Ethnopharmacological survey of home remedies used for treatment of hair and scalp and their methods of preparation in the West Bank-Palestine

Statistical analyses were performed by using the Statistical Package for Social Sciences (SPSSversion17.0).

All citations were placed into ailment categories for each type of cancer. The factor of informant’s consensus (F_ic) was employed to indicate how homogenous the information was. In fact, its main use is to select the disease categories where there is consensus on the use of plants among the informants. The F_ic value is close to 0 if plants are chosen randomly or if informants do not exchange information about their use. High values of F_ic (close to 1) occur when there is a well-defined selection criterion in the community and/or if information is frequently exchanged between informants [19].

The F_ic is calculated as in the following equation:

Where Nur is the number of use citations in each category and Nt is the number of taxa used.

Fidelity level (Fl) was defined as the ratio between the number of informants who independently suggested the use of a species for the same major purpose and the total number of informants who mentioned the plant for any use. Fl is of equal importance to F_ic and it can be calculated according to the following equation:

Where Np is the number of informants that reported a use of a plant species to treat a particular disease and N is the number of informants that used the plants as a medicine to treat any given disease.

The use-value (UV) is a quantitative method that can be used in order to prove the relative importance of species known locally. It can be calculated according to the following equation:

Where UV is the use value of a species; U is the number of citations per species; n is the number of informants.

Results of calculated F_IC, Fl, and UV are shown in Tables 2, 3, 4 and 5.

In total, 41 plant species distributed across 40 genera and 27 families were reported as locally and traditionally used cosmetics and cosmeceuticals for the hair and scalp in Palestine, which were presented in Table 2 and the family use value is explained in Fig. 2. The largest families of cosmetic plants were Lamiaceae and Rosaceae (5 species and 3 species respectively), with only 1–2 species reported for the 19 remaining families. However, the calculated UV values for plants that belong to Lamiaceae family are close to 0 whilst only Rosa canina, which belongs to Rosaceae, showed similar UV value. In contrast, the highest UV value (0.84) was registered for Lawsonia inermis, which belongs to the Lythraceae family.

Similarly to the above-mentioned disorders, hair loss, split hair endings and hair damage were widely mentioned with a Fic equal to 0.94. However, the highest Fic (1) was recorded for the enhancing of hair color.

Table 6 and Fig. 3 summarized the parts used as well as the method of preparation and application of herbal products to the hair and scalp. As can be seen, oils alone or oil mixtures are the most used products and they are applied or rubbed directly onto the scalp. In addition, olive oil was used in most herbal products, not only as a vehicle but also because of its emollient effect and high nutritional value. This showed synergistic effects in most of the listed treatments such as: hair endings, damaged hair and hair loss. At a lower degree, we found that Ricinus communis oil showed synergistic effects with olive oil in most of the reported treatments, especially in the treatment of split hair endings, hair loss and the use of hair conditioners (Table 3). Regarding products obtained from mineral or animal sources, Table 7 showed that the most frequently used methods in the use of these products were by mixing them with other natural products such as: eggs, honey or olive oil. Olive oil was again used as a vehicle but to a lesser extent than in herbal products. However, the egg was used in about 50% of the animal and mineral products. This may be explained due to its high lecithin content and nutritional value (Table 4). In addition, it was used with honey in the treatment of 9 out of the 13 reported hair and scalp disorders. They showed synergistic effects in 6 out of these 9 treatments, especially for the treatment of split hair endings and hair loss (Table 5). Meanwhile, Table 8 showed the Factor of Informant’s Consensus (Fic) values for minerals and animals products, categorized by the types of cosmeceutical treatment.

In Table 4, reported hair loss, dandruff, split hair endings and lice treatment were reported as the most treated disorders. In fact, the total number of plant species used was 19, 14, 13 and again 13 with a factor of informant’s consensus (Fic) for these disorders corresponding to 0.93, 0.94, 0.95, and 0.92 respectively.

Cosmetic preparations used for the: coloring or lightening of hair, prevention of hair loss or the treatment of scabies, have been included in our study. Most of the plant ingredients (Anthemis cotula, Rosa canina, Simmondsia chinensis, Lavandula coronopifolia, and Prunus dulcis) are also used today in modern phyto-cosmetics, whilst a few ingredients are less known, nowadays, for cosmetic purposes (Citrullus colocynthis, Abelmoschus esculentus and Aegle marmelos). From a cultural point of view, it is interesting to note how Palestinian women are still trying to find a diverse and wide range of ingredients in order to enhance their hair appearance; this usually involves the lightening or coloring of their hair to a shade of blond, which is considered a synonym of beauty for most of them. The use of chamomile paste, apple vinegar, and lemon juice indicates a new trend in the cultural concepts of aesthetics, which has been emphasized in recent years. Nowadays, in fact, blond hair, altered by cosmetic products, is normally considered a sign of beauty in Arab countries. Therefore, many women are willing to add and use any natural additives to enhance the performance of certain hair dyes such as Henna and Chamomile.

Many reported formulations have been or are still being used to enhance the appearance of hair: lightening and coloring, prevention of hair loss and to combat scabies. Less is known about the phyto-pharmacology of the ingredients used in these preparations, they often had an emollient rule and were thought to optimize and restore the functions of the scalp and appendices, which are highly affected by a lifestyle characterized by hard daily activities. This group of remedies comprises onions, honey, eggs, aloe, fish oil, mustard, rosemary, pomegranate, and even milk. A few of these species are in fact medicinal plants, well-known in the modern, evidence-based European and also Mediterranean and Arab phytotherapy herbal treatise of the past five centuries [22].

Bee products (wax and honey), milk products (yogurt, fresh milk, and butter), eggs and even kerosene represent the most commonly reported ingredients of non herbal origin used cosmetically by rural women (Table 2). A few of these ingredients were used as excipients and active ingredients at the same time, mainly as emollients, whilst others, such as kerosene, were used as pesticides.

Similar to other studies conducted on home cosmeceutical remedies, we can deduct that traditional Palestinian knowledge, in the preparation of domestic home remedies and cosmeceutical products for the healing of hair and scalp disorders, rarely include exotic or expensive ingredients from the Mediterranean market. The only exception to this is represented by the use of oils extracted from Simmondsia chinensis, Lavandula coronopifolia, Pimpinella anisum, Syzygium aromaticum, and Azadirachta indica oils. Thus the Palestinian cosmetic and cosmeceutical practices have taken a different direction from the historical “schools” of cosmetics.

According to our findings, members of the Lamiaceae and Rosaceae families were the most commonly used cosmeceuticals as reported in Table 2. The methods used in the preparation of these herbal products consisted of the mixing of more than one natural product together followed by the direct application of this mixed product to the hair or scalp. This method, however, may result in low compliance as these products are often oily or have bad organoleptic properties, making them difficult to be clean without the use of strong detergents, which may, possible, have a detrimental effect on the hair and scalp. Asking for the appropriate advice and counseling from a pharmacist may resolve this issue. Pharmacists are capable of preparing these products in a more suitable form such as creams or lotions, which are easily rinsed from the hair whilst leaving a suitable odor.

As can be seen in Figs. 4 and 5, hair loss was the most common hair disorder treated with natural products including herbal, mineral or/and plant remedies. This was then followed by hair ending damage, dandruff, hair conditioners and lice whilst scabies was the least common disorder.

Finally, most of the reported natural products in this study are edible herb, mineral or animal products such as honey, eggs and milk derivatives. Moreover, they are used externally and so minor restrictions would be applied, as they have the minimum risk in comparison to the synthetic cosmetic or cosmeceutical products. This excludes the unsuitable preparation methods that were mentioned before.

This study is of great importance as it helps to preserve and improve the knowledge of herbal, mineral and animal products used as cosmeceuticals and nutraceuticals, for hair and scalp disorders, by women in the West Bank.

In the present study Olea europaea, Lawsonia inermis, Ricinus communis, Allium sativum, Aloe vera, Cocos nucifera, Trigonella arabica, Prunus dulcis, Citrus limon, Pimpinella anisum, Punica granatum and Sesamum indicum were the most frequently used plants as home remedies for the treatments of the hair and scalp. Table 9 summarizes published cosmeceutical and skin uses of these frequently used plants.