THE DERMATOLOGIST LOOKS AT THE HAIR PROBLEM 135 occasionally in complete disappear- ance of this type of eruption when other standard measures of treat- ment had failed. Probably the last word has not been said in the matter of sham- pooing and certainly we are chang- ing radically in our views as to what is the best type of preparation to cleanse and wash the hair. The sulfonated oils which get us away from the alkaline soaps,. are un- doubtedly an improvement in some respects but they unquestionably have certain disadvantages, chiefly the fact that they do not lather well and that they are extremely drying to the hair in most cases. It is not my purpose to go into the dangers attendant to hair wav- ing or hair straightening except to point out that bad results have been reported from the cold wave and also to draw attention to the fact that hair waving usually causes changes in color of the hair but especially if other preparations are being used in the hair and scalp at the same time. It is probable that the number of cases of alopecia areata we see following the waving of the hair, may be purely coinci- dental. It might be a distinct ad- vantage to examine the hair and scalp under a wood light before waving, as a protective measure to the patient as it would give an ex- cellent idea as to the condition of the hair and its suitability for waving. I do not have in mind ruling out the possibility of a fungus infection, which would be unlikely in an adult, but it would give the operator fairly definite data as to whether the indi- vidual had been using other chem- icals on the hair that had not been thoroughly washed out. An ex- amination of the hair with the wood light after the wave would give you a good picture of what damage had been done to the hair, and might be a good check on the operator. Mild dermatitis venanata of scalp in fairly sharply localized patches with temporary hair loss due to breaking off of hair at a level close to the skin is not an infrequent sequella. Cotter (9) in 1946 reported that the number of cases in which a toxic reaction has been observed from the "cold wave" process using thiogly- colic acid appear to be on the in- crease. He reported in detail 5 cases from a large group because in these it had been possible to demon- strate their lesions in the laboratory. He showed that severe allergic reac- tions can result in sensitive persons from thioglycolic acid. Those indi- viduals with anemias and allergic disturbances are most vulnerable. In the majority of cases recovery occarred without permanent damage to the liver when the exposure was promptly terminated. In those cases in which the acid acted as a systemic poison as well as an aller- gen the first signs of trouble were to be found in the blood count, the elevation of the alkaline phospha- rase, the change in the ratio of free to esterified cholesterol, and the appearance of a positive cephalin flocculation test. The danger of using celluloid combs in water waving are too well

13t3 JOURNAL OF THE SOCIETY . known to deserve more than a mere comment. It is surprising, however , ' that in this day and age, thallium acetate could have been used as re- cently as a few years ago on the body to remove unwanted body hairs when the effect of this poison, in causing depilation of the scalp hairs, but not body hairs, was so well known to most everyone. Chemical hair straighteners be- gan to evolve in 1910 and today do a huge business. Their mode of ac- tion is to make a supple out of a rigid shaft. The cystine variety of the hair proteins can be broken at its disulfide bond to produce this fiber relaxation. Thus the kinking, due to thickness gradations and axial twists, may be overcome. Ac- cording to Lewis (9a) three general types of treatments can be utilized: (1) Reducing substances, which ordinarily contain stannous chloride, sodium hyposulfite, sodium polysul'fide, and the like. (2) Agents which bring large amounts of heat to the indi- vidual hairs by their exother- mic reaction with water( cal- cium oxide, for example). (3) Caustics, chiefly sodium and barium hydroxide. Three changes occur: hydrolysis, inhibition, and destruction of the disulfide linkage. The re- sult is a malleable protein gel susceptible to mechanical straightening, a softer hair. ' The use of these caustics is not Without danger. Burns may be of OF COSMETIC CHEMISTS such severity that the employment of straighteners is inadvisable ex- cept with great care or under the supervision of a qualified expert. Of two cases seen by the author, one suffered permanently damaging burns, as though by lye, and the other a permanently depigmented area across his forehead. Hair was subjected to a careful analysis by Bagchi and Ganguly (10) and. was found to contain, in much excess,. all the metals which are likely to be present in human tissues. There is marked vari- ability in the amounts of the me- tallic elements in hair. MXxED HAXR-oF 30 MALE ADULTS--FROM A BARBER S}tOP Per Cent C ........................... 44.60 N ........................... 14.60 H ............................ 5.40 S ............................ 3.80 P ........................... 0.08 C1 ................... : ....... 2.00 Mg. per Kilo Water ....................... 4.10 Pb .......................... 47.7 Cu .......................... 108.0 As .......................... 2.2 Zn .......................... 212.0 Fe .......................... 141.0 Mn .................... • ..... 38.0 Co .......................... 18.1 Ni .......................... 8.2 Ca .......................... 208.4 A1 ........................... 32.0 Si ........................... 150.4 Bi ........................... -- St) .......................... -- Hg .......................... -- Aspa•rtic acid (3.5%) has been isolated for the first time from hfiman hair by Beveridge and Lucas (11). Glutamic acid has been iso- lated from human hair in higher yields than previously reported.