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Herbal armamentarium for the culprit dandruff

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Abstract

The present article discusses about the pathogenic agents responsible for dandruff, clinical manifestation and mechanism of action of dandruff. The article also discusses about various synthetic and herbal treatments available for dandruff and the side effects associated with synthetic antidandruff agents. These herbs have wide range of active principles and are used in their crude form or they may be extracted purified or derivatized to render them more suitable for use in cosmetics .The status of dandruff is ambiguous-a disease/disorder therefore relatively less medical intervention is sought after for the treatment of dandruff. Dandruff can be treated with over the counter products which are shampoos containing antifungal and antibacterial ingredients like zinc pyrithione, selenium sulfide, salicylic acid etc. These can slow down flaking. Herbal extracts have proved to be good alternatives for the chemical preparation. A number of herbal preparations have excellent result due to their synergistic antifungal, anti-inflammatory and immuno-stimulatory action.
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e - ISSN 2249-7544
Print ISSN 2229-7464
HERBAL ARMAMENTARIUM FOR THE CULPRIT DANDRUFF
Shalini Sharma*, UM Upadhyay, Siddhi U Upadhyay, Tanvi Patel, Pratiksha Trivedi
Dept. of Pharmacognosy, Babaria Institute of Pharmacy, Varnama, Vadodara, Gujarat, India.
ABSTRACT
The present article discusses about the pathogenic agents responsible for dandruff, clinical manifestation and
mechanism of action of dandruff. The article also discusses about various synthetic and herbal treatments available for
dandruff and the side effects associated with synthetic antidandruff agents. These herbs have wide range of active principles
and are used in their crude form or they may be extracted purified or derivatized to render them more suitable for use in
cosmetics .The status of dandruff is ambiguous-a disease/disorder therefore relatively less medical intervention is sought after
for the treatment of dandruff. Dandruff can be treated with over the counter products which are shampoos containing
antifungal and antibacterial ingredients like zinc pyrithione, selenium sulfide, salicylic acid etc. These can slow down flaking.
Herbal extracts have proved to be good alternatives for the chemical preparation. A number of herbal preparations have
excellent result due to their synergistic antifungal, anti-inflammatory and immuno-stimulatory action.
Keywords: Dandruff, Herbal treatment, Herbal cosmetic, Pityrosporum ovale, Seborrheic dermatitis.
INTRODUCTION
In light of recent developments in scientific and
technological world, even today herbs are widely used as
remedial agents. India is one of the countries in this
artificial world which is rich in large varieties of medicinal
plants. WHO currently encourages, recommends and
promotes traditional or herbal remedies in National health
care programs because such drugs are easily available at
low cost and comparatively safe and the people have good
faith in such remedies [1].
Dandruff is a common scalp disorder affecting
almost half of the pubertal population of any ethnicity in
both the genders but most prevalent in male population
between the age group of 20-60 years. Worldwide 55% of
global population is suffering from the same problem.
Dandruff is also called scurf historically termed pityriasis
capitis it is due to the excessive shedding of dead skin
cells from the scalp. As it is normal for skin cells to die
and flake off, a small amount of flaking is normal and in
fact quite common. Excessive flaking can also be a
symptom of seborrhoreic dermatitis, psoriasis, fungal
infection or excoriation associated with infestation of head
lice. There are two types of dandruff (a) dry and flake type
(pityriasis scale) (b) oily type (seborrhoeic scale). It sticks
to the nails when the scalp is scratched. Other reasons of
dandruff are excess androgenic hormone, excessive
sebaceous secretion. Keratinization of the scalp tissue may
be accelerated by physical irritation, such as scratching
with the nails, chemical irritation from drugs,
photosensitivity, tinea capitis, xerotic eczema and vitamin
B or zinc deficiency or however the result of poor
personal hygiene or use of dirty comb.
Dandruff has been shown to be the result of 3
required factors.
a) Skin oil commonly referred to as sebum or sebaceous
secretions.
b) The metabolic byproduct of skin micro-organisms
(most specifically Malassezia yeast, a lipophillic
fungus).
c) Individual susceptibility against presence of
Malassezia species.
Candida albicans is one of the major causes for
dandruff together with the fungus. There may be some
bacterial infestation on scalp wound by nail scratching [2].
Mechanism of action
Malassezia organism can be found on the skin in
75-90% healthy people. Malassezia Furfur is a lipophillic,
saprophytic, budding, unipolar, dimorphic, gram positive
double walled, oval to round yeast. Colonization by M.
furfur begins soon after birth, the peak presence of yeast
occurs in late adolescence and early adult life. Pityriasis
ovale is present on 90-100% of surface of healthy skin,
pityrosoprum follicullities is a most common in those aged
13-45 years. Malassezia yeast requires free fatty acid for
survival. Usually found in stratum corneum and in pilar
folliculi. The yeast hydrolyzes triglycerides into free fatty
acids and creates long chain and medium chain fatty acids
Corresponding Author Shalini Sharma Email:- shalineesharma29@gmail.com
INTERNATIONAL JOURNAL
OF
PHYTOPHARMACY RESEARCH
www.phytopharmacyresearch.com
Vol 4 | Issue 1| 2013 | 23-28.
24
from free fatty acids. The result is a cell mediated response
and activation of the alternative complement pathway,
which leads to inflammation. C. albicans is also a major
cause of dandruff together with bacterial infestation on
scalp. More than 7 species of Malassezia has been reported
i.e. M. globa, M. sympodialis, M. furfur, M. obtuse, M.
sloofiae, M. restricta, M. pachydermatis [3].
Antidandruff agents and their mechanism of actions
An agent is associated with treatment of scalp
disorder that controls excessive formation of dandruff cells
from the horney layer of skin. It may also alleviate the
itching and scaliness associated with seborrhoeic
dermatitis. Antidandruff agents may be natural or
synthetic. These agents free the scalp from natural grease,
oil, dirt or fatty lipids which avoid creating a prime
environment for Malassezia, Candida and bacterias to
thrive. This stops the formation of oleic acid and prevents
the increased turnover of skin cells thus getting rid of
dandruff [4].
Synthetic antidandruff agents and their side effects
In the current scenario many chemical substances
are used for treating dandruff by controlling the abundance
of fungi on the scalp. The main active agents used
currently for controlling dandruff include imidazole
derivative such as ketoconazole and other compounds such
as selenium sulfide, zinc pyrithione, ethylene glycol,
piroctone, olamine, salicylic acid, guar hydroxy
propyltrimonium chloride, dimethiconol, glycolic acid,
steroids, tar derivatives. Most products which are designed
to fight dandruff contain zinc pyrithione. Zinc pyrithione
has antifungal effect; it has the ability to disrupt membrane
transport by blocking the proton pump that energizes the
transport mechanism. A new study proposes that the mode
of action of zinc pyrithione arises from iron starvation4.
Ketoconazole and Zinc pyrithione (ZnPTO) based
shampoos (Over the Counter products) are used more by
the consumers for common dandruff problems. The
shampoos with ZnPTO are preferred by majority of the
consumers, as the shampoos brands with ZnPTO (Anti
Dandruff ingredient) are not only cheaper but also provide
the desired functional benefit. However, in very severe
cases of dandruff, ketoconazole based shampoos are
preferred despite their relatively higher costs, so it may
take some experimenting to find a formula that works for a
specific condition. Antidandruff activity of ketoconazole
coated silver nanoparticles (AgNp) of 4±2 nm on the
dandruff scales collected from human volunteers by disc
diffusion method was investigated. It was concluded that
AgNp enhanced the activity of ketoconazole. This is
because Ketoconazole acts on fungi at the level of cell
wall, while AgNp powerfully penetrates through the
membrane leading to complete eradication of the fungi [5].
Scalp lesions are quite common among all patients. A
number of topical corticosteroids are used for the
treatment, but corticosteroids as creams and ointments may
have some undesirable effects. A shampoo containing
fluocinoloneacetonide (0.01%) is approved for the
treatment. This study showed that clobetasol propionate
shampoo improved the results [5]. Patients with
dermatoses have a deficient cell mediated immune
response to Malassezia furfur.
Salicylic acid
Salicylic acid is a beta hydroxy acid keratolytic
agent that is useful in removing scaly, hyperkeratotic skin:
it decreases cell to cell adhesion between corneocytes.
Although the mechanism of action of organic acid is
unclear, it may involve the release of desmogleins and the
disintegration of desmosomes.
Sulfur Sulfur is a yellow non-metallic element with both
keratolytic and anti-microbial properties. Keratolytic effect
is thought to be mediated by reaction between the sulfur
and cysteine in keratinocytes, whereas anti-microbial effect
may depend on conversion of sulfur to pentathionic acid by
normal skin flora or keratinocytes.
Zinc It is thought that zinc pyrithione heals the scalp by
normalizing epithelial keratinization, sebum production, or
both. Some studies have shown a significant reduction in
number of yeast organisms after application of zinc
pyrithione.
Tar Tar have been classically used to treat psoriasis
and proved as effective in treating dandruff. Tar is used as
second line therapy due to its limitations such as staining,
odor and messiness in its application. Tar products disperse
scales, which may reduce Malassezia colonization.
Steroids The pharmacokinetic properties of topical
corticosteroids depend on the structure of the agent, the
vehicle and skin on which it is applied. Topical
corticosteroids work via their anti-inflammatory and anti-
proliferative effects. Topical steroids are often used in
combination with other treatments such as antifungal
agents.
Selenium sulfide
It is thought that selenium sulfide controls
dandruff by its anti-pityrosporum effect rather than its anti-
proliferative effect. It also significantly reduces the rat of
cell turn over. It has anti-seborrheic properties and appears
to produce a cytostatic effect on cells of epidermis and
follicular epithelium. The antidandruff effects of
ketoconazole were superior to those of selenium sulfide
and zinc pyrithione.
Ketoconazole
Ketoconazole acts by blocking the biosynthesis of
ergosterol, a primary sterol derivative of fungal cell
membrane. It is a broad spectrum antimycotic agent that is
active against both Candida albicans and M. furfur of all
the imidazole currently available, ketoconazole has become
a leading contender among treatment option because of its
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effectiveness in treating seborrheic dermatitis. A
ketoconazole 1% shampoo has been approved for over the
counter use and 2% shampoo is available by prescription
(Nizoral). It may cause irritation and stinging.
Hydroxypyridones
Hydroxypyridones do not affect sterol
biosynthesis; instead they interfere with active transport of
essential macromolecule precursors, cell membrane
integrity, and cell respiration processes of dermatophytes
and yeasts. Ciclopirox, a member of hydroxypyridone
family, has broad-spectrum action against dermatophytes,
yeast and fungi. Its anti-inflammatory has been
demonstrated in human polymorphonuclear cells.This
agent also inhibits prostaglandin and leukotriene synthesis
[6].
Some of the very common side effects associated
with antidandruff shampoos are itching, mild irritation or
oiliness and dryness of hair and scalp. Severe allergic
reactions includes rash, hives, itching, difficulty in
breathing, tightness in chest, swelling of mouth, face, lips,
increased or abnormal hair loss, blistering, peeling or
burning of skin or scalp [7]. The chemicals used for the
treatment of dandruff have certain limitations; they are
unable to prevent occurrence, which is a common
troublesome clinical problem.
Herbs as antidandruff
Dandruff is an overall scalp disorder/disease. The
treatment of dandruff includes application of topical,
antifungal or other products. Since recurrence occurs
commonly prophylaxis using products for skin and hair to
maintain good healthy skin of scalp and hairs. Herbs are
compatible with both human skin and hair. Unlike
chemical based products, herbs are completely safe,
extremely effective and have almost no side effects due to
their compatibility with human body.
Herbal drugs or their formulations are viable
alternative to synthetic drugs. During the past few decades,
there has been a dramatic increase in the use of natural
products in cosmetics. The awareness and need for
cosmetics with herbs is on the rise, primarily because it is
believed that these products are safe and free from side-
effects. Now-a-days, many herbal shampoos are available
in the market which contains herbal ingredients such as
plant extracts and essential oils [8]. There are large
numbers of plants which are reported to have beneficial
effects on hair and are commonly used in shampoos.
A novel protein from lemon grass- lemin can
inhibit the generation upto 95%. Use of essential oils for
controlling candida albicans growth has gained
significance due to the resistance acquired by pathogens
towards a number of widely used drugs. The lemon grass
essential oil vapour is more potent inhibitor of C. albican
growth leading to deleterious morphological changes in
cellular structure of cell surface alteration as compared to
lemon grass essential oil [9].
The Maka (Lepidium meyenii), Aloe (Aloe
barbadensis), Neem (Azadiracta indica), Shikakai (Acacia
concinna), Brahmi (Centella asiatica), Ritha (Sapindus
trifolatus), Amla (Embilica officinalis) powder decoction
shampoo was prepared and it was found safer than the
chemical conditioning agent. It also gradually reduces the
hair loss during combing as well as strengthens the hair
growth [10].
The Saponin containing Acacia concinna,
Sapindus trifoliate, Dodonea viscose, Albizzia amara and
Trigonella foenum graceum were used in poly herbal hair
care powder and showed effective antidandruff property
[11]. Polyherbal hair oil was prepared by using six
methanolic crude extracts of herbs namely, Albizzia amara,
Achyranthes aspera, Cassia fistula, Cassia auriculata,
Datura stramonium and Azadirachta indica. A zone of
inhibition of poly herbal oil observed as 15 mm diameter
for Pityrosporum ovale and 13 nm for Candida albicans.
Preclinical trials were performed with human volunteers.
There was a clear symptomatic relief from dandruff
observed after 10 days usage [12].
The extracts of Hibiscus rosasinensis (China
rose), Centella asiatica (Brahmi), Eclipta alba
(bhringaraj), Emblica officinalis (amla) and Terminalia
bellerica (vivitaki) were used to preparae antidandruff hair
oil. This study was planned to evaluate the clinical efficacy
and safety of “Anti-Dandruff Hair Oil” in the management
of dandruff. The aim of treatment is to reduce the level of
the Pityrosporium ovale on the scalp and the goals of
therapy are to reduce morbidity and prevent complications.
This study observed a significant reduction in the mean
scores of itching and white scales. Subjective evaluation
revealed remarkable improvement. The excellent
antidandruff action of “Anti- Dandruff Hair Oil” might
have been due to the synergistic antifungal, anti-
inflammatory and local immunostimulatory actions of its
ingredients [13].
Poly-herbal hair oil was studied for antidandruff
activity using microbiological and clinical tests. There was
a clear symptomatic relief from dandruff in all the
volunteers after 10 days of use. The plant extracts included
Wrightia tinctoria (Indrajev), Cassia alata (Dadmari) and
bitter fraction of Azadirachta indica (Neem). Methylene
blue reductase test was employed to study the anti-dandruff
efficacy of the oil.
The shampoo extract of Ocimum sanctum (tulsi)
and Azadirachta indica (neem) leaves have good
antimicrobial activity due to the presence of flavonids, it
was found to be effective, harmless and economic [14]. A
number of plants have been used for antidandruff
shampoos and oils like Glycine max (soyabean),
Rosmarinus officinalis (rosemary), Arctium lappa
(burdock), Zingiber officinalis (ginger), Plantago major
(greater plantain), Melaleuca spp (tea tree), Camellia
chinensis (tea), Salvia officinalis (sage), Mentha piperata
(mint), Thymus vulgaris (thyme), Glycerriza glabra
(yashtimadhu) [15]. Inhibitory effect of the fruit extracts of
Terminalia bellerica (baehra) can be attributed to the
chemical substances gallic acid and ethyl gallate present in
the fruits [16] and in the case of Terminalia chebula
(haritaki) tannins like beta sitosterol, gallicacid, ellagic
acid, gallate, galloyl glucose, chebulagic acid [17]. Crude
and methanol extracts of dry fruit of Terminalia bellerica
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possessed broad spectrum antimicrobial activity [18].
Among the herbal ingredients tea tree oil recorded
significant anti-fungal activity. Tea tree oil is an essential
oil of the leaves of the Australian Melaleuca alternifolia
(tea tree) tree. It is a mixture of hydrocarbons and terpenes,
consisting of almost 100 substances. The antimicrobial
property is attributed primarily to the major component,
terpinen-4-ol. Tea tree oil represents a sound alternative for
patients with dandruff who prefer a natural product and
who are willing to shampoo their hair daily. Basil oil and
Coleus oil are known to have the highest activity among
the herbal ingredients. Other herbs used were Nyctanthes
arbortristis (Harshingar), Hibiscus rosasinensis (Gurhal),
Azadirachta indica (Neem), Emblica officialis (Amalki),
Casytha filiformis (Amar Bel), Cinnamomum camphora
(Karpoor), Curcuma longa (Haldi), Rubia cordifolia
(Majistha). Herbal ingredients like tea tree oil, rosemary
oil, clove oil, pepper extract, neem extract, rosemary oil,
henna, and lemon also recorded good anti-pityrosporum
activity [19]. A polyherbal shampoo containing the extracts
of Rosmarinus officinalis (rosemary), Vetiveria zizanioides
(khus), Nigella sativa (nutmeg), Santalum
album(sandalwood), Ficus bengalensis (banyan), Citrus
limon (lemon) and oil of Melaleuca leucadendron(tea
tree), showed anti-fungal, anti-inflammatory and local
immunostimulatory actions [20].
Formulated polyherbal antidandruff hair oil is
very effective in management of dandruff. Experiments
with volatile oils of Eucalyptus globulesand Ocimum
gratissimum (African basil) along with the petroleum ether
extract of Hibiscus rosa-sinensis (china rose), Phylanthus
embelica (Amla), Tridax procumbens (jayantiveda) posses
antifungal activity. The last two extracts have significant
hair growth activity. Hibiscus is used in management of
dandruff. Its leaves and flowers not only promote the
growth of hair but also color the hair and are good for
healing ulcers. Amla helps in good growth of hair hence
most of the marketed herbal hair oils contain amla as one
of the chief ingredients [21]. A total of 50 patients who
were diagnosed as suffering from moderate to severe form
of dandruff with dry and damaged hair were included in a
study using polyherbal cream recommended for the
treatment of dandruff. The formulations contained the
extracts of Cicer arietinum (Indianpea), Rosmarinus
officinalis (rosemary), Ocimum sanctum (Tulsi) and oils of
Pongamia glabra (karanja) Melaleuca leucadendron
(Teatree), Azadirachta indica (Neem), Sesamum indicum
and Vitis vinifera (commongrape vine) [22].
Henna is shown to have strong fungicidal as well
as anti-inflammatory, analgesic and antibacterial
properties. The chemical constituents of this plant extract
include naphthaline derivatives, quinoids, beta sitosterol,
flavonoids and gallic acid. It also acts as a very good
conditioner to the hair and has anticancer properties [23].
Antifungal effects of chloroformic, methanolic and
aqueous extracts of henna (Lawsonia inermis) leaves on
Malassezia furfur were studied. The study reported that
chloroformic extract of henna completely inhibited the
growth of Malassezia furfur [24]. Plant extracts were
prepared from Citrus limon (lemon), Emblica officinalis
(amla), Trigonella foenum graecum (fenugreek), Vitis
vinifera (grape vine), Papaver somniferum (poppy) and
Allium cepa (onion) in different concentration. The
aqueous plant extracts were added to the wells of
Malassezia furfur inoculated plates. Results showed that
Citrus limon extract had maximum zone of inhibition than
other plant extracts and extracts of Papaver somniferum
and Allium cepa did not show any inhibition zone [25].
The potentials of four extracts viz. Hibiscus rosa-
sinensis (chinarose), Phyllanthus emblica (amla), Allium
sativum (garlic) and Terminalia chebula(haritaki) were
established as active antidandruff plants [26]. Acacia
concinna (shikakai) is an important medicinal plant in
Thailand and throughout Asian countries. Its dried pods are
traditionally utilized as herbal medicine to treat many
health symptoms e.g. constipation, cough, dandruff and
skin diseases. The antimicrobial potential of A. concinna
extracts against the fungal causative agents has been
worked out [27].
In an investigation nineteen plant spp. were
collected from in and around Karur District of Tamil Nadu
and were tested for their antimycotic activity against M.
furfur. Aloe vera
(kumari) Eucalyptus globules (blue gum), Phyllanthus
emblica (Amla) and Wrightia tinctoria (pala) leaf extracts
and oil showed antifungal property as they progressively
inhibited the growth of M. furfur on Sabouraud's dextrose
agar medium. The volatile oil of Eucalyptus globulus,
significantly reduced the growth of M. furfur [28].
The effect of piroctoneolamine and climbazole
with extracts of Urtica dioica (nettle), Matricaria
chamomilla (chamomile), Rosmarinus officinalis
(rosemary), Salvia officinalis(sage), Mentha piperata
(pepper mint) and Triticum (wheat germ) were assessed.
Benefit of these herbal extracts on the skin and hair is clear
and are widely used in Iranian shampoos. Both shampoos
containing climbazole or piroctoneolamine besides herbal
extracts are effective in the reduction of dandruff and relief
of other seborrheic dermatitis symptoms but climbazole
seems to be more effective than piroctoneolamine in the
treatment of dandruff. The petroleum ether extract of
Tridax procumbens was found to be effective against
dandruff. Formulation (liquid cream shampoo) was
developed using active extract of Tridax procumbens and
was evaluated using various parameters, which proved its
efficacy and safety [29].
A polyherbal hair oil containing methanolic
extracts of Albizia amara, Achyranthes aspera, Cassia
fistula, Cassia auriculata, Datura stramonium and
Azadirachta indica was formulated. The hair oil was
effective against dandruff and was safe [30]. Emblica
officinalis decreased the induction of nitric oxide synthase.
The antifungal activity of the plant extracts was determined
by well diffusion method using Terminalia bellerica,
Terminalia chebula, Emblica officinalis and Lantana
camara [31]. Lantana camara possesses antifungal
properties .The essential oil of Lantana camara, tested
against seven bacteria and eight fungi showed a wide
spectrum of antibacterial and antifungal activity [32].
Ocimum sanctum has a high content of flavonoids .The
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principle ingredients of Ocimum sanctum are fatty acid i.e,
stearic, palmitic, oleic and linoleic acid [33]. It has
significant anti inflammatory activity against prostaglandin
E2, leukotriene, and arachidonic acid and acts as a
microbial agent [34]. Studies have been conducted to check
the antifungal properties of Neem (Azadirachta indica)
leaves extract to treat hair dandruff. The 100% extract of
neem leaves produced the widest zone of inhibition which
was found statistically higher than the other concentration.
It can also cure skin diseases or epidermal problems
ranging from dandruff, acne, and psoriasis and ringworm
infection. It is also known to produce pain relieving anti-
inflammatory compounds [35].
A completely herbal shampoo from Asparagus
racemosus, Acacia concina, Sapindus mukorossi as main
ingredients along with other herbal ingredients was
prepared. This shampoo was self-preserving to avoid the
risk posed by chemical preservatives. They used Aloe vera
gel and other plant extracts to provide the conditioning
effects [36].
DISCUSSION AND CONCLUSION
Herbs are compatible with both human skin and
hair. Unlike chemical based products herbs are completely
safe, extremely effective and have almost no negative side
effects due to their compatibility with human body, cost
effectiveness, their demand is increasing day by day. This
also promotes research for newer plant constituents. The
synthetic treatments available have certain limitations
which may be either due to poor efficacies or due to
compliance issues, furthermore, these synthetic drugs are
unable to prevent recurrence, the common problem
associated with them. The best approach to treat dandruff
is to use herbal products and go for a balance diet. A
combination of nutritional and herbal treatment should
bring improvement 6-8 weeks.
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... commensal yeast that causes dandruff and seborrheic dermatitis. [27] Fig.14 Fenugreek ...
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The most common problem in teenage and adult is of dandruff which is scientifically known as ‘Malassezia’ which if ignore can further continue with secondary symptoms like Acne, itching, discomfort etc. The present review highlighted the mechanism of ‘Malassezia’ along with the available treatment for it. Though the number of synthetic formulations available, the present review focuses on alterative and safe way to treat dandruff i.e. use of herbs with their biological source and constituents responsible for effectivity to solve the problem in broad population. Due to wide range of activity phytoconstituents like anti-inflammatory, antibacterial and antifungal, these synergistic effect may increase the applicability of herbs in cosmetics and cosmeceuticals as well. Hence the considering the need of herbal formulation development an attempt has been made to discuss about formulation commonly used to treat dandruff i.e. shampoo, different parameters of evaluation and invitro method evaluation of Antidandruff activity.
... Tannins have inhibitory roles similar to those of beta sitosterol, gallicacid, ellagic acid, gallate, galloyl glucose, and chebulagic acid in T. chebula (haritaki) . [117] ...
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A shampoo is a cleaning aid for the hair and is counted among the foremost beauty products. Today's shampoo formulations are beyond the stage of pure cleaning of the hair. Additional benefits are expected, e.g, conditioning, smoothing of the hair surface, good health of hair, i.e, hair free of dandruff, dirt, grease and lice and, above all, its safety benefits are expected. As the scalp is one of the most absorbent part of the body, products applied to the scalp go directly to the blood, without being filtered in any way. So it is very important to know and understand the effects of ingredients used in shampoo formulations. In the present review the shampoos based on synthetic ingredients and herbal ingredients are compared for their effectiveness and safety.
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