DETERMINATION OF THE EPILATION FORCE.
Hair loss is a common problem encountered either due to pathological causes or nutritional deficiencies. There are various tests available to investigate the hair loss like, hair pull test, hair pluck test (Trichogram), phototrichogram, digital phototrichogram, unit area trichogram, hair diameter assessment and trichotillometer. Trichotillometer is a device that is used to determine the force required to pluck the hair. Trichotillometer is not available commercially. Instron universal Tensile Strength Tester 6021 (Instron limited, UK) is a machine, used in textile industry to test the tensile strength of textile fibers.  This study was planned to utilize Instron to determine the epilation force (EF) required to pluck the hair.
Aim of The Study
To determine the epilation force (EF) required to pluck the anagen hair and telogen hair from four regions (Frontal, vertex, occipital and parietal) of the scalp.
MATERIALS AND METHODS
This is an observational study. Ten healthy volunteers who did not complain of hair loss were studied. The EF required to pluck hair from 4 regions (Frontal, vertex, occipital and parietal) on each volunteer was determined using Instron fabric tensile strength tester 6021 (Instron limited, U K) (Figure 1).The volunteer sat in front of the Instron equipment with the chin placed over the flat surface on the Instron (Figure 2). Each hair was individually attached to the pneumatic side-action grip clamp of Instron and the hair was plucked. The EF was recorded in grams. Ten hair was plucked from each site. The root of the plucked hair was examined under microscope to determine whether the follicle plucked was in the anagen or telogen phase. Subsequently the mean force required to pluck the anagen hair and telogen hair from each area was calculated. Data were analysed using SPSS PC (11.5 version). Mean and standard deviation (SD) were calculated. Z test was done to test the statistical significance. Examination of hair was carried out at standard time (at least 3 days) after the last washing of the hair. Institutional ethics committee approval was obtained for this study project.
A total of 10 volunteers were included in the study among them five were males and 5 were females. A total of 400 hairs were examined. The mean EF required to pluck the anagen hair was 63.10 gms and telogen hair was 39.86 gms (P-value -0.000). In frontal area the mean EF required to pluck the anagen hair was 69.62 gms and telogen hair was 53.22 gms (P-value -0.128) (Table 1). In vertex area the mean EF required to pluck the anagen hair was 68.30 gms and telogen hair was 38.29 gms (P-value -0.000). In occipital area the mean EF required to pluck the anagen hair was 57.72 gms and telogen hair was 26.78 gms (P-value-0.000). In parietal area the mean EF required to pluck the anagen hair was 59.31 gms and telogen hair was 26.92 gms (P-value -0.034). In male the mean EF required to pluck the hair anagen hair was 73.98 gms and telogen hair was 46.87 gms (P-value -0.037). In female the mean EF required to pluck the hair was 52.16 gms for anagen hair and telogen hair was 33.39 gms (P-value -0.000) (Table 2).
Trichotillometer is a non-invasive tool that estimates quantitatively and objectively the force required to epilate the hair. This device is not available commercially. To estimate the EF required to epilate hair from various regions of scalp, Instron universal Tensile Strength Tester 6021 (Instron limited, U K) equipment was utilized in this study. Instron universal tensile strength tester has been used to study the tensile strength and elasticity of the hair.  Greater force was required to epilate the anagen hair than the telogen hairs on all the areas of scalp and this difference was statistically significant. Greater force was required to epilate the anagen and telogen hairs in males than the females, which was statistically significant. Among the various regions of scalp frontal region required greater force to epilate the hairs (Both anagen and telogen) followed by vertex, parietal and occipital regions and this is not statistically significant.
Mechanical resistance of anagen hair while plucking is because of the following reasons, anagen follicle lies deeper, the dermal papilla connected to the fibrous sheath protrudes into the bulb and the inner root sheath is closely opposed to the shaft. Hence greater EF is required to pluck anagen hair that the telogen hair.
Few studies estimated the force required to pluck the hair in normal healthy volunteers using a hand held trichotillometer. [2,3,4] Chase et al reported that the average observed range among well-nourished patients, when plucking 10 individual hairs, was 36.0 [+ or -] 12.4 g. Wyness et al reported that mean hair pluckability measurements for the 12 participants obtained by the three observers were 39.5 g, 41.2 g and 32.7 g respectively.  Smelser et al. determined the usefulness of trichotillometry under field conditions by measuring hair epilation force of 69 subjects at a hospital in Nigeria, the mean force was 36.5 +/- 9.5 g.  The average EF reported in the above studies was 37.18 g which is low when compared to our finding of 63.10 gm for anagen and 39.86 gms for telogen hair. In our study the EF was calculated separately for the anagen and telogen hairs in various regions of scalp, which was not done in previous reports and this could explain the variations in the findings. This may be due to biological variation in hair pluckability as the force required to pluck hair is likely to vary throughout the different stages of growth, over the different regions of scalp and in different races.
The variations in EF among the individual and the observes has been reported in previous studies.  In order to obtain a reproducible and representative mean hair pluckability measurement, an adequate amount of individual hairs need to be plucked and a standard instrument needs to be designed. In our study to eliminate the variations, the EF was measured separately for anagen and telogen hairs over the various regions of scalp and for both genders. We utilized the Instron universal Tensile Strength Tester 6021 to pluck the hair to avoid the intra-observer variation, since it is a mechanized device. If the reliability of the trichotillometer could be improved, for example, by adjusting the design, hair pluckability would be an extremely useful method of nutritional assessment and in assessment of the treatment response to various hair disorders.
Greater force was required to epilate the anagen hairs than telogen hairs on all the areas of scalp and greater force was required to epilate the anagen and telogen hairs in males than in females.
 Srinivasan G, Srinivas CR, Mathew AC, et al. Effects of hard water on hair. Int J Trichology 2013;5(3):137-9.
 Chase ES, Weinsier RL, Laven GT, et al. Trichotillometry: the quantitation of hair pluckability as a method of nutritional assessment. Am J Clin Nutr 1981;34(10):2280-6.
 Wyness LA, McNeill G, Prescot GJ. Trichotillometry: the reliability and practicality of hair pluckability as a method of nutritional assessment. Nutr J 2007;6:9.
 Smelser DN, Smelser NB, Krumdieck CL, et al. Field use of hair epilation force in nutrition status assessment. Am J Clin Nutr 1982;35(2):342-6.
Shanmuga Sundaram (1), Kumaresan M (2), Srinivas C. R (3)
(1) Associate Professor, Department of Dermatology, Karpagam Medical College, Coimbatore, Tamilnadu, India.
(2) Dermatologist, Department of Dermatology, Cutis Skin Clinic, Coimbatore, Tamilnadu, India.
(3) Dermatologist, Department of Dermatology, Rangas Skin Clinic, Coimbatore, Tamilnadu, India.
'Financial or Other Competing Interest': None.
Submission 07-01-2019, Peer Review 08-03-2019, Acceptance 13-03-2019, Published 25-03-2019.
Corresponding Author: Kumaresan M, #43, 20 Third Cross, Om Ganesh Nagar, Vadavalli, Coimbatore-641041, Tamilnadu, India.
Caption: Figure 1. Instron Universal Tensile Strength Tester
Caption: Figure 2. Volunteer Position for Determining EF
Table 1. Epilation Force (EF) for Various Regions of Scalp Region Phase Nos. Mean in gm Z- p-Value (SD) Statistics Total Anagen 375 63.10 (35.48) 5.441 0.000 * Telogen 25 39.86 (19.29) Frontal Anagen 92 67.62 (25.43) 1.54 0.128 Telogen 08 53.22 (25.83) Vertex Anagen 90 68.30 (51.56) 4.41 0.000 * Telogen 10 38.29 (12.92) Occipital Anagen 96 57.72 (32.80) 7.82 0.000 * Telogen 04 26.78 (04.22) Parietal Anagen 97 59.31 (25.94) 2.15 0.034 * Telogen 03 26.92 (05.88) Table 2. Epilation Force for Males & Females Sex Phase Nos. Mean in gm (SD) Z- p-Value Statistics Male Anagen 188 73.98 (44.38) 2.095 0.037 * Telogen 12 46.87 (23.12) Female Anagen 187 52.16 (17.64) 3.766 0.000 * Telogen 13 33.39 (12.65)
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|Title Annotation:||Original Research Article|
|Author:||Sundaram, Shanmuga; Kumaresan, M.; Srinivas C.R.|
|Publication:||Journal of Evolution of Medical and Dental Sciences|
|Date:||Mar 25, 2019|
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