Detumescence is defined by a reduction of the swelling in an organ or the skin, a subsidising of a tension state. When considering detumescence therapy for people suffering from hair loss, the concept refers to the reduction of inflammation or thickness in the scalp that is characteristic of hair loss sufferers.
the massage resulted in an increase of hair thickness as the scalp massage caused the gene expression to change significantly
Scalp massage or stimulating the scalp mechanically for hair regrowth has been, historically, one of the most popular self-treatments. From Chinese medicine to Indian practices and all through the Western world, massage was linked to better blood circulation and a healthy scalp. In the book “Hair culture”, the author describes a few methods for treating hair loss; he states that scalp massage along with hair pulling and vigorous brushing of the scalp were prescribed in the 20s for those seeking to improve their condition. (McFadden, 1922, retreived 2016)
Sibley (1932) showcases several treatment methods in the book Alopecia and its treatment. Among them, there are a few mechanical ones from high frequency currents applied by the vacuum electrode creating “electrical massage” which promises to penetrate even the scalps covered with the thickest hair. Another type of mechanical stimulation of the scalp is proposed by raising the scalp from the bone and then releasing it.
These mechanical methods of scalp simulation were promoted more than 80 years ago. However, recent studies show that stimulating the scalp might not be just an old wife’s tale, but a successful hair loss treatment.
Treatment for fibrosis
Before understanding why scalp massage might prove to be a useful treatment in hair loss, we need to understand the process behind it. There are certain theories regarding scalp fibrosis, one issue that many researchers consider to be important in understanding hair loss. Fibrosis is the thickening of the scalp tissue that occurs in people with alopecia. Researchers have hypothesized that the hair follicles cannot push through a thickened scalp to produce new hair. Furthermore, scalp fibrosis seems to also starve the follicles and can destroy the local metabolism. (Hiroyuki et al., 1972)
Treatment for inflammation
Inflammation is one of the main culprits in hair loss. A study on patients suffering from alopecia areata showed that the regrowth response to Minoxidil treatment was less than in patients who had significant micro-inflammation in the scalp when compared to the group that had little scalp inflammation. This shows the importance of understanding the causal role of inflammation and the thickening of scalp tissue in the treatment for hair loss. This is the reason why some researchers suggest that an anti-inflammation inducing agent should be considered during any alopecia treatment. (Zari et al., 2008)
Improved blood circulation in the scalp
The study indicates that massaging the scalp with oils promoting scalp and hair health can be an effective treatment for hair loss
Better blood circulation improves the health of the scalp and hair. A press release from Massachusetts General Hospital (2001) stated that research shows blood vessels were in fact the culprit for hair loss and hair grows thicker and stronger if there is an increase of blood vessels in the skin.
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Certain authors have linked scalp massage to the mechanoresponsiveness of human skin and how adaptable it is in harsh conditions. There are various biochemical and scaffolding functions in our cells that can be modulated by force. (Wong et al., 2011) Scalp massage has been hypothesized to not just have a relaxing effect but also help reduce inflammation. Research has shown that scalp massage does result in an increased blood flow and skin softening (Ando et al., 2013) but the benefit of massage in the treatment of hair loss has not been evaluated clearly, although it has been historically proposed as a treatment.
Koyama et al. (2016) evaluated the effect o scalp massage on various hair characteristics such as the number of hair follicles, thickness and growth rate as well as the mechanical effect of scalp massage on the subcutaneous tissue and dermal papilla cells.
The study was conducted on Japanese males and the evaluations of the human derma papilla cells were done in vitro using stretching forces. The men who volunteered for the study received a 4 minute long scalp massage for 24 weeks. The derma papilla cells were cultured using a 72-hour stretching. The results were as follows: the massage resulted in an increase of hair thickness as the scalp massage caused the gene expression to change significantly. It seems that standardized scalp massage can transmit mechanical stress to human dermal papilla cells and can help increase hair thickness.
Massaging may improve results of hair transplants
The importance of scalp massage is also exemplified in a paper about various hair loss treatment techniques. In alopecia reduction surgery a good scalp laxity needs to be obtained before any surgery is done and it can easily be obtained with massage. Before alopecia reduction surgery, patients are required to undergo preoperative scalp massage due to the ability of the scalp skin to stretch over a period of time from prolonged mechanical tension. This helps increase the success of alopecia reduction surgery and shows how the scalp can change its structure to allow for better success in various treatments. (Sattur, 2011)
Beneficial use of oils
Another study (Hay et al., 1998) evaluated the use of oils during scalp massage and whether it improves hair loss and hair structure such as the hair root, hair shaft and the overall scalp health. The study was conduction over a period of 7 months and involved 86 people diagnosed with alopecia areata, which were divided into two groups. One group received a massage every day for seven months with a mixture of oils containing: lavender, rosemary, thyme, cedar wood, jojoba and grapeseed, all known for promoting hair growth and thickness. The second group received massage with a mixture of jojoba and grapeseed oils only. There was a significant difference between the two groups. 44% of the members in the first group saw an improvement in their overall hair and scalp condition but there was also an improvement in 15% of the members of the second group. The study indicates that massaging the scalp with oils promoting scalp and hair health can be an effective treatment for hair loss.
Detumescence for hair loss: by reduction of scalp swelling
One of the breakthrough discoveries that mentioned the term detumescence for hair loss is the study conducted by Choy (2012). The author’s premise was that the root cause of hair loss is not really understood fully and an out of the box approach needs to be applied. He analysed the distinct localized regions of bald and non-bald scalps as well as the geometrical shape of each head. The study concluded that in bald scalps, some of the regions have a non-uniform thick skin, as opposed to non-bald scalp where the skin is uniform and thin. Also, it seems that in bald scalps the skin is harder and the head is shaped as a dome.
The author suggests that both female pattern hair loss and male androgenetic alopecia seem to go in-sync with a certain skin modification in both molecular and macro levels. This change can be viewed as a swelling of the scalp skin and if the swelling it reduced, the hair may regrow again. To promote a thinner and softer skin the researchers used detumescence therapy on the human scalp. The study was conducted on 100 bald people (50 males and 50 females) and 100 people without baldness, all aged between 6-86 years. The study concludes that regular 20 minute long massage, twice a day will help thin the tissue and help promote hair regrowth, as well as reduce the shape that bald heads have acquired.
In conclusion it seems that detumescence therapy may be a viable treatment method for patients that have hair loss. If skin thickness is indeed the culprit for lack of hair regrowth, the research done by now and future investigation may come up not only with an easy solution for hair loss but also a less costly one when compared to the treatments available today.
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- MacFadden, Bernarr. “Hair Culture.” Google Books. N.p., n.d. Web. 26 Aug. 2016.
- Sibley, K. (1932). Alopecia and its Treatment. Postgraduate Medical Journal,8(78), 110–113.
- Hori, Hiroyuki et al., The Thickness of Human Scalp: Normal and Bald, Journal of Investigative Dermatology , Volume 58 , Issue 6 , 396 – 399
- Zari, J., Abdolmajid, F., Masood, M., Vahid, M., & Yalda, N. (2008). EVALUATION OF THE RELATIONSHIP BETWEEN ANDROGENETIC ALOPECIA AND DEMODEX INFESTATION. Indian Journal of Dermatology,53(2), 64–67. http://doi.org/10.4103/0019-5154.41647
- Wong, Victor W. et al., Pushing Back: Wound Mechanotransduction in Repair and Regeneration, Journal of Investigative Dermatology , Volume 131 , Issue 11 , 2186 – 2196
- T. Ando et al., “Biosignal-based relaxation evaluation of head-care robot,” 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Osaka, 2013, pp. 6732-6735. doi: 10.1109/EMBC.2013.6611101
- Koyama, T., Kobayashi, K., Hama, T., Murakami, K., & Ogawa, R. (2016). Standardized Scalp Massage Results in Increased Hair Thickness by Inducing Stretching Forces to Dermal Papilla Cells in the Subcutaneous Tissue. Eplasty,16, e8.
- Sattur, S. S. (2011). A Review of Surgical Methods (Excluding Hair Transplantation) and Their Role in Hair Loss Management Today. Journal of Cutaneous and Aesthetic Surgery, 4(2), 89–97. http://doi.org/10.4103/0974-2077.85020
- Hay IC, Jamieson M, Ormerod AD. Randomized Trial of Aromatherapy: Successful Treatment for Alopecia Areata.Arch Dermatol. 1998;134(11):1349-1352. doi:10.1001/archderm.134.11.1349.
- Massachusetts General Hospital. (2001, February 19). Blood Vessels Hold Key To Thicker Hair Growth. ScienceDaily. Retrieved August 26, 2016 from www.sciencedaily.com/releases/2001/02/010215074636.htm
- Choy H (2012) Detumescence Therapy of Human Scalp for Natural Hair Regrowth. J Clin Exp Dermatol Res 3:138. doi:10.4172/2155-9554.1000138 http://www.omicsonline.org/detumescence-therapy-of-human-scalp-for-natural-hair-regrowth-2155-9554.1000138.pdf