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The Human Hair: from Anatomy to Physiology

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The Human Hair: from Anatomy to Physiology Education The human hair: from anatomy to physiology Barbara Buffoli1, PhD, Fabio Rinaldi2, MD, Mauro Labanca1, MD, Elisabetta Sorbellini2, MD, Anna Trink2, MD, Elena Guanziroli2, MD, Rita Rezzani1, PhD, and Luigi F. Rodella1, MD 1Section of Anatomy and Physiopathology, Abstract Department of Clinical and Experimental Background Hair is a unique character of mammals and has several functions, from Sciences, University of Brescia, Brescia, protection of the skin to sexual and social communication. In literature, there are various Italy and 2Studio Rinaldi & Associati, Milan, studies about hair that take into consideration different aspects within many fields of Italy science, including biology, dermatology, cosmetics, forensic sciences, and medicine. Correspondence Methods We carried out a search of studies published in PubMed up to 2013. Luigi F Rodella, MD Results In this review, we summarized the principal anatomical and physiological aspects Section of Anatomy and Physiopathology of the different types of human hair, and we considered the clinical significance of the Department of Clinical and Experimental different structures and the distribution of the hair in the human body. Sciences University of Brescia Conclusion This review could be the basis for improvement and progression in the field of V. le Europa 11 hair research. 25123 Brescia Italy E-mail: [email protected] Conflicts of interest: None. areas of the body surface, it is possible to note that Introduction human hair growth is reduced with tiny and virtually Hair is a unique character found on all mammals but not colorless hair on most of the body surface, whereas hair on other animals. In humans it is a special and cherished is longer, thicker, and heavily pigmented in other areas, feature, especially in females, but its main functions are such as the scalp, eyelashes, and eyebrows. Differences in protection of the skin from mechanical insults and to are also related to the hair’s form, which can be facilitate homeothermy1,2; eyebrows and eyelashes, for straight, helical, or wavy; color, depending on the example, stop things entering the eyes, while scalp hair balance of different types of melanin (brown to black, prevents sunlight, cold, and physical damage to the head indolic eumelanin, and yellow to reddish brown, sulfur- and neck.3 It also has a sensory function, increasing the containing pheomelanin); length; diameter; and cross- perception of the skin surface for tactile stimuli, and sub- sectional shape.3,6,7 serves important roles in sexual and social communica- Human hair is usually classified according to three con- tion, considering the psychological impact on quality of ventional ethnic human subgroups, i.e., African, Asian, life seen in hair disorders, such as hirsutism, hair loss, and European. Nevertheless, a recent study showed that etc.3,4 In particular, regarding this last point, a signifi- it is possible to classify the various hairs found worldwide cantly higher prevalence of personality disorders in sub- into eight main coherent hair types, by the measurement jects with androgenetic alopecia regarding the prevalence of three easily accessible parameters: curve diameter; curl of such diagnoses in the general population have been index; and number of waves.8 reported.5 Based on different aspects and points of view, several Mammalian skin produces hair almost all over the studies on human hair have been made within many fields body surface except for a few areas of the body, i.e., of science, including biology, dermatology, cosmetics, sole of the foot, palm of the hand, buccal surface of forensic sciences, and medicine. the lip, and portions of external genitalia; in addition, The aim of this review is to summarize the principal considering the distribution of human hair in different anatomical and physiological aspects of the different 331 ª 2013 The International Society of Dermatology International Journal of Dermatology 2014, 53, 331–341 332 Education The human hair Buffoli et al. types of human hair and to consider the clinical signifi- From a macrostructural point of view, hair varies cance of the different structures and distribution of hair in length, diameter, color, and cross-sectional shape in the human body. among the different ethnic groups and among singular individuals.9 Hair has two separate structures: the follicle in the skin Anatomy and Physiology of the Hair and the hair shaft, which is visible on the body surface Macroscopic and microscopic structures of the hair (Fig. 1). Hair is a derivative of the epidermis. Externally, hair is The hair shaft consists of a cortex and cuticle cells, and thin, flexible tubes of dead, fully keratinized epithelial in some cases, a medulla in the central region. The cells, whereas inside the skin, it is a part of individual liv- medulla is the central part of the hair, whereas the cor- ing hair follicles, cylindrical epithelial downgrowths into tex, which represents the majority of the hair fiber com- the dermis, and subcutaneous fat, which enlarge at the position and plays an important role in the physical and base into the hair bulb surrounding the mesenchymal- mechanical properties of hair, is the peripheral part and derived dermal papilla.3 is made up of approximately 50–60% of macrofibrils, Figure 1 Hair and its follicle. *Melanocytes International Journal of Dermatology 2014, 53, 331–341 ª 2013 The International Society of Dermatology Buffoli et al. The human hair Education 333 which consist of rods of microfibrils embedded into a The upper bulb can be divided into four parts: (i) matrix.10 The hair shaft cuticle covers the hair from the above the critical level, in the wide portion of the bulb, is root to the tip of the epidermis and is formed by flat the pre-elongation region, where the cells align themselves overlapping cells.11 Each cuticle cell is generally 0.3– vertically and become slightly larger; (ii) above this 0.5 lm thick, and its visible length is about 50 lm; it region, where the diameter of the bulb is narrower and consists of various sublamellar structures (the epicuticle, the cells become conspicuously elongated, is the cellular A-layer, exocuticle, endocuticle, and inner layer) and the elongation region; (iii) immediately above, in the cortical cell membrane complex.10 The integrity and properties of pre-keratinization region, distinct fine fibers or fibrils the cuticle layer have an important role in protecting the stainable with basic dyes can be seen; and (iv) further up cortex from physical and chemical insults and in main- is the keratogenous zone where the cells become hyali- taining the hair in a clean and disentangled state and have nized and the keratin of the hair is stabilized. Depending a great impact on its appearance.12 upon the length of the follicle, the keratogenous zone ter- The follicle is the essential growth structure of hair. minates at approximately one-third of the way between From the outermost aspect of the follicle, the histological the tip of the papilla and the surface of the skin. structures are: Above the bulb, the upper hair follicle is composed of 1 the outer root sheath (ORS), which has been identified two anatomical parts: the infundibulum and the isthmus. as a reservoir of multipotent stem cells, i.e., keratino- The infundibulum is a funnel-shaped structure filled with cyte and melanocyte stem cells, and contains keratino- sebum, a product of the sebaceous gland; it extends from cytes. The ORS forms a distinct bulge area between the the surface of the skin to the sebaceous duct, serves as a insertion of the arrector pili muscle and duct of the reservoir, and provides an interface for interactions with sebaceous gland.3,13 Adjoining the ORS on the dermal hair follicle-associated cell populations. In detail, in the side is a basket-like arrangement of two orthogonally upper part, called the acroinfundibulum, the epithelium is arrayed layers of collagen fibers, the glassy layer14 continuous with the keratinized epidermis and is covered known as the dermal sheet.15 by an intact, rather impermeable stratum corneum; this 2 the inner root sheath (IRS) consists of three layers: Hen- barrier is interrupted in the lower follicular infrainfundib- le’s layer, Huxley’s layer, and cuticle layer. The IRS cuti- ulum, as the differentiation pattern switches from epider- cle layer adjoins the cuticle of the hair shaft, anchoring mal differentiation to a tricholemmal differentiation the hair shaft to the follicle. IRS cells produce keratins pattern. Only few differentiated corneocytes remain, and and trichohyalin that serve as an intracellular cement the invagination of the epidermis in the infundibulum giving strength to the IRS to support and mold the grow- must be considered as highly permeable.17 ing hair shaft, as well as guide its upward movement. The isthmus completes the upper part of the hair folli- The IRS separates the hair shaft from the ORS.3 cle, and it extends from the duct of the sebaceous gland The hair bulb is the portion of the follicle which to the exertion of arrector pili muscle.3,18 actively produces the hair. It encloses the follicular der- mal papilla, dermal papilla cells, mucopolysaccharide-rich The innervation and vascularization of a hair follicle stroma, nerve fibers, and a single capillary loop. The fol- The innervation and vascularization of hair represent an licular papilla is believed to be one of the most important interesting aspect in hair research. In literature, there are drivers to instruct the hair follicle to grow and form a data about both, even if the description of the detailed particularly sized and pigmented hair shaft; moreover, it architecture of nerves was more difficult. is an essential source of growth factors (keratinocyte Nerves that supply the hair follicles are arranged simi- growth factor, bone morphogenetic protein, hepatocyte larly to the dermal nerve network and include sensory growth factor, insulin-like growth factor, stem cell fac- afferents and autonomic sympathetic nerves.
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