An epidemic of hair styling burns?

The Increasingly Common Story of Chemical Burns to Hair styling products

I see chemical burns after visits to hair salons at an ever increasing rate. I'm not sure why it's occurring so much more frequently now than years ago,  but I do believe it is. The story is typical in most cases.

1. Product applied to scalp

2. Burning sensation experienced by the patient within seconds to minutes.

3. Patient says "get this off my scalp"

3. Product is removed

4. Hair loss occurs days to weeks later

Some of these stories lead to thinning of hair, some lead to actual bald scarred spots where the product was applied. ALL are associated with inflammation. The reason this is important is because targeting inflammation is so important in the early stages. This is probably best done with topical and injectable steroids and rarely oral anti-inflammatories like doxycycline.  This has been by approach. Some patients improve a lot, some a bit and some actually worsen over time.

Is a biopsy needed?

A biopsy may or may not be necessary. It depends on how much itching, burning and/or pain the patient in the days and weeks after the salon visit AND how many symptoms the patient has now.

Surgery is not an option in early stages. If the area is associated with significant bald patches (rather than thinning alone), a hair transplant may be possible after 1-2 years of close observation.