Hair Foundation Blog

As we enter the holiday season, there’s lots of parties and family gatherings to attend. One of the easiest and not too expensive ways to get ready is with holiday hair. This could be a new hair cut, a blowout or adding curls to your straight hair.

We took a look around the Web and found the following sites with helpful holiday hair ideas. After a closer look, we also saw that some of our partners’ products have been included with some of the hair styles.

Take a look at these sites for ideas:

From Allure magazine, here’s 31 holiday party hair ideas.

The website Monsters and Critics has an article on holiday hair that mentions the Hair Foundation’s partner, Bosley, new USA Bosley Professional Strength products.

InStyle suggests 10 holiday hair styles and includes a list of 2011′s Best Hair Products. This could help with some gift ideas.

Cosmopolitan put together a presentation of 10 hot party hair ideas.

Essence has festive holiday hairstyles.

Elle highlights holiday hair with celebrities.

Woman’s Day has four hassle-free holiday hair ideas that only take 10 minutes.

Huffington Post has holiday hair ideas with photos.

Real Beauty includes holiday hairstyles for different ages. It also includes a top 10 list of 2011 best beauty products.

Here’s a shopping list of our partners’ products:

Proctor and Gamble: Fekkai Sheet Hold Hairspray, Pantene Pro-V shampoo and conditioner, Pantene Nature Fusion Moisture Balance, Pantene Pro-V Beautiful Lengths Shampoo and Conditioner, Pantene Pro-V Medium-Thick Anti-Humidity Hairspray and Pantene Pro-V Normal-Thick Split End Repair Keratin Protection Créme.

Bosley: USA Bosley Professional Strength products – shampoos and conditioners

To learn more about hair care, check out this Hair Foundation blog by Dr. Zoe Diana Draelos and our videos.

After her recent visit to Bronner Bros. International Hair Show in Atlanta, Surgeon General Dr. Regina M.Benjamin commented about one of her pet causes: too many women, particularly African American women, forgo exercise because they’re worried it will ruin their hair.

Does this sound familiar?

Benjamin, who has struggled with this issue herself, said that she constantly hears:

 “I don’t want to sweat my hair back or I don’t want to mess up my hairstyle.  It cost me too much to get my hair done this week.”

She further explained that African Americans spend a little bit more time on their hair and an alternative would be nice since their type of hair isn’t “wash and wear” like other races and ethnic groups.

Benjamin expressed concern that hair is a barrier to exercise for a group that that sees almost 50 percent of black women over the age of 20 as either overweight or obese as compared to the obesity numbers of white women (33 percent) and Hispanic women (43 percent).

In a recent study at the Wake Forest Baptist Medical Center in North Carolina, researchers reviewed 103 local black women and discovered that almost one third exercised less because they were concerned it would affect their hair. Furthermore, 88 percent of the sample did not meet the Centers for Disease Control and Prevention guidelines for physical activity.

This guideline encompasses 150 minutes of moderate intensity exercise each week, equal to approximately 20 minutes of exercise per day.

Dr. Amy McMichael, a professor of dermatology  and a member of the Hair Foundation’s Scientific Advisory Council, led the study. She noted that throughout the year, some of her overweight patients mentioned that because of their hair, they would not go to the gym.

McMichael said:

“Being an African-American woman myself,” she said, “I have to go through those same trials and tribulations when I exercise, so I started to realize that this is probably a barrier for many women.”

Benjamin recommended people speak with their hairstylists and barbers about this concern because these hair professionals have a positive effect on clients overcoming their concerns about “messing up” their hair during exercise. Many can suggest hair products or more natural hairstyles that should not deter excercising.

To read more about Benjamin’s thoughts on this topic, please read this interesting CNN article.

If you have questions about hair care, please contact one of our specialists at info@hairfoundation.org.

Beginning this month, the Hair Foundation will be sending out monthly online newsletters. For this post, we’ve included some timely stories as we slowly approach the end of summer. If you are interested in receiving our online newsletter or have story ideas, please contact us at info@hairfoundation.org.

Sun Care for Your Scalp 

While we all put sunscreen on our bodies to protect it from the sun, it’s also important to put it on your scalp. For those with thinning hair or balding heads, you’re more susceptible to sunburn and skin cancer in these overexposed areas than on your body, so protect your head accordingly.

You don’t want to deal with a dry, peeling head after the sun damage is done.

“Remember to always apply sunscreen with at least an SPF15 to the scalp that is exposed to the sun, usually at either the part or the scalp area that is most exposed,” says Paul T. Rose, MD, JD, and Hair Foundation Board Member. “After swimming or sweating, it’s important to reapply frequently as sunscreen easily comes off and leaves the scalp unprotected.”

Here are a few tips:

• Buy new sunscreen every year. It’s tempting to just finish that half-full bottle in your cabinet at the start of another summer, but most sunscreens lose sun protection over time and the product will not protect as needed.
• Look for some of the new dry shampoo, styling and color coverage products that also offer UV protection
• Purchase sunscreens with zinc oxide or titanium oxide. Sunscreens with oxybenzone are toxic and when it soaks into your skin, it is also a contributor to skin cancer
• Always use a product with a SPF. This summer there’s been a trend toward higher SPFs which are now readily available; try to buy the highest coverage possible. SPF 30, will provide protection for most of the day but if you get sunburnt in 10 minutes, SPF 30 will protect you for 300 minutes and with an SPF as low as 15, you’ll be protected from the sun for only 150 minutes
• Just by walking, sitting in a car or a near a window, you are subject to harmful UV rays known as secondary UV exposure
• If you are concerned about your hair looking greasy, try either a light spray sunscreen or a stick version on the exposed skin. Then, use a clarifying shampoo at the end of the day to remove any remaining build-up
• If you get sunburn on your scalp, take an anti-inflammatory like Advil or Aleve and avoid powder-based hair products. Also, try not to wash your hair over the next few days to avoid further dryness and irritation
• Remember, the sun is strongest during the midday between 12:00 p.m. and 3:00 p.m. so it’s recommended you reduce your exposure during these hours
• Always wear a hat if possible. It will cover your scalp and protect your face and neck

Summer Hair: Dealing with Heat and Frizz

Combating this summer’s heat wave is hard enough but dealing with the effects on hair is sometimes an even greater challenge. Wearing hair in a ponytail or a hair clip are often the go-to remedies but there’s more you can do for this summer time effect. 

Why do when summer hair frizzies happen? This occurs when dry hair sucks up moisture from the humidity and your shafts swell and kink up all over. Many people will have “bigger” hair from humidity. By hydrating your hair, it can help your hair from acting as a sponge in humid weather.

“Ways to combat summer heat and frizz will depend on your hair texture,” said Dr. Zoe Diana Draelos, Secretary of the Hair Foundation Board of Trustees. “However, there are a lot of simple at-home things you can do and lots of great products on the market that will help.”

Fine and straight hair? This type tends to go flat so style it by lifting sections and then misting your hair with a dry shampoo or a mist shine spray. Before leaving the house spritz on some heat-protective spray to prevent further damage.

Curly hair? It’s the battle of the frizzies and to combat them, try using mousse through wet hair, then air-dry your hair. For dry hair, put on some anti-frizzing styling cream and glide it over your hair to smooth frizzies. Think about washing your hair at night. Apply a styling product on your hair, and then tie it in a knot or loose ponytail.

Coarse or textured hair? The sun can dry your hair, making it dull. To add some life back in your hair, rub a serum over it to get some for shine. Also use a deep conditioner on your hair.

And for all hair types, use a deep condition on your hair every time you wash it and leave it on for five minutes while showering.

Pool Hair? One last summertime effect on your hair that many people think is a myth: chlorine can turn your hair green. It has this effect on blonde hair.

Why does hair turn green? Dr. Matt Leavitt explained, “Oxidized metals in the water binds to the proteins in your hair shaft. They deposit their colors and blonde hair turns a green tint. Regardless of hair type and color, chlorine in swimming pools not only dries out your hair, it can leave hair brittle, especially on colored or highlighted hair.”

To protect your hair from chlorine, wear a swim cap, rinse in non-chlorinated water before and after swimming and use a mild clarifying shampoo and proper conditioner.

Finasteride Task Force

In April, the ISHRS convened the Task Force on Finasteride (Proscar) Adverse Event Controversies to evaluate published data and to inform and update ISHRS members regarding “men with androgenetic alopecia who have claimed to have experienced persistent sexual side effects following the use and subsequent discontinuation of Finasteride.”

At the time, the ISHRS Web site noted that the task force was in the process of gathering information and forming an interdisciplinary panel to discuss the issues. It will keep ISHRS members informed regarding post-marketing adverse events.

Here’s a link to the statement.

According to the May/June Forum newsletter, Hair Foundation Board members, Drs. Ken Washenik, and Dow Stough, have been included on the task force and they have joined a group that is currently evaluating this complex topic.

The newsletter story further notes the task force will consult urology and sexual function experts to evaluate the connection between Finasteride and persistent sexual dysfunc­tion. They will determine if hair restoration specialists need to make changes when counseling and treating patients should a link between the two be found.  

We will continue to update you on this topic.

In this recent Dermatology Times article, the Hair Foundation’s Board of Trustees Secretary, Dr. Zoe Diana Draelos answered commonly asked hair questions. Today’s post answers questions about hair-styling products and acne, changes in hair at menopause, and thinning eyebrows.

Q. Do the newer hair-styling products cause acne?

A. Acne induced by hairstyling products was popularized by the concept of pomade acne.

Pomades are products used by persons with kinky hair to add shine, confer water resistant properties following hair straightening and moisturize the hair shafts. The ingredient in pomades responsible for acne was olive oil. The newer pomade formulations have replaced olive oil with dimethicone and cyclomethicone, which are noncomedogenic and nonacnegenic.

I am not aware of any modern haircare products that produce acne, but the older pomade formulations are still on the ethnic care market. Pomade acne has been decreased, but certainly not eliminated.

Q. Can hair change in both appearance and shape at menopause?

A. Hair can definitely change in appearance and shape at menopause. Hair growth is under hormonal control, and hormone status changes at menopause.

With the reduction in endogenous estrogen secretion, androgenetic alopecia is a frequent concern at menopause. While hormone replacement can possibly minimize further hair loss, I do not believe that it can reliably stimulate regrowth.

Some women on oral hormone replacement who are continuing to experience rapid hair loss may achieve better results when switched to an estrogen patch. Topical minoxidil is another option.

In addition to change in growth rate, hair appearance can also change. Straight hair can become curly, and curly hair can become straight. It is more common for straight hair to become curly. This is due to a change in the shape of the hair shaft. With menopause, the hair cross-sectional shape may become more irregular, resulting in curly hair.

Q. How can thinning eye-brows be cosmetically addressed?

A. Thinning eyebrows are a common concern among mature women with challenging treatment options. The most effective way to prevent thin or absent eyebrows with age is to prevent the problem earlier in life.

The most common cause of eyebrow loss in maturity is overplucking of the eyebrows during youth.

It might be worthwhile for the dermatologist to counsel young women who are plucking their eyebrows to a thin line that this might not be a good practice. Each time a hair is plucked, there is a chance of permanent follicular damage and no regrowth. Over years of plucking, the incidence of hair loss from traumatic plucking increases. Since eyebrows thin with age, as does all body hair growth, it is important not to hasten the process by overplucking during youth.

Another common cause of eyebrow loss is scratching of the eyebrows from seborrheic dermatitis. This problem can be diagnosed by examining the eyebrow hairs for irregular breakage and the obvious presence of erythema and yellowish skin scale characteristic of seborrheic dermatitis. Treating the seborrheic dermatitis with a combination of desonide cream and ketoconazole cream twice daily for one week should control the problem, which can be better maintained by the use of over-the-counter ketoconazole shampoo.

Finally, severe eyebrow loss can be managed cosmetically. Eyebrow pencil, which is a wax crayon, can be artistically applied in between existing eyebrow hairs and the hairs can be held in place to camouflage areas of thinning with an eyebrow gel.

Eyebrow gels are available as a clear or pigmented fixative to keep the hairs in place for a pleasing line above the eye. Hair spray can also be used, if a commercial fixative is too expensive.

Eyebrows can also be tattooed on the skin, a common practice in the Middle East. Some persons might find this attractive, while others prefer a more natural appearance. Unfortunately, eyebrow transplantation is not a reliably successful procedure.

Hair Foundation post about thinning eyebrows

In addition, the Hair Foundation wrote the previous blog, LATISSE May Thicken Brows, Thinning Hair .  In this post, it includes a story about a 27-year-old bride who you used LATISSE on her thinning brows before her wedding and couldn’t be more pleased by the results.

To learn more about hair loss, please visit the Hair Foundation’s new physician videos.

In this Marie Claire article, it gives tips on how to get healthy hair. What’s interesting about this article is it includes three opinions for each diagnosis/hair topic. One opinion is from a trichologist, a medical professional that diagnoses and treats diseases and disorders of the human hair and scalp. The other experts are a hairdresser and nutritionist.

The topics include hair loss or thinning, breakage and brittleness, scalp sensitivity, dullness, dandruff and oiliness.

Recommended hair products from Hair Foundation’s partners includes Pantene Pro-V Anti Dandruff Shampoo, Head & Shoulders Anti-Dandruff Care Scalp Massage Cream and Herbal Essences Hello Hydration Moisturizing Shampoo for Dry/Damaged Hair.

In the ongoing debate on Brazilian blowouts, NBC Today had a story on June 15 that involved both advocates and critics. Interviewees included hair stylists, clients and a doctor.

What do you think: Is it worth having straight hair or do the risks scare you from getting the process?

Here’s a link to the video and a link to the story’s text.

In recent hair news, there’s been a lot of press about keratin hair treatments. While many customers are pleased by the results, there are some side effects that are causing a lot of discussion and proposed FDA changes.

For this two-part series, John Halal, president of the Honors Beauty College, discusses the keratin smoothing treatment, its risks and alleged unacceptable levels of formaldehyde in an article written for Milady’s online newsletter.

In this second part, Halal discusses formaldehyde and its health risks and standards.

The CIR report referred to “free” formaldehyde used as a preservative in cosmetics that are applied to the skin, not for the use of formaldehyde as a hardener in nail products. The concentration of formaldehyde needed for nail hardening is higher than 0.2%. The FDA has approved the use of up to 5 % formaldehyde in nail hardeners as long as shields are used to keep the product from touching the skin.

The typical levels of formaldehyde used in nail hardeners are well below 5%.

The current safe limits of formaldehyde in cosmetics were intended for its use as a preservative or a nail hardener. They were never intended for solutions that use heat to vaporize the formaldehyde.

Aldehydes may be listed by many different names, including: formaldehyde, Formol, formalin, methanal, morbidic acid, formic aldehyde, methyl aldehyde, oxymethylene, glutaraldehyde, (glyoxal) ethanedial  n-octyl aldehyde, aldehyde C-8, caprylaldehyde.

Chemicals that release formaldehyde are diazolidinyl urea, imidazolidinyl urea, 2-bromo 2-nitropropane-1 (Bronopol), DMDM hydantoin (Glydant), and quaternium-15 (Dowicil).

Some products contain formaldehyde’s cousins such as gluteraldehyde or glyoxal and are marketed as formaldehyde free, even though they react in exactly the same manner as formaldehyde. These formaldehyde substitutes expose the stylists and their customers to the exact same health risks as formaldehyde.

Although gluteraldehyde or glyoxal are weaker than formaldehyde, they may be used in higher concentrations in order to achieve the same results.

The question has been raised as to whether it is scientifically correct to include methylene glycol when measuring the formaldehyde content of a solution. Based on an understanding of both the chemistry and the toxicology involved, CROET and Oregon OSHA have concluded that it is indeed appropriate to refer to methylene glycol as formaldehyde, finding the distinction to be of no relevance in the context of worker protection.

Methylene glycol is the hydrate formed when formaldehyde is dissolved in water. One molecule of formaldehyde plus one molecule of water equals one molecule of methylene glycol. When the hair is heated and dried, the water evaporates and releases formaldehyde vapors.

The hydrated formaldehyde portion of the solution effectively becomes a reservoir of gaseous formaldehyde. Describing the solution as containing only the amount of gaseous formaldehyde or “free formaldehyde” in the solution distorts the risks and dramatically understates the amount of formaldehyde that is readily available in the solution.

On October 8, 2010, Oregon OSHA issued an advisory suggesting “continued caution by salon workers” and noting that the federal OSHA standard applies not only to gaseous formaldehyde but also to formaldehyde in solution, including methylene glycol.

Salon owners who employ hairstylists have an added liability.

Oregon OSHA is advising Oregon salons and stylists that smoothing treatments generally referred to as “Keratin-based treatments” should be treated as formaldehyde-containing products and the requirements of the OSHA Formaldehyde Standard must be followed.

The Formaldehyde Standard requires employers using products above the 0.1 percent threshold to assess actual airborne exposures, as well as to meet other requirements related to personal protective equipment and emergency eyewash, depending upon the exact hazards involved. It also includes additional requirements that are invoked when employees are exposed to airborne levels above an eight-hour average of 0.1 ppm.

The employer must institute an annual training program and must provide medical surveillance to employees reporting formaldehyde signs and symptoms. When employees are exposed to levels exceeding the action level or the Short Term Exposure Limit (STEL), the employer also must perform periodic air monitoring and institute a medical surveillance program.

When exposures exceed the Permissible Exposure Limit (PEL), the employer must also establish regulated areas and provide respiratory protection.

The variables that affect the level of exposure for hair stylists applying hair smoothing products include the amount of product used, the length of time for each service, the number of services, the type and degree of ventilation, the size of the room and even the configuration of the stations.

Extra caution should be used when handling and storing formaldehyde.

Formaldehyde is a flammable, colorless gas that is incompatible with oxidizers, alkalis, acids, phenols, and urea. Explosive reactions occur when formaldehyde comes in contact with hydrogen peroxide or haircolor developer.

CROET has received reports of hair loss from consumers who have had the treatment and more than seven or eight repeated applications may cause a non-reversible “plastification” of the hair.

If all of this scares you–it should–but there is a bright side. Consumer demand for keratin smoothing treatments continues to grow and manufacturers are scrambling to develop a safe alternative to satisfy that demand.

The textile industry continues to develop promising new technology. In 1992, Haggar first began to employ (1,2-Dimethylol-4,5-dihydroxyethyleneurea) DMDHEU in wrinkle free garments. However, DMDHEU still releases some formaldehyde, so it is not entirely without health risks.

More recently, nanotechnology has been applied to the problem of wrinkles in clothing.

In 1998, the Nano-Tex company was formed by chemist David Soane to apply a “nanotechnology” process to fabrics. Rather than coating the fabric with a formaldehyde resin, tiny nano molecules are permanently attached to the fabric. The new nanotechnology is used in clothes sold under major brands such as Dockers, Eddie Bauer, The Gap, Perry Ellis and Old Navy.

It should come as no surprise that this technology would eventually be applied to keratin smoothing treatments and one cosmetic company already claims to use nano-technology in their keratin smoothing treatment.

Another newly reformulated “formaldehyde free” keratin smoothing treatment contains a thio compound similar to those used in permanent waving. Several other keratin smoothing treatments now claim to have “formaldehyde free” formulas, but since most companies aren’t willing to share proprietary information, many of the details are still rather vague.

One thing is clear: the technology for keratin smoothing treatments is still in its infancy and it’s changing fast. Stay tuned for the latest changes as they develop.

I promise to keep you informed.

I welcome your comments and questions at john1@honorsbeautycollege.com.

This article was published in the March/April issue of Hair Transplant Forum International, the newsletter by Hair Foundation’s partner, ISHRS. It is a case report of scalp necrosis and subsequent scarring alopecia caused by a hair highlighting procedure; this illustrates a serious complication of a commonly performed hair salon process.

In this article, the Hair Foundation’s doctors William Parsley, Russell Knudsen, E. Antonio Mangubat, and Paul Rose shared their experiences with similar injuries caused by hair highlighting. Their responses came from an online discussion about the case as well as a review of the pathophysiology of this injury as previously reported in medical literature.

This is the conclusion of a three-part series.

Conclusion

Chemical burns of the scalp have been known to occur as a consequence of permanent wave and straightening products. Case reports have found scalp burns and ulcerations following hair highlighting procedures. These highlighting procedures involve an oxidation reaction between the active ingredients, which include hydrogen peroxide (concentrations up to 6% in the United States, 12% in Europe and other areas of the world), persulfates, and alkalizers.

The mixture apparently breaks down upon contact with hair keratin, which results in the activation and release of oxygen. The hydrogen peroxide in concentrations greater than 10% can cause blistering and burns. The persulfates, especially in alkaline conditions, facilitate hair dye absorption by making the hair porous.

They are themselves acidic.

In 2001, the Cosmetic Ingredient Review Expert Panel published a report on the safety of ammonium, potassium, and sodium persulfates and reviewed their toxicity. Each can cause allergic and irritant contact dermatitis.

The report found that these persulfate agents are “safe as used as oxidizing agents in hair colorants and lighteners for brief discontinuous use followed by thorough rinsing from hair and skin.”

The alkalizer used is sodium metasilicate, which is highly water soluble and has a pH of 13 in a 1% aqueous solution.

Although there were references to the possibility of either thermal or chemical burns, stemming from the ingredients and techniques used in hair highlighting procedures, in the case that was biopsied during the healing phase, there was no evidence of the type of coagulation necrosis and loose collagen bundles that are expected histologic changes seen in a thermal burn.

Instead, the collagen was normal, with the presence of granulation tissue in the ulcerated areas, and occasional foreign body type reaction, consistent with a chemical burn. In most of the reports, patients experienced discomfort within minutes of application of the solution and being placed under a hair dryer,and the scalp was initially intact but sloughed off later.

It appears that onset of pain is usually quite acute with either a thermal or chemical burn, but may be slightly delayed in some chemical burns.

In these reported cases, while many were treated with antibiotics, most did not show overt infection and the doctors concluded adequate treatment occurs with applications of white petrolatum gauze or similar dressing over the ulcerated areas, to maintain a moist environment during the granulation phase.

It can take many weeks before re-epithelialization of the ulcerated area occurs. In Dr. William Parsley’s review case, the final wound did not have a thermal burn keloid or hypertrophic scar.

It seems there may be merit and value to the public health in pooling and reporting the case experiences among our ranks to provide a larger study population of this event in order to illustrate a problem that may be avoided with greater education of this risk both to customers and hair stylists.

Given the apparent higher frequency of reported cases in younger patients and amongst patients with darker hair, the possibility of cofactors predisposing to this complication exists and may be further elucidated by sharing of information.

A further discussion of these approaches will be discussed in future posts.

In recent hair news, there’s been a lot of press about keratin hair treatments. While many customers are pleased by the results, there are some side effects that are causing a lot of discussion and proposed FDA changes.

For this two-part series, John Halal, president of the Honors Beauty College, discusses the keratin smoothing treatment, its risks and alleged unacceptable levels of formaldehyde in an article written for Milady’s online newsletter.

Keratin Smoothing Treatments

Keratin smoothing treatments, also called Brazilian keratin treatments, originated in Brazil and first appeared in the United States in 2006. Although there are differences in the application, the technology is essentially the same as the process that was first developed in the 60’s to create permanent press fabrics for the textile industry.

These treatments loosen curl and leave unruly hair smooth and frizz-free. It may seem like a dream come true for those with curly, frizzy and unmanageable hair, but the treatments are not without risk.

Oregon Occupational Safety and Health Agency (OSHA) and the Center for Research in Occupational and Environmental Toxicology (CROET) have concluded that there are meaningful risks from exposure to the high levels of formaldehyde that hairstylists and their customers are exposed to during the process.

Treatment Risks

Oregon OSHA and CROET have determined that the treatments (marketed under different brand names) contain unacceptable levels of formaldehyde; a known carcinogen as well as an irritant to eyes, lungs and nasal passages. Consumer and stylist complaints have ranged from difficulty breathing to skin irritation and nasal and throat problems.

The section below is from the Oregon OSHA, a Division of the Oregon Department of Consumer and Business Services and CROET at Oregon Health & Sciences University, report dated October 29, 2010.

The full report is available online at: http://www.orosha.org/pdf/Final_Hair_Smoothing_Report.pdf

A stylist at a Portland area hair salon contacted staff at the Center for Research in Occupational and Environmental Toxicology (CROET) at the Oregon Health Sciences University (OHSU) as a result of difficulty breathing, nose bleeds and eye irritation when using a popular hair smoothing product.

In evaluating the issue, CROET noted that the material safety data sheet (MSDS) accompanying the product listed no hazardous ingredients or impurities. The MSDS also indicated no respiratory hazards or related precautions.

CROET asked for Oregon OSHA’s assistance in collecting a sample and determining the content of the product. The Oregon OSHA laboratory analyzed the sample using five different test methods. Each of the five separate analyses concluded that formaldehyde was present well above regulated levels, with the quantitative methods producing respective results ranging from 6.3 to 10.6 percent. In analyzing samples of a newer “formaldehyde free” version of the product, Oregon OSHA’s laboratory found it contained roughly 8.5 percent formaldehyde.

Effects of Formaldehyde

The irritant effects of formaldehyde are well documented, with reports of eye, nose and throat irritation, loss of sense of smell, increased upper respiratory disease, dry and sore throats, respiratory tract irritation, cough, chest pain, shortness of breath and wheezing.

Adverse effects of formaldehyde on the central nervous system include headaches, depression, mood changes, insomnia, irritability and attention deficit. Impaired dexterity, memory and equilibrium have been reported from long-term exposure.

Special consideration regarding the exposure of pregnant women is warranted since formaldehyde has been shown to damage DNA.

The heat, up to 450 degrees fahrenheit, from a hairdryer and flat iron causes the aldehyde in the product to form oxymethylene crosslinks and side chains with the amino acids in the hair. These keratinous bonds are responsible for the majority of the softening and smoothing and are stable for three to four months, at which time the hair will revert back to its original configuration.

Although the aldehyde does not break disulfide bonds, the extreme heat does break disulfide bonds and accounts for some of the straightening and smoothing.

Unfortunately, the extreme heat also releases aldehyde vapors that present a health hazard to anyone in the room. Even in a well ventilated room, the release of aldehyde vapors could easily exceed the maximum concentration allowed by OSHA of 0.75 parts per million (ppm) over an eight hour period, especially with multiple services.

The American Conference of Industrial Hygienists (ACGIH) notes that “there is a substantial portion of the population, comprising up to 20%, for whom airborne formaldehyde at concentrations on the order of 0.25 to 0.5 ppm is troublesome” and that “it is plausible that a similar proportion (10% to 20%) who are more responsive, may react acutely to formaldehyde at concentrations as low as 0.25 ppm.”

ACGIH further states that in consideration of these reports, “individuals who may already be sensitized or otherwise unusually responsive to formaldehyde may not be adequately protected from adverse health effects caused by formaldehyde exposures at or below the recommended Threshold Limit Values (TLV) ceiling of 0.3 ppm.”

Although formaldehyde has been safely used as a preservative in cosmetics for decades, in 1984, the Cosmetic Ingredient Review (CIR) Expert Panel reported that cosmetics containing formaldehyde in excess of 0.2% are not safe.

Part II will discussed the expert panel’s findings and current options for this popular treatment

This article was published in the March/April issue of Hair Transplant Forum International, the newsletter by Hair Foundation’s partner, ISHRS. It is a case report of scalp necrosis and subsequent scarring alopecia caused by a hair highlighting procedure; this illustrates a serious complication of a commonly performed hair salon process.

In this article, the Hair Foundation’s doctors William Parsley, Russell Knudsen, E. Antonio Mangubat, and Paul Rose shared their experiences with similar injuries caused by hair highlighting. Their responses came from an online discussion about the case as well as a review of the pathophysiology of this injury as previously reported in medical literature.

This is Part II of a three-part series.

After a cyberchat, Parsley responded:

Parsley: [I agree with Paco] that if similar treatment is done to many clients, there should be more ulcers and burns. Unlike allergic contact dermatitis, irritant dermatitis would be very common if the treatments were all the same. I think that the differences may lie in the patient’s hair color and hairstylist mistakes. There are big differences in the bleach concentration used as well as time on the scalp, and both would be higher in women with dark hair.

Mistakes also may play a part.

For example, lye (sodium hydroxide) hair relaxers are the most caustic solutions used in hair salons requiring protective gloves. If it was inadvertently mistaken as bleach, when applied to the scalp, the scalp would have no protection and the heat would have been doubly bad. Lye relaxers can come in pH levels of 10-14, with 14 being the most caustic. A mistake like this could explain the rarity of this hair styling injury and hopefully this type of mistake would be very rare. It seems that most of these cases may be multifactorial with combinations of ingredient concentrations, ingredient volume, ingredient types, ingredient mistakes, air heat, foil heat, and length of heat.

Secondary infection could also play a role, but I think a secondary role. I agree that there is undoubtedly a spectrum of injury and that probably most cases are mild and therefore don’t get reported. It’s only when severe cases “make the headlines” that we become tuned in. I suspect the salons that do a lot of these procedures are well aware of this potential problem, and they probably see a lot more of it than we do.

Part III will be the conclusion.