Hair damage is a common concern for many individuals, often resulting from various factors such as heat styling, chemical treatments, or environmental stressors. To effectively address and manage hair damage, it is essential to accurately assess its condition.
Outlined below are the EIGHT questions that form the foundation of a thorough cosmetic hair assessment. We will elaborate upon each question to provide a deeper understanding of the assessment process.
1. Does the hair have shine?
Visually assess hair shine by observing the amount of light reflection from the hair. Healthy hair has high shine representing an intact cuticle with closely overlapping cuticular scales. It is the smoothness of the overlapping scales that promotes light reflection, interpreted by the eye as shine. Normal grooming processes such as combing and brushing result in loss of cuticular scales, which is more pronounced at the distal hair shaft. Overly aggressive grooming and chemical processing accelerate this process, known as ‘weathering.’ The naturally irregular nature of the shape of the hair shaft in African-American patients also contributes to decreased hair shine in kinky hair.
Hair with decreased or absent cuticular scales appears dull, harsh, and frizzy. If the cuticular scales significantly decrease at the distal hair shaft, the weak medulla becomes exposed, causing the hair to split—a condition medically known as trichoptilosis. Split ends lead to frizzy and unmanageable hair. Occasionally, cuticular loss combines with hair twisting and knotting, a condition known medically as trichonodosis.
2. Does the hair feel soft ?
Hair shine results from visually assessing the state of the cuticle, while hair softness involves tactically assessing the cuticle. A smooth hair shaft surface, created by an intact cuticle, contributes to the perception of hair softness. In the case of permanently waved or dyed hair, a disrupted cuticle is necessary to facilitate the penetration of waving lotion or dye. Consequently, chemically processed hair never attains the same level of softness as virgin hair, despite the temporary smoothing attempts of hair conditioners on the disrupted cuticle. The sensation of harshness in hair indicates severe cuticular damage.
3. Does the hair lay in an orderly fashion?
Hair with a disrupted cuticle not only looks dull and feels rough but is also susceptible to static electricity, particularly in chemically processed hair from procedures like dyeing or permanent waving. This static effect causes frizz and unruliness, especially at the ends of the hair, where similar electrical charges repel each other. Due to fewer cuticular scales, chemicals penetrate the distal hair shaft more easily. Knowledgeable cosmetologists address this by applying chemicals to the scalp first and diluting the product before treating the ends.
Hair that is overprocessed becomes frizzy, weakens significantly, and cannot be restored to its original state, with static electricity serving as an indicator of irreversible hair shaft damage.
4. Is there evidence of hairstyling aid use?
Styling aids, such as hairspray, mousse, or sculpturing gel, can mask some of the previously discussed cuticle damage. These products have the ability to restore shine, add softness, and reduce static electricity. When physicians evaluate hair covered with these styling aids, they must avoid being misled.
These products contain polymers that create a thin film over the hair shafts, enhancing the cosmetic appearance. Combing the hair removes the polymer film, manifesting as tiny white flakes throughout the hair, allowing for a better appreciation of the true state of the hair shafts.
Unfortunately, some patients who dye their hair will not openly admit that they use hair coloring. Furthermore, many patients do not know the type of dye that has been applied to their hair or whether any bleaching has occurred. This means that the physician makes an assessment based on guided observation. The hair color should be compared to eyelashes, eyebrows, or other body hair.
If the scalp hair color is lighter than other hair, bleaching has occurred.Regrowth at the scalp indicates permanent color, while gradual color variation with grayish hairs suggests semipermanent color. A yellowish cast signifies metallic color. These guidelines prompt discussion during patient history.
5. Does the hair color look natural and match the patient’s eyebrows, eyelashes, and body hair?
It is also crucial to observe the difference in hair color between the patient’s scalp hair and the rest of the body hair. The greater the contrast in color, the more damage the hair shafts have endured. The most damaging method of hair coloring is bleaching the hair to a lighter shade, which significantly weakens the hair shafts and makes them more prone to breakage. With repeated bleaching, especially of selected hairs, patients may report that their hair is no longer ‘taking’ the bleached color. In reality, the hairs are successfully bleaching, but they are selectively breaking off, leaving only the unbleached hairs and color.
Patients who extensively bleach their hair may also mention that their hair is not growing. This, too, is linked to hair breakage surpassing overall hair growth, resulting in the shortening of the hair shafts. It is important for the physician to evaluate hair loss in the context of chemical processing.
6.is the hair curly or straight?
Additionally, assess the curl of the hair, as tightly curled hair is more prone to breakage. Determine whether the curl is natural or due to permanent waving. Chemically waved hair appears straight at the scalp and curlier at the ends. Hair that is naturally curly will have an even curl throughout the length of the hair shaft.
If the hair has been chemically waved, either the patient or the salon should provide information about the type of permanent wave and length of processing.
Several common problems accompany permanent waving of the hair besides hair breakage. One is an irregular, uneven curl. This is typically due to failure to wrap the hair evenly on the mandrels with consistent tension. demonstrates the proper even wrapping technique and careful placement of the curling mandrels over the scalp.It is also important to avoid having loose hair ends sticking out of the mandrels; any hairs not wound around the mandrel will remain straight, resulting in an uneven appearance of the hair. This unevenness will contribute to decreased shine and lack of hair softness.
7.How long are the strands, and when was the last cut?
The length of the hair is also crucial. Longer hair, naturally, has been on the scalp for a longer duration, and one would expect it to be more weathered and prone to increased breakage. The distal ends of the longer hair shafts may also exhibit a lighter color and increased weakness due to photodegradation. Patients often gauge the amount of hair loss based on what they observe in the sink.
Longer hair shafts create a larger mass than shorter ones, even if the same number of hairs are lost. Therefore, patients with longer hair tend to overestimate their actual hair loss.
The physician should also inquire about the last haircut. Hair that undergoes frequent cutting tends to display less evidence of damage than hair that is cut infrequently. If the patient removes the damaged ends of the hair shaft before visiting the dermatologist, the full extent of hair damage may not be evident.
However, it’s important to note that chemical processing damages the entire hair shaft, and issues will reappear shortly.
8. Is there evidence of heat damage?
Lastly, assess the hair for heat damage. The presence of ‘bubble’ hair under the electron microscope typically indicates heat damage, resulting from rapid exposure of the hair shafts to high heat, such as that generated by a curling iron. When high heat, such as that from a curling iron, quickly exposes the hair shafts, the water in the hair shaft immediately turns to steam and attempts to escape, leading to the formation of bubbles within the hair shaft. These bubbles pop off the cuticular scale, resulting in a hair bubble that lacks the overlying cuticular scale. However, bubble hair is not visible to the naked eye.
Visually, hair that has undergone heat damage appears frizzy, with extreme frizziness observed at the ends of the hair shafts due to denaturation of the hair protein. This weakened hair is prone to easy fracture, even with minimal tension applied by hand. The physician should caution patients experiencing heat damage to change their hair care practices.
Conclusion:
By utilizing these eight assessment methods, hair professionals can gain a comprehensive understanding of the extent and type of damage present in the hair. This knowledge allows for targeted treatment and prevention strategies to restore and maintain hair health effectively.