What are the best practices for maintaining healthy hair?

Best Practices for Maintaining Healthy Hair

For healthy individuals without hair loss conditions, focus on gentle hair handling, adequate nutrition with attention to iron and zinc status, and avoiding harsh chemical treatments and heat damage. 1, 2

General Hair Care Practices

Physical Hair Handling

• Minimize mechanical trauma by avoiding tight hairstyles, excessive brushing, and aggressive towel-drying that can damage hair shafts and lead to breakage 2
• Limit heat styling tools (blow dryers, flat irons, curling irons) as thermal damage weakens hair structure and impairs hair health 2
• Protect hair from environmental damage including UV exposure from sun, which degrades hair proteins and causes structural damage 2

Chemical Treatments

• Avoid or minimize harsh chemical treatments including certain shampoo ingredients that can impair hair health 2
• Be cautious with antimicrobial agents, harsh surfactants, and certain preservatives in hair products, as these can damage existing hair and impair growth 2
• Limit chemical processing (perms, relaxers, bleaching) that disrupts hair structure 2

Nutritional Considerations

Essential Nutrients

• Ensure adequate intake of essential fatty acids and vitamins, as malnutrition of these nutrients causes damage to existing hair and impairs hair growth 2
• Monitor iron status, particularly in women, as iron deficiency is associated with hair changes including telogen effluvium and thin, brittle hair 3, 4
• Maintain adequate zinc levels, as zinc deficiency can result in extensive hair changes including telogen effluvium and induction of thin, brittle hair 3

Vitamin D

• While lower vitamin D levels have been observed in patients with alopecia areata, prospective data shows no association between vitamin D status and risk of developing hair loss in healthy individuals 3
• Routine vitamin D supplementation for hair health in those without deficiency is not supported by evidence 3

Biotin Supplementation

• Biotin supplementation is NOT routinely recommended for hair improvement in individuals without documented biotin deficiency 5
• Despite popular marketing claims, there have been no clinical trials or randomized controlled trials demonstrating biotin's efficacy for improving hair quantity or quality in healthy subjects 5
• Only 38% of women complaining of hair loss actually have biotin deficiency, making indiscriminate supplementation inappropriate 6
• Biotin supplementation should only be considered after documented deficiency through serum biotin levels and careful patient history 6

Risk Factor Assessment

Identify Predisposing Factors

• Age, malnutrition, malabsorption disorders, and certain medications are the most common risk factors for nutritional deficiencies affecting hair health 1
• Take a thorough history to identify these risk factors, which will guide any necessary laboratory testing 1

Lifestyle Factors

• Avoid smoking, as it is an external factor that causes damage to existing hair and impairs hair growth 2
• Maintain good generalized health through balanced nutrition and mindful health care practices 1

Common Pitfalls to Avoid

• Do not supplement with biotin without documented deficiency, as its popularity vastly exceeds clinical evidence supporting efficacy 5
• Avoid the assumption that all hair concerns require micronutrient supplementation; large double-blind placebo-controlled trials are still needed to establish clear associations 4
• Do not ignore underlying medical conditions or medications that may affect hair health when evaluating nutritional status 1