Prospective Single Center Randomized Double Blind Controlled Tolerability Trial of Six Hair Cleansing Conditioners

Study Aim: The objective of this study is to evaluate the tolerability of daily use of f hair
cleansing products.

Background/Study Rational/Significance: There have been consumer reports of irritancy and
hair loss with use of Wen cleansing conditioner. A recent study of 142 patients found no
increase in hair loss when used in normal subjects, however skin assessments for tolerability
were not evaluated.

Methodology: This double-blind, randomized, controlled clinical trial will evaluate the
tolerability of six hair cleansing products including Wen cleansing conditioner using two
standard clinical and research methods, Repeat Open Application Tests (ROAT) (a test for
irritancy) and Semi-Open Patch Tests (a test for allergenicity). For the ROAT, participants
will apply the hair cleansing products to 6 separate locations on the forearm using a
standardized, protocol and scored using a 10-point scale. Application site of each cleansing
product will be randomized. Exposure time will be increased in a step-wise fashion over 5
weeks. Participants and investigators will be blinded to location of products. The primary
outcome is intolerance; intolerance will be defined as 1) ROAT skin component scoring >6 (of
10 maximum) or 2) ROAT global score of >4 (of 5 maximum). If intolerance to a specific
product is reached, the ROAT for that product will be discontinued. . Clinical assessments
(global scoring and component scoring) will be performed at 0, 2, and 4 and 5 weeks. Primary
outcomes will be measured at 5 weeks. Allergenicity is a secondary outcome and will be
assessed with semi-open patch tests to the 6 hair cleansing products performed at week 4 and
read at week 5

Setting/ patients: Single center study of 200 patients. To represent a broad spectrum of skin
barrier function, recruitment will target enrollment of 150 individuals with a no history of
childhood eczema (non-atopic) and 50 individuals with a history of childhood eczema (atopic).

Population: Men and women over the age of 18 years old.

Inclusion Criteria:• Age of 18 years or older

- Signed and witnessed written informed consent

- Willingness and ability to comply with the study protocol

- For women of child-bearing potential, negative urine pregnancy test at enrollment

Exclusion Criteria:

- The presence of an overt bacterial, viral or fungal infection of the arms

- The presence of any skin condition on the arms that, in the opinion of the
investigator, could interfere with study assessments.

- History of bullous skin disorders, psoriasis, ichthyosis, and/or any other chronic
skin condition which could result in skin barrier dysfunction (other than atopic
dermatitis).

- Treatment with systemic immunosuppressive drugs within 2 weeks of enrollment.

- Treatment with topical antibacterial, antimycotic, or immunosuppressive medications
(including topical corticosteroids) on the forearms within 2 weeks of enrollment.

- Use of over-the-counter moisturizers to the forearms in the 3 days prior to protocol
commencement.

- Menstruating females of childbearing potential who are not willing to use a medically
accepted method of contraception, during the study and up to 4 weeks after the end of
study. Medically approved contraception may, at the discretion of the investigator,
include abstinence.

- Women who are breastfeeding

- Patients with a severe medical condition(s) which, in the view of the investigator,
prohibits participation in the study

- Use of any other investigational agent in the 30 days prior to study commencement

- Known allergy to the study products or ingredients