There are many causes of hair loss including disease and genetic predisposition. Yet, the most common reason men and women
experience hair loss is due to poor cosmetic grooming practices.
Even though mild to moderate seborrheic dermatitis does not cause hair loss, the scratching associated with the scalp pruritus
can definitely predispose to hair loss. It is possible to remove all of the cuticular scale off of a hair shaft with only 90 minutes of
continuous scratching by the fingernails. This loss of cuticle leaves the hair shaft weakened and permanently cosmetically
damaged. Thus, treatment of scalp itch is important to preventing hair loss.
Long hair is much more likely to be cosmetically damaged than short hair. Therefore, patients who have extensive hair damage
may wish to select a shorter hair style to maximize the appearance of the hair. In this case, it is extremely important to identify the
cause of the hair damage so that the newly grown hair remain healthy and cosmetically attractive.
It is a wel -known fact that hair growth slows down with age. This means that cosmetically damaged hair will be preset longer on
mature individuals. Also, the diameter of the hair shaft decreases with advancing damage from chemical processing. For this
reason, all chemicals used on mature hair should be weaker than those used on youthful hair.
Hair combing is a daily grooming ritual that frequently causes hair damage and loss. Hair should only be combed when dry, if
possible. Wet hair is more elastic than dry hair meaning that vigorous combing of the moist fibbers can stretch the shaft to the
point of fracture. The ideal comb should be made of a flexible plastic and possess smooth, rounded, coarse teeth to easily slip
through the hair.
Extensive hair brushing should also be avoided while hair is wet. A good brush should have smooth, ball-tipped, coarse, bendable
bristles. The brush should not tear the hair, but rather gently glide. Brushes used while blow drying hair should be vented to
prevent increased heat along the brush, which could damage hair. Patients should be encouraged to brush and manipulate their
hair as little as possible to minimize breakage. Older teachings that the hair should be brushed 100 strokes a day and the scalp
vigorously massaged with the brush should be dispelled.
Common sense applies to the selection of appropriate hair pins and clasps. Rubber bands should never be used; hair pins should
have a smooth, ball-tipped surface; and hair clasps should have spongy rubber padding where they contact the hair. Loose-fitting
clasps also minimize breakage. The fact remains, however, that all hair pins or clasps break some hair since they must hold the
hair tightly to stay in place. To minimize this problem, the patient should be encouraged to vary the clasp placement so that hair
breakage is not localized to one scalp area. This problem is particularly apparent in women who wear a ponytail. These women
frequently state that their hair is no longer growing when in actuality it is repeatedly broken at the same distance from the scalp
due to hair clasp trauma. Pulling the hair tightly with clasps or braids can also precipitate traction alopecia.
The hair should always be cut with sharp scissors. Any defect in the scissor blade will crush and damage the hair shaft. Crushing
the end of the hair shaft predisposes to split ends.
Hair styling products are an important way to improve the cosmetic appearance of the hair shaft, but should always leave the hair
shaft flexible. High hold stiff styling products can actually precipitate hair breakage when trying to restyle the hair with combing.
Hair colouring and bleaching are universally damaging to the hair shaft. It is sometimes said that chemical processing adds body
to the hair. This means that the dyeing procedure allows the hair to stand away from the scalp with greater ease. This is not due
to better hair health, but rather due to hair damage that makes the hair frizzy and more susceptible to static electricity. The basic
rules of fair dyeing are always stay within you colour group preferably dyeing the hair no more than 3 shades from the natural
Hair relaxing is weakening to the hair shaft, but can actually facilitate hair length in patients with kinky hair. This is due to
decreased hair breakage during combing. The relaxing procedure straightens the hair and makes it easier to groom, but the
grooming should be done gently to avoid hair shaft fracture.
Lastly, hair permanent waving is also damaging. The curls should be as loose as possible with the interval between procedures as
long as possible. For patients with damaged hair, the perming solution should be weak and left in contact with the hair for as
short a period as possible.
Author: Zoe Diana Draelos is a board certified dermatologist in private practice and a primary investigator for dermatology consulting Services.
Published according to translation: Dr. Lorenzo