Chemical Scalp Burns After Hair Coloring: Is this Story Becoming More Common?

The Classic Story Of Hair Highlighting Burns

I was interested to read a report in the Journal of Clinical Medicine about a scarring alopecia that followed hair highlighting by a 17-year-old female. This story appears all too commonly - and I do wonder if reports are actually increasing worldwide. This is something I’m seeing often!

The authors describe a 17 year old who attended a hairdressing salon in order to lighten the hair. Within a very short time of applying the preparation to her hair, the woman felt a strong burning sensation on her scalp. The preparation was then washed off and further activities were discontinued. Initially, the patient experienced erythema, swelling, and painful inflammatory infiltration. Pain, swelling and erosions and hair continued over the next few days and eventually the patient developed purulent discharge.

The patient was treated with antibiotics, antifungals and had local wound care but eventually developed a large area of scarring alopecia. She had a tissue expander placed but it needed to be removed sooner after the procedure due to purulent discharge.

Figure 1. Appearance of the lesion during treatment-ulceration after chemical burn in the parietaloccipital part of the scalp. A necrotic eschar is visible in the central part, the surrounding skin is healing. SOURCE: Welc N et al. Chemical Scalp Burn after Hair Coloring-Case Report with Literature Review. J Clin Med. 2024 Jun 17;13(12):3542. doi: 10.3390/jcm13123542.

Figure 2. The appearance of the lesion during treatment-ulcer after chemical burn in the parietooccipital part of the scalp (1–3) during the healing process, complicated by the enlargement of erosions and leakage of purulent contents (2). After complete healing, an area of scarring is visible at the site of the original ulcer (4). SOURCE: Welc N et al. Chemical Scalp Burn after Hair Coloring-Case Report with Literature Review. J Clin Med. 2024 Jun 17;13(12):3542. doi: 10.3390/jcm13123542.

Comments

These sorts of chemical dye related burns are not that uncommon. The story is classic - within seconds to minutes of the hair reagents being applied to the scalp the patient has pain, burning. Soon thereafter, the patient develops swelling, redness, worsening pain and shedding. A patch of scarring alopecia often ensures. The cause is thought to be a chemical burn from agents such as hydrogen peroxide or other oxidizing agents.

I don’t think we fully understand this phenomenon yet! Why does this happen to some and not others? Is it always an error of the hairdressing team? Or are there idiosyncratic factors? I don’t think we fully know all the factors.

This phenomenon does appear to be increasing. I’m hearing more and more and more stories just like this.

More research is needed to understand the chemical scalp burn that follows hair highlighting in some patients.

REFERENCE

Welc N et al. Chemical Scalp Burn after Hair Coloring-Case Report with Literature Review. J Clin Med. 2024 Jun 17;13(12):3542. doi: 10.3390/jcm13123542.