17 March 2014

Getting past the hype: Dermatologist untangles common hair care misconceptions

DENVER, Colo. (March 21, 2014) —With all the hair-care products available via stores, salons, television, and the internet, it’s no surprise that consumers often are overwhelmed by their choices and have a hard time evaluating products that claim to improve one’s hair. From products promising to help thinning hair to those that offer temporary changes to the texture of one’s hair, consumers can potentially spend hundreds or even thousands of dollars on products without knowing if their claims are scientifically based or if they pose potentially damaging, long-term effects. Fortunately, dermatologists — experts in hair health and treating conditions of the hair — can help consumers navigate the road to better hair.

Information provided by board-certified dermatologist Nicole E. Rogers, MD, FAAD, assistant clinical professor in the department of dermatology at Tulane University School of Medicine in New Orleans, La.
Sodium laureth sulfate and sodium lauryl sulfate are two of the most common shampoo ingredients. They are a popular type of detergent that produces a lathering effect in personal care products and removes dirt and debris from hair by creating a rich lather. 
The trade-off is that sulfates can be harsh on the hair by removing natural oils and allowing more damage to hair that is already color- or chemically treated. In addition, there are a few reports linking sodium laureth sulfate and sodium lauryl sulfate to contact dermatitis in some people. For that reason, people with eczema or sensitive skin may not be able to tolerate them. 

To capitalize on these concerns, manufacturers are marketing sulfate-free shampoos that make claims not supported by research:

  • Sulfate-free shampoos are advertised as gentler because sodium laureth sulfate and sodium lauryl sulfate can strip moisture from the hair. However, Dr. Rogers pointed out that there is no scientific evidence that the “sulfate-free” component makes shampoo gentler than other shampoos that contain sulfates.
  • Some sulfate-free shampoos are marketed to extend the life of hair color or keratin treatments, but Dr. Rogers noted that scientific data supporting these claims is not available. Instead, people should choose shampoos designed for color-treated hair that can be purchased at stores or pharmacies.
  • Sulfate-free shampoos cost more than regular shampoos, but at this time the cost benefit is unknown.  
  • For people who have an allergy to sodium laureth sulfate or sodium lauryl sulfate, Dr. Rogers said sulfate-free shampoos can be beneficial.

Originating as the Brazilian blowout for its sleek, straight hairstyle, keratin treatments are technically relaxers that contain a hydrolyzed form of keratin — but a derivative of formaldehyde is used to chemically straighten hair. These treatments can last up to five months in some cases, but Dr. Rogers explained that they can be potentially very damaging to the hair. Consumers should be aware of the following:

  • The irritant properties of formaldehyde can be harmful to the eyes, lungs, and nasal passages.
  • Truth in advertising is a problem with keratin treatments, demonstrated by manufacturers receiving numerous citations by the Occupational Safety and Health Administration (OSHA) for using higher than the allowable levels of formaldehyde in products.
  • There are no data showing that keratin treatments can penetrate and strengthen the hair shaft. Rather, the high-heat flat irons needed to seal the formaldehyde into the hair shaft can cause long-term damage to the hair shaft.
  • The least damaging of all hair-straightening chemicals are ammonium bisulfite-based creams, which are available for at-home use but have a short-lived straightening effect.

Products marketed as hair thickeners temporarily coat the hair shaft to make hair look thicker, but they cannot change the natural density of hair. As such, results will only last until the hair is shampooed. Dr. Rogers noted that these products are very safe and advised consumers to keep the following in mind if they want the appearance of thicker hair:

  • Look for hair-thickening products that contain hydrolyzed keratin or dimethicone, which coat the hair shaft and make hair appear thicker.
  • Some hair-thickening products are now being marketed with a product containing minoxidil — the only topical medication approved by the Food and Drug Administration (FDA) to regrow hair and slow future hair loss — to boost the density of thinning hair and create noticeably thicker hair.
  • People experiencing bald patches or lots of thinning may have hair loss. Dr. Rogers stressed that hair loss is chronic and progressive, and only proven medical therapy or hair-restoration surgery can permanently replace lost hair. She estimates that people with hair loss can waste years on unproven products or expensive supplements, often resulting in a considerable delay in seeking an accurate diagnosis for hair loss from a dermatologist.
Heat from hairdryers, flat irons, or curling irons can be very damaging on the hair. A condition known as bubble hair occurs when the water in the hair gets heated and turns to steam, causing hair bubbles to occur on the hair shaft. The result is brittle hair that is more prone to breakage and frizzy ends. 

To counter the effects of heat, Dr. Rogers recommends using a heat protectant before applying any form of heat to hair. These products are sprayed or applied directly on the hair and contain protective polymers and silicones to insulate the hair cuticle from heat. Other ways to avoid overheating the hair include:

  • Use the lowest temperature settings on hairdryers and heating devices.
  • Moderation is key when using heat on the hair. Use heat as little as necessary and for as short an application time as possible. 
  • Hold hairdryers at least 6 inches (15cm) away from the scalp.
  • Air dry hair whenever possible.
  • Moisturizing the hair regularly can help reduce the appearance of heat damage, but it cannot repair the hair.
“The less you do to your hair, the healthier it will be,” said Dr. Rogers. “I would recommend avoiding the use of any sort of flat irons or relaxers, as they can be especially damaging to hair when used regularly. It’s also important to consult your dermatologist if you notice any unexplained hair loss or if you have questions about what hair care products can work best for your hair type.”
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 17,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or Follow the Academy on Facebook (American Academy of Dermatology) or Twitter (@AADskin).