People are more confident about asking for advice about hair loss and scalp problems

The past 12 months has seen its fair share of discussion about imminent ‘cures’ for baldness in the national press and one manufacturer has claimed it may even be able to prevent or reverse the greying of hair. Putting speculation to one side, all this media attention does confirm that the hair and scalp category is a very important area for consumers.


Thinning Hair Awareness Week (3 to 9 March) will provide a great opener to discuss the issues surrounding hair and scalp problems and educate consumers about what is available.

Market analysis suggests a growing demand for natural and organic hair products. An analyst from Infiniti Research says: ‘Consumers are paying more attention to the ingredients in hair care products before buying them.’ They suggest the greatest challenge to the sector has been the recession and the limit on disposable income.

According to IRI data, the UK market for scalp treatments over the past 12 months is down by 9.7 per cent in value terms. However, analysts also point to a global trend for a higher prevalence of scalp problems and an increasing desire for consumers to look groomed at all times.

Hair loss

According to the Belgravia Centre, a leading hair loss clinic in London, 65 per cent of men have noticeable hair loss by the age of 60, while 50 per cent of women may experience some level of problem hair loss over the course of their lifetime.

After a growing number of high-profile celebrity endorsements, the acceptance of hair transplants is at an all-time high. A recent poll of hair specialists conducted by found a 260 per cent rise in the number of men enquiring about hair transplants. The procedure can cost more than £30,000 depending on the number of grafts required. Another specialist option is low-level laser therapy where light emitted at a frequency between 500 and 1,000 nanometres is claimed to help enhance hair growth.

Treatments for hair loss can be divided into two categories: restoration and maintenance, explains Dr Bessam Farjo, medical director of the Institute of Trichologists. ‘The first step for pharmacists should be to find out the patient’s goal as this will determine the appropriate treatment.’

The total market for hair regrowth products is about £16 million a year, says Regaine. Hereditary hair loss is the most common hair loss disorder affecting men and women – 40 per cent of men under the age of 35 are already losing their hair.

Research from the brand suggests that some pharmacists are not confident answering questions from customers on hair loss – with more than a quarter saying they were less confident dealing with questions on the topic compared with other health topics. However, the proportion of men suffering hair loss who would consider purchasing Regaine increases by 80 per cent when it is recommended by a pharmacist, says the brand. The use of minoxidil, the active ingredient in Regaine, is supported by guidelines from the European Dermatology Forum.

While hair loss is a natural process for many, nutritional factors such as zinc, calcium, and vitamin D levels have been linked to optimum hair health. Metabolic conditions such as diabetes and thyroid disease can also cause hair loss. Some women can have increased shedding after pregnancy. Women reporting this should be reassured that it is quite common and acts to restore the balance, as shedding stops during pregnancy. Within six months, their hair should return to normal, advises Dr Farjo.

Nourkrin is a supplement taken twice a day to support and maintain the hair growth cycle and prevent further hair loss. The brand is launching a campaign this year targeting GPs and pharmacists, to raise awareness about hair loss treatments and to support the care and advice offered to patients. Chris Keeble, chief executive at Pharma Medico Ltd, says: ‘We need healthcare professionals to be aware of recent studies that have found hair loss or hair thinning is a possible precursor to serious health concerns, such as diabetes, hypertension and hyperthyroidism.’ An addition to the Nourkrin range will be released in March – a natural scalp lotion that Mr Keeble suggests may be as effective as some existing treatments.

Caffeine-based shampoos have also gained popularity, such as Alpecin and Plantur 39 from The Dr Wolff Gruppe company. Plantur 39 is designed for women with hormone-induced hair loss. These products are being supported by a TV campaign targeting women over 40 and highlighting the brand’s success in Germany.

Despite the increased acceptability of hair loss treatments, the issue remains a sensitive topic for patients and the consultation room should be made available to discuss treatment options in private, suggests Dr Farjo. People should be encouraged to keep using their product of choice to see results, he stresses. ‘Patients should be advised that maintenance treatments require ongoing use. If treatment is stopped, the effects will disappear over a period of a few months.’

Dandruff and dry scalp

Dandruff will affect around 50 per cent of adults at some point in their lives. The problem is commonly the result of a dry scalp and the yeast malassezia, which occurs naturally on the skin, can exacerbate the problem. Anti-dandruff shampoos and conditioners contain ingredients that either slow the production of skin cells, attack the fungus that can cause dandruff, or a combination of the two. ‘They all work very well, it’s just about finding the right product for the customer,’ says Dr Farjo. Dandruff cannot be prevented but regular use of these products will help to keep the problem at bay, he advises. Dandruff can mask other conditions, such as eczema, he warns, and people should be referred if necessary.

The important issue is to differentiate between a dry scalp and dandruff, as the two scalp skin problems have common symptoms, including itchy skin and white flakes, says an E45 spokesperson. Pharmacists can help to diagnose the correct issue, as treating a dry scalp with a dandruff shampoo won’t help, says the brand.

More and more people describe their skin as ‘sensitive’, says E45, and research shows up to 66 per cent of women claim not to have normal skin. Causes of dry skin can be a dry environment, use of harsh soap products, insufficient fluid intake or excessive sunbathing. There are also seasonal trends with dry skin worsening in colder months.

Many people forget that when the skin on their body is dry and itchy this could also be the same on their scalp, giving pharmacy teams the opportunity to offer advice. ‘A key example would be when a customer is purchasing emollients and moisturisers. Talk about their hair and scalp and discuss whether a conditioning shampoo for scalp management such as E45 Dry Scalp shampoo would be appropriate.’ For people with very dry skin complete emollient therapy may be key to managing the condition.

Head lice

Itchiness might be dismissed as a symptom of dandruff or a dry scalp, but it can indicate head lice, especially if the customer is a parent or works with children. The customer needs to make sure they have got an infection before treating, says Dr Ian Burgess, director at the Medical Entomology Centre in Cambridgeshire. ‘Some people who have itchy scalps assume they have lice and treat themselves repeatedly.’ But these treatments will not relieve scalp conditions. Conversely, people can have head lice without any itching at all.

Head lice can be a sensitive issue and good advice goes a long way. Stress to patients the importance of following up after a week to ensure their treatment is successful. Dr Burgess explains: ‘Not following up is where many people go wrong. They don’t check to see if the treatment’s worked. So three to four weeks later, they start finding lice again and think they’ve been re-infested when, in fact, they didn’t actually get anywhere in the first place.’


 Pharmacy can lose out to grocery in terms of head lice treatments, but other areas of the category attract people wanting specialist advice. 

Fiona McElrea, Whithorn Pharmacy, Whithorn ‘We are generally the first port of call for advice regarding hair and scalp conditions. The main issues we hear about are a dry, itchy scalp and head lice. We mostly sell Polytar (although this is currently unavailable of course), Alphosyl, T-Gel and Nizoral if a fungal infection is suspected. Some patients buy these, but they are also prescribed by me to those eligible for the Scottish Minor Ailments Service. Nyda and Hedrin are the two main products for head lice are the majority are supplied on eMAS scripts. This category is of relatively small value to us in a financial sense.’


Ani Patel, Savages Pharmacy, Burnham on Crouch ‘This category tends to hold its own in the business. Customers usually ask for specific products and we stock the main brands that are most often advertised. Depending on the time of year, we see spikes in sales of certain products, such as head lice treatments in September and more dry scalp conditions in the winter. The main advice my team gives is to monitor results and to report back to the pharmacy or the GP if symptoms worsen or there is no viable improvement. Only exclusivity of products within the pharmacy sector will stimulate growth and further sales. Being able to purchase these products from any retailer means that price will always win over the service offered by pharmacy.’ 


William Hughes, RJ Jones Pharmacy, Nefyn ‘The hair and scalp conditions category is not as large as painkillers or cough and cold remedies, but it is certainly an important one that we do get enquiries about. In fact, I think that we have a way to go in terms of raising awareness with patients about what we have to offer for hair and scalp conditions. We could raise awareness further with in-store campaigns and nationally through advertising, for example. The category includes products for head lice, hair loss and treatments for a flaky, itchy scalp, such as T-Gel and Nizoral. Regaine does have a market for us and some customers buy it from us on a regular basis. I’ve also had two or three ladies who have had a chat to the doctor about hair loss issues and have been referred back to us, so we’ve gone through how Regaine might work for them. We’ve taken them into the consulting room and gone through it with them.’



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