have the same negative side effect of damaging the hair shaft, which corroborate our findings. This jibes with the findings of a research utilising a scanning transmission electron microscope by Yoonhee Lee et al., 2020, which found that chemical hair straightening damages the cuticle (TEM).
Eight biopsies of the scalp were taken as part of our research. Both longitudinal and transverse cuts were made on the eight samples.
The results showed that in 5 of the cases the scalp biopsy was normal, in 1 case there were an abnormally high number of catagenic hairs and fibrosis, in 2 cases there were an abnormally high number of oblong hairs and distortion of some hair follicles, and in 1 case there were an abnormally high number of telegon follicles and stella. Chemical relaxers put stress on the hair and the scalp, leading to these results. According to the research by Joane N et al., 2021, hair straightening led to erythema, interfollicular and perifollicular desquamation seen by dermoscopy, and psoriasiform and spongiotic patterns observed via histology.
No information on scalp biopsies performed post-straightening has been found in the literature.
In the second group, 25 people committed to using natural hair oils on a regular basis for a full six months. We did a thorough history and physical examination as well as a battery of tests.
Eight patients (32% overall) in group II reported aesthetic satisfaction with natural hair oils, but the remaining seventeen patients (68%) did not.
Because hair oils nourish the hair, maintain the scalp’s moisture levels, stimulate hair follicles, and boost hair development, our study found that the percentage of subjects with a history of hair loss was negative in 80% of instances and positive in 20%. (Alpaslan and Hayta, 2006).
Twenty-five patients (100%) in group II tested negative for hair greying, but seven patients (28%) tested positive for hair dandruff and five (20%) tested positive for frizzy hair. Saponification, lubrication, antibacterial activity, antifungal activity, emollient, prevention of protein loss, follicular feeding, sebostatic impact, photoprotection, and anti-oxidant action are just a few of the ways in which hair oils improve the health of your hair and scalp (Sarkar et al., 2017).
Since hair oils serve a crucial function in preventing hair damage, just five participants (20%) tested positive for dandruff in a hair pull test, while eighty percent (80%) tested negative. Also Some hair oils, such as argan oil, are thought to be beneficial because they nourish hair, hydrate it, and stop hair loss (Monfalouti et al., 2010).
While 20% of patients had a positive tug test, just 5 cases Filling the space between cuticle cells with oil makes it more difficult for aggressive compounds like surfactants to enter the follicle. Oiling your hair on a daily basis might reduce breakage by increasing shaft lubrication (Rele and Mohile, 2003).
Test results indicated that 16 out of 17 patients (68%) had pointed (regrowing) ends, whereas 4 out of 17 (32%) had splitted ends and 4 out of 17 (32%) had sharp cutted ends ( broken). Research conducted by Fregonesi et al. in 2009 on Brazilian oils and butters indicated that oil-based treatments prevented the development of split ends.
The results of the trichogram showed that the proportion of telogen hairs varied from 2 to 15% (Mean SD = 8.8 4.2), that 5 patients (20%) had damaged hair shafts and 20 patients (80%) had normal hair shafts, and that 1 patient (4%), 24 patients (96%) did not have dystrophic hairs. Vegetable oils are often used as hair pomades, and according to Rele and Mohile., 2000, this practise is associated with healthier hair. Oils that accumulate on hair provide a protective function. Therefore, oil-based hair conditioners are thought to help stop the dryness and brittleness that results from hair losing its natural oils. In this case, coconut oil’s protective impact as a prewash conditioner against cuticular damage during combing. Natural oils may reach the hair cortex, and this has been shown by Ruetsch et al., 2001 to have a restorative effect by reducing fibre swelling.
Patient satisfaction, hair loss, greying, dandruff, frizz, pull test, tug test, card test, telegon percentage, presence of hair shaft damage, and presence of dystrophic hair all differed significantly between the chemical relaxers and the natural hair oils (p0.0001, 0.0001, 0.0001, 0.002, 0.0001, 0.003, 0.002, 0.007). These findings matched those of a research by Hallégot et al., 2006, which used an environmental electron microscope to compare the swelling of treated and untreated hair (ESEM). According to this research, relaxers cause swelling in hair fibres (fibre damage), but natural hair does not have this effect. Our findings were similarly in agreement with those of a 2019 research on the microscopic characteristics of scalp hair that was treated to various ethnic styling practises. According to the results of this research, girls of African descent whose hair is naturally unstyled and whose hair is styled without the use of chemicals do not see a noticeable change in their hair’s characteristics. Because the waterproofing components of chemically treated hair were removed during the processing, the larger diameter of the hair shafts suggests that the hair is now more susceptible to water penetration. The hair’s natural structure is protected and structural damage is minimised by limiting the amount of water that may enter the hair.
This is the first research that we are aware of to compare the effectiveness of chemical and physical hair relaxers against that of natural hair oils.