Grey hair and premature greying

The human skin contains three pigments in the entire body: haemoglobin, carotenoids and melanin pigments. However, melanins are responsible for the pigmentation (colour) in the skin and the hair. 

• Melanin is formed by melanocytes which are specialized pigment cells that place themselves at the openings of the skin’s surface, also known as hair follicles, through which hair grows.
• Hair follicles contain two types of melanin, namely eumelanin and pheomelanin.
• A single hair follicle contains either of the two types of melanin.
• The black-brown pigment called eumelanin gives the black and brown colour to the hair.
• The yellow or red pigment called pheomelanin gives auburn and blonde colour to the hair.

There are possibly two theories that could explain the greying of hair:

• With growing age, the melanocyte activity (melanin production in the hair) slows down or stops, thus decreasing the pigment our hair receives which causes greying of hair.
• Another reason is thought to be hidden in the hair cycle. Human hair essentially undergoes three stages of hair cycle: anagen, catagen, and telogen phases. The hair grows during the anagen phase, followed by a transitional period (where no change takes place) of the catagen phase. After the catagen phase, telogen phase starts when the hair releases from the follicle and falls off.

Hair is actively pigmented during the anagen phase and the pigmentation stops during the catagen phase and absent during telogen.

When hair starts graying before the age of 20 in European countries, 25 in Asia, and before 30 in African countries, then this parameter is considered as premature graying of hair. There can be many reasons for hair turning gray at an early age, such as hormonal and environmental reasons. Although there is no exact reason for premature graying of hair, there are some conditions that can be linked to this problem -

• Genetic factors - If this type of problem has existed in parents or any generation of the family, then it can persist in the future also. This fact has also been confirmed in a report published in 2013 in the Indian Journal of Dermatology, Venereology, and Leprology.
• Hypothyroidism - People suffering from hypothyroidism (decreased level of thyroid hormone in the body) are prone to premature graying of hair.
• Protein deficiency - Hair starts turning gray at an early age due to protein deficiency in the body due to cruciferous disease, nephrosis, celiac disease, and some other disorders.
• Lack of minerals - Due to a lack of minerals like iron and copper, hair turns gray at an early age.
• Vitamin deficiency - The problem of graying hair at an early age is seen in most people due to a deficiency of Vitamin B12 in the body. A study was published in 2016 on the site of the International Journal of Trichology. In this study, the main reasons behind the graying of hair of youth under 25 years of age living in India were looked at. It was found to have low levels of serum ferritin, which stores iron in the body.
• Vitiligo - In some cases, the body's immune system starts attacking its melanocytes, which also causes the hair to turn grey.
• Von Recklinghausen disease (neurofibromatosis) - This is a genetic disease that causes tumors to form, as well as abnormal development of bones and skin.
• Down syndrome - Down syndrome is a genetic disorder. Due to this, the face and nose become flat, the neck becomes short, and mental disability and hair color start turning grey.
• Werner syndrome - This is a genetic disease in which the affected person may have symptoms such as skin changes, juvenile cataracts (glaucoma in children), short stature, and premature aging.
• Medications - Side effects of certain medications such as chloroquine (a medication used for malaria), tripersonal (a medication used to lower cholesterol), and phenylthiourea (used in DNA testing),  as an effect, hair color also starts turning white.
• Stress - Studies have shown that hormones produced during times of stress (adrenaline, cortisol) start affecting melanocyte cells, resulting in graying of hair. A New York University study shows that when we are under stress, the cells that provide natural color to the hair start dying. The study is available in the 2013 edition of Nature Medicine.

Since the cause of the greying is not clear, there is no effective therapy available. Research is still being done to find efficient treatment for premature greying. Meanwhile, other treatment modalities are:

• The most conservative treatment involves colouring of grey hair. It can be done with natural dyes like Henna, Amalaki (Emblica officinalis), Bhringaraj (Eclipta alba), mooncake seed tree (Sterculia platanifolia), and the lotus tree (Zizyphus spina-christi).
• Topical anti-ageing compounds like green tea polyphenols, selenium, copper, phytoestrogens and melatonin can also be used to decrease the intensity of greying.
• Vitamin B supplements along with rich healthy diet and thyroxine tablets are given in case of vitamin B deficiency and hypothyroidism.
• A study has proved that 200mg of ap-aminobenzoic acid (PABA) for two months leads to darkening of hair for a limited period of time. Thus PABA has proved to be a temporary hair darkening drug. 
• Taking calcium pantothenate 200 mg/day along with the removal of grey hair from the scalp has given effective results in repigmentation of hair.
• Cinnamidopropyltrimonium chloride is a UV absorber and is used for photoprotection of hair. It can be used at home as it is available in shampoo form.
• Psoralens with sunlight as the source of ultraviolet A-rays (PUVASOL) is a phototherapy that stimulates melanocytes into the follicles, leading to initiation of pigmentation.
• Solid lipid nanoparticles of UV blockers have been developed for use on skin and hair which provide photoprotection by reacting and scattering ultraviolet radiation (UVR) on its own.
• Use of hormonal anti-ageing protocols containing recombinant human growth hormone has resulted in improvement of hair thickness, hair growth, and in some cases darkening of hair.
• Delivery of melanin into hair follicles through the liposomes has resulted in darkening of hair follicles. Liposomes are vesicles used to deliver microscopic substances such as drugs or DNA to the cells of the body. They can be used to restore hair colour via molecular and gene therapy.

Greying of hair is a natural process that occurs as you age. Melanin production in hair reduces with age, and hence the older you are the whiter your hair will turn. Premature greying is a problem that many face, but it doesn’t have a single common cause. It can happen due to genetic factors, deficiency of nutrients like vitamins and proteins, pre-existing health conditions like hypothyroidism, vitiligo, etc, stress or use of certain medications. While nutrient supplements and healthy lifestyle choices can stop or prevent premature greying, the most effective treatment - and the most popular one - is colouring of hair.