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A healthy scalp is essential for a person's well-being.

A healthy scalp is essential for a person's well-being.

There is a term "scalp care". Can we say scalp care in a part of science?
By making it science, problems related to scalp and hair may be solved. That leads to well-being (the state of being healthy or happy physically, psychologically and socially) in a real sense.

It makes more sense to find what is happening to the
patient’s scalp.

First, could you tell me why you paid attention to bed sores?

It was the first year when I started to work as a nurse that I discovered early bed sores for the first time. I reported them to a head nurse. Then, “It is a disgraceful for a nurse to find bed sores” said the head nurse. I was surprised to hear it in that tone for the first time. So, I looked up scientific papers to learn how to prevent bed sores and all I found was that the mechanism behind bed sores had not been elucidated scientifically at all.
In addition, it was not a rare case where a patient suffered from bedsores for 8 years or 10 years without cure. Nurses themselves gave up “because they thought bedsores could not be cured”. Both patients and nurses distressed themselves. That is why I decided to tackle with research on bed sores.

Why did it put you on research on scalp?

Triggered by bed sores, I have widely performed research on chronic wounds. One of all is cancer wounds (cutaneous metastasis of breast cancer). Cancer wounds begin to spread to the entire body, especially the breast area, a symbol of women. Patients are forced to live a social life with distress such as a large amount of effusions, strong smell or pain. It is the very situation that wellbeing is impaired. I started a research to review cancer wound care thoroughly in an effort to relieve patient’s pain as much as possible. Under such circumstances, I recognized that patients were deeply wounded by loss of hair, a symbol of women same as breast, in the course of cancer treatment. Then, I felt that this was a challenge we had to tackle with because our accumulated knowledge and technology on skin care could also be applied to hair. Many patients use wigs. When hearing their stories at a patient advocacy group, “Wearing a wig makes me stressed because I feel itchy or pain. So, I wear a bandanna around my head, not a wig” a woman said. From a woman’s point of view, living a life with a bandana on and going to work are both distressing. For well-being, I felt that it was necessary to create a wig suit able for each patient. When I looked for data on what was happening to the patient’s scalp which made her wear a wig uncomfortable, I could find no data. Unless we can learn whether tingling pain is associated with any problem in the epidermis or dermis, or whether the problem lies physiologically, patient would never feel comfortable however hard we deal with wigs. Then, I came up with an idea that a patient could choose a wig she liked if her scalp conditions could be maintained better. That is why I started a research to learn what was happening to the patient’s scalp. A term, scalp care, is commonly used, but it is not used in a scientific context. Making it scientifically is to provide evidence- based medicine by accumulatingdata on phenomena and mechanism as a body of evidence. This is how the multidisciplinary team was formed in order to develop scalp care science.

Aim at solving problems by changing scalp conditions themselves.

A structure of the inside of skin 3 weeks after applying vehicle (Veh) or HSL. In the mouse skin to which vehicle was applied (left), hair follicle atrophy was observed, while in the mouse skin to which HSL was applied (right), hair follicles in the growth phase were observed.
Minematsu et al. PRS-GO. 2013

Is elucidating scalp conditions the ultimate goal for you?

Of course, just elucidating the mechanism gives us no solution. To propose a solution is true research beneficial for clinical practice.
Dr. Takeo Minematsu, one of our collaborators had already found that a substance called as AHL had an effect of promoting hair growth. I thought that proceeding with his research finding in parallel with our research on the scalp conditions might make scalp science possible. It was three years ago.

Which stage are you in now?

To tell you the truth, we have just got to the point where participating institutes are decided. It is very difficult to ask a patient who is distressed by the loss of her breast, a symbol of women to examine further her scalp. For this purpose, we needed excellent nurse researchers who were capable of doing research as well as being excellent as a nurse. In addition, they are required to be able to construct a relationship of confidence with patients.
It took one and a half year to discover such candidates and foster them. Moreover, in order for these researchers to demonstrate their ability, it is necessary to win understanding and confidence of participating institutes. Now, we have just completed the training of researchers and acquired participating institutes so that we are at the start line of investigation. This is where we are.

What do you expect from the research?

We will be able to elucidate the mechanism on what is happening to the scalps of patients who suffer from hair loss due to breast cancer treatment and to construct methodology on how to care for such patients. I believe changing scalp care will lead to solution of the problem on hair loss.

Interviewer/writer: Takeshi Maeya Photographer: Kuninobu Akutsu

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