Hair, Scalp Health Linked to Perceived Stress and Sleep Quality

Recent research has yielded a new consumer-relevant wellbeing instrument, the Hair & Scalp CARE, for assessing the direct psychological impacts of dermatological wellbeing, including scalp and hair health.1

Study findings suggest a significant association between hair and scalp wellbeing and other psychological wellbeing indicators, with healthier hair and scalp linked to lower levels of perceived stress and good sleep health.1

“The investigation of scalp-related wellbeing is an established practice in clinical samples with dermatological conditions, supported by several well-established clinical and objective instruments,” Alice Newton-Fenner, PhD, a Consumer Science Manager at Unilever, and colleagues wrote.1 “Conversely, the assessment of scalp-related wellbeing in healthy populations is comparatively sparse, despite the evidence of the importance of scalp and hair health for mental wellbeing and self-confidence.”

The majority of research to date has focused on the relationship between scalp and/or hair health and quality of life within clinical samples to better understand the psychological impact of various dermatological conditions, including the Dermatology Life Quality Index, the Scalpdex, and the Skindex, but their lack of applicability to healthy samples limits their utility.2

To develop and validate a new consumer-relevant wellbeing instrument for assessing the direct psychological impacts of dermatological wellbeing in diverse populations, investigators employed a multi step iterative process that yielded a scale comprising 23 items alluding to hair and scalp issues and needs, associated feelings, and how these needs influence respondents’ behavior in their daily lives.1

Study participants were recruited from various panellist databases with wide geographic representation between November 2021 and February 2022. All participants completed a short online screening questionnaire to qualify for study inclusion. To ensure that participants were engaged in relevant areas of personal care, women were required to have used and purchased ≥ 1 deodorant product, hair product, and skin product in the last 6 months. Men were required to have used ≥ 1 deodorant product and 1 hair product in the last 6 months.1

Participants also provided demographic information and completed the Sleep Health Index (SHI) and Perceived Stress Scale (PSS). They were given reimbursement of $120 for their time and expenses upon completion of the survey.1

A 2-stage factor analysis approach was adopted to examine the factor structure of Hair & Scalp CARE. The data were randomly split into 2 equal samples, with Sample 1 analyzed using an initial exploratory factor analysis (EFA) and Sample 2 analyzed using confirmatory factor analysis (CFA) to assess the validity of the factor structure identified through EFA.1

The final sample consisted of 1184 participants. Participant ages ranged between 18 and 65 for women (n = 886; 74.8% of total cohort) and between 18 and 55 for men (n = 298, 25.2% of total cohort).1

While the Hair & Scalp CARE tool originally consisted of 23 items, 2 items with reverse scoring were removed prior to EFA analysis to limit additional variance due to observed differences in consumer response patterns between the negative and positive items.1

The suitability of Sample 1 data to FA was confirmed with a Kaiser–Meyer–Olkin index of 0.98, and a significant result for Bartlett's sphericity test (P <.001) indicated correlations between items were sufficient for EFA. All criteria used to assess the number of factors suggested a single factor was appropriate, with loadings on individual questions ranging from 0.65-0.80 and a 55% proportion of explained variation.1

Additionally, the CFA demonstrated an acceptable fit for the Sample 2 data (Comparative Fit Index, 0.961; Tucker-Lewis Index, 0.956; RMSEA, 0.053; SRMR, 0.035).1

Results showed the overall mean Hair & Scalp CARE score for the cohort was 72.01 (± 22.05), with men reporting greater mean scores (77.62; ± 21.70) than women (70.12; ± 21.86), indicating a higher average hair and scalp-related emotional wellbeing.1

Concern for ≥ 1 hair or scalp condition was reported by 83.4% of women and 65.1% of men. Investigators noted participants who reported conditions had significantly lower Hair & Scalp CARE scores than those who did not, with an average decrease in mean Hair & Scalp CARE score of 91.18 (± 11.24) to 65.93 (± 21.03) for women (t(383.2), 20.912; P <.001) and 88.68 (± 15.01) to 71.69 (± 22.43) for men (t(281.74), 7.785; P <.001), confirming the generally negative impact of hair and scalp conditions on emotional wellbeing.1

Further analysis revealed Hair & Scalp CARE scores were negatively associated with PSS and positively associated with SHI, indicating better hair and scalp wellbeing is related to lower levels of stress and better sleep.1

“It is our hope that this instrument will aid future research to better understand consumer experiences, and the potential impact of consumer products to alleviate symptoms and directly improve self-confidence,” investigators concluded.1 “Utilization of Hair & Scalp CARE will also provide valuable insights into the development and refinement of products that will effectively promote wellbeing across diverse populations.”

References

1. Newton-Fenner A, Hirst WM, Jones T, et al. Development of the Hair & Scalp CARE questionnaire: Measuring the impact of hair and scalp issues on psychological wellbeing in healthy populations. International Journal of Cosmetic Science.https://doi.org/10.1111/ics.13070

2. Finlay AY, Salek MS, Abeni D, et al. Why quality of life measurement is important in dermatology clinical practice: an expert-based opinion statement by the EADV task force on quality of life. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.13985