Misuse of Hot Styling Tools Can Lead to Scarring Alopecia

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IF YOU USE MISUSE HEATED STYLING APPLIANCES, YOU CAN DAMAGE YOUR HAIR FOLLICLES AND CAUSE A HAIR LOSS CONDITION KNOWN AS “SCARRING ALOPECIA” OR CENTRAL CENTRIFUGAL CICATRICIAL ALOPECIA (CCCA).

While heated styling tools are a favorite choice of styling for many women and especially teenage girls, there’s a right way and a wrong way to use them. If they are used correctly and sparingly, you’ll reap the rewards of a style that behaves, but if they are used too often or carelessly, you’re setting up your hair for severe damage, breakage, burns and a follicular degeneration disease that results in hair loss.

Dr. Valerie Callender, M.D., board-certified dermatologist and director of the Callender Skin & Laser Center in the Washington, D.C., metropolitan area, adds that the inflammatory condition and permanent scarring of the skin can damage hair follicles to the point of their death. Sometimes called hot comb alopecia, the condition continues without the person knowing there is a problem, because most women cannot see the very top or back of their head where the hair loss from these appliances is occurring. The condition will go unnoticed until they feel pain and soreness or see the hair loss or someone else, such as a friend or hairstylist, alerts them to the problem. Some women may mistakenly believe it’s female-pattern baldness and also not seek medical intervention, but if they practice a lot of chemical or heated styling, they need to be on the alert for this condition, because, as Callender says, “if caught early on, it can be reversed!”

Signs your misuse of styling tools might be causing hair loss:

  • Frizzy hair
  • Noticeable breakage
  • Hair fall-out
  • Sore scalp
  • Actual burns
  • Hair thinning on the top of your head
  • Daily use of heated styling tools

No heated styling tools are “healthier for your hair,” no matter what the packaging says

First of all, warns Diahna Husbands, a hair replacement specialist and owner of Diahna Lynn Hair Studios in the Washington, D.C. metropolitan area, “do not believe any heated device that claims to protect hair or make it even healthier. That’s just marketing and advertising. Whether or not it emits negative ions, is made of ceramic or uses some kind of nanotechnology, the plain truth is that you are directing heat at your skin and hair, and repeated heat, especially at the highest heat settings, breaks down the hair shaft and destroys the cuticle of your hair … period.” In fact, at a recent annual meeting of the American Academy of Dermatology (AAD), Dr. Paradi Mirmirani, from the Department of Dermatology at the Permanente Medical Group, presented evidence that when ceramic flatirons are used too often and improperly, hair breakage can occur. “At home, use the device on the lowest heat setting, and avoid using it on wet hair,” advises Dr. Mirmirani. AAD member Amy McMichael, M.D., associate professor of dermatology at Wake Forest University School of Medicine, agrees, “Take one or two weeks off per month or at least several days off between fatiron use.”

Always work on the smallest-possible section at a time

Husbands explains that most women work on too large a section as they repeatedly apply the heat to it and then wonder why the appliance doesn’t work well. The correct way is to take small 1-inch to 1 ½-inch sections if you are flatironing or using a curling iron. This way the heat will get through with one pass instead of five. “Every time you pass the device over your hair, you are subjecting it to further heat damage and chances of pulling and snagging on the plates and device itself.”

The only device for use on wet hair is a blow-dryer

Even though some flatirons are labeled “wet-to dry” most stylists agree never to use them on wet hair, “because it’s like boiling your cuticle! Hair shafts hate hot water, and only bad things can happen,” exclaims Husbands.

Always protect your hair from the heat

Use products labeled for heat protection or even a leave-in conditioner to coat the hair shaft and smooth down the cuticle, but always use something in between that heat and your hair, says Husbands. Use a liquid product or serum on wavy or straight hair and a cream-based product on coarser, curlier hair types.

Keep irons and curlers at least 1 inch away from your scalp

Dermatologists agree that in order to avoid scalp trauma, irons and curlers need to be at least 1 inch away from the scalp; otherwise real burns can occur and follicles can suffer irreparable damage.

Don’t use the highest heat setting

The best results with the least amount of exposure to heat and damage can be achieved with your appliance set on the “medium” temperature control. “There is no need for 450 degrees on a flatiron unless you are receiving a Brazilian keratin treatment in a salon, so keep your device set on medium,” suggests Husbands.

Never stop in any one spot

Stylists agree: Keep the appliance moving. Never hold the flatiron clamped down on any one spot, since burns and irritation can easily occur. And the same goes for the blow-dryer. Be careful to avoid directing the heat at one spot on your scalp. Hold your blow-dryer at a 45 degree angle to your scalp.

Stay cool

It’s the cool-down period that sets your style, explains Husbands, so when using hot rollers, the maximum set time should be about eight minutes. Then gently unroll curlers and pin up curls in place with bobby pins while cooling down. Same with a straight style; hit it from the top with a hair dryer set on “cool” to set the look.

Bigger is not better

You’ll notice that some flatirons vary in plate size (where the hair gets clamped down) — but the optimum size is about 1-inch to 1 ½-inch plates. The larger plates make the appliance bulky to use, which can result in burns, and the larger plate size often does not contain a larger heater inside, so the plates will not be as efficient, prompting you to use larger sections and going over them several times to achieve your look.

Look for real features that protect

Most of the real advances in heated tools for styling are in protection from burns, with an added “burn-guard” between the heated surface and the scalp, so look for this along with finger or thumb grip spots for easy handling. There are also different types of plates. Titanium is a solid plate that is lightweight and long wearing. If plates are ceramic, ask how many layers coat the base — the more the better, all the way to solid ceramic. The fewer the coatings, the faster the plates may show wear or snag hair. Some of the newest flatirons have new heaters that heat up faster to reduce recovery time in between strokes and also reduce the actual number of strokes necessary, thereby reducing the amount of heat surface the hair and scalp are exposed to.

The newest blow-dryers also have new, more powerful heaters and blowers that reduce drying time and the amount of time that hair and scalp are exposed to heat. New hot curlers also use ceramic coatings to enhance heat delivery.

Scarring alopecia: The bottom line

Give your hair a rest and be gentle with your hair, especially if you are noticing fall-out and hair thinning or if you have pattern baldness or a hair loss condition of any kind. Practicing these lessons can help to further prevent hair loss. “There is so much you can do with cutting and natural, gentler styles that won’t put any stress at all on follicles. Sometimes, you just got to give it a rest!” Husbands concludes.