Root Cause: The Ultimate Guide to Scalp Care

It’s gone from the have-to-hide-in-the-shower shampoo to a study in the ultra-science. Here are the latest healthy-scalp solutions taking strands by storm.

LEVEL 01: The Magic of Massage
Trichologist Shab Reslan says regular scalp massages are good for the health of your hair, and this is one solution that’s—surprise—free. “You can have a friend or partner give you one while you watch your favorite show, or even spend a couple extra minutes in the shower while your conditioner is applied and massage your scalp slowly using the cushions of your fingers,” she explains. “The stimulations and blood circulation promote healthier hair and scalp.”

LEVEL 02: Scalp Soothers
It may be up for debate if finding a friend who wants to deliver a head massage is easier than purchasing a product, but one thing is certain: As both stylists and brands learn more about the link between healthy hair and a healthy scalp, “scalp health is undeniably a hot topic,” Reslan says. She counts Neuma ReNeu Scalp Therapy ($26) and Christophe Robin Purifying Scalp Scrub ($53) as two scalp products that hit the top on her “favorites” list. Celebrity hairstylist Creighton Bowman is also a fan of the product route, and his number-one solution is long-time staple Head & Shoulders ($9). “I like using it on the ‘hot spots’ of the head that are dry,” he says.

LEVEL 03: Try a Treatment
HydraFacial is another traditionally skin care–focused brand that’s taking on the scalp-care revolution with its new HydraFacial Keravive. The brand says it decided to launch the three-step treatment—which involves an in−office cleansing, exfoliation and hydration steps, and a take-home spray—because it found its customers are “very aware of the detrimental effects of poor scalp health, including visible signs of flaking, dry and itchy scalp, and limp and damaged hair.”

Montclair, NJ dermatologist Jeanine B. Downie, MD likes spraying ISDIN Lambdapil Spray on patients’ scalps to encourage hair growth and overall healthier hair. “I tell them not to scratch, and I encourage them to limit the heat they use on their hair and scalp,” she says. “All of those steps work wonders.”

LEVEL 04: Go to the Doctor
Smithtown, NY facial plastic surgeon James Marotta, MD sees many patients “very concerned with scalp health and hair health in general,” but by the time they come to him, it’s a bit more than some flakes on the shoulders. Because statistics show hair loss is a universal problem, affecting 85 percent of men and 40 percent of women by the age of 50, that’s a whole lot of people who most likely share the same concerns.

When patients visit Beverly Hills, CA hair restoration surgeon Dr. Craig L. Ziering, it’s almost solely because of hair-loss reasons, but he doesn’t deny that an oily scalp and dandruff can be problematic. “Medicated shampoos can manage these conditions and function by cleansing the scalp, along with mechanical cleansing created by vigorous finger action during shampooing, to remove any debris.”

The Dos and Don’ts for a Healthy Scalp

DO: Wash Your Hair
Reslan says infrequent hair washing is a huge detriment to the quality of your hair growth. “Buildup and sebum [the oil the scalp produces] can clog your follicles and cause inflammation. Keeping your scalp in this constant state can lead to weaker and thinner hair growth over time.”

DON’T: Run Too Hot
Dr. Marotta, who also specializes in hair restoration surgery, stresses the importance of avoiding overdrying by showering with water that is too hot or excessively blow-drying the hair.

DO: “Anti-” Up
Dr. Marotta says that for scalps with specific conditions like dandruff or seborrheic dermatitis for example, “treatment with anti-dandruff shampoos or anti-fungal creams may be necessary.”

DON’T: Overdo the Dry Shampoo
Perhaps the biggest debate of them all: What role does dry shampoo play in scalp health? When used properly, it is a great hair-refresher, Reslan says, but, when used incorrectly, like in cases where it is applied directly to the scalp or not properly washed out, it can lead to problems.

Perfect Pairing

Spoiler alert: The scalp is skin, and treating it with the same care we give our facial routines might not be such a bad idea—a concept not lost on Drunk Elephant founder Tiffany Masterson. That’s why she’s rolling out a two-year-in-the-making line with celebrity hairstylist and longtime friend Chris McMillian of Jennifer Aniston fame, and it does not fool around in the efficacious ingredient department. The four-product collection includes Cocomino Glossing Shampoo, Cocomino Marula Cream Conditioner, Wild Marula Tangle Spray and the alpha- and betahydroxy acid–packed T.L.C. Happi Scalp Scrub, all of which follow the brand’s clean-compatible philosophy.

The Hair-Loss Link
Dr. Marotta says to think of the scalp as the “soil” that grows the “plants”—i.e., the healthy hair. “If the scalp is unhealthy, it will affect hair health and hair growth,” he explains. “Treatments for specific scalp conditions can improve hair health and hair growth. If there are sores, patches of hair loss, redness, itching, or scaling anywhere on your scalp, seek evaluation and treatment.”

Constant Flare-Ups
Inflammation is just “part of the factor” in a number of types of alopecia, says Dr. Ziering. Often it can fly under the radar, he adds, in a sub-clinical level, thus avoiding detection and delaying treatment.

Healthy Habitat
Researchers have zeroed in on the scalp’s microbiota as the origin of inflammation, says Dr. Ziering. “Microorganisms have been identified residing deep within the hair follicle, which places them in close proximity to immune-privileged regions. If they compromise function by their presence deep within the follicle, hair cycling and regeneration may be affected.” As researchers continue to examine the scalp’s microbiome, doctors are hopeful their findings may lead to new therapies for cicatricial or scarring alopecias, which can lead to irreversible hair loss.

Oily Buildup
Another often-heard scalp concern: sebum buildup. “Sebum is an oily substance produced by the sebaceous gland for the physiologic purpose of lubricating the hair follicle,” explains Dr. Ziering. However, he believes any correlation between excessive oil production and hair loss is much ado about nothing. “An oily scalp can be easily managed by over-the-counter medicated shampoos. The use of these scalp-cleansing solutions will prevent the remote possibility of the sebum buildup that can create an inflammatory state within the hair follicle.”