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Questions and Answers by Dr. Seymour Weaver Dermatologist

Countess Vaughn recently sharing with the media that she has suffered painful scalp issues caused by wearing a lace front weave for years. She spoke of damage to her hairline, painful pustules, and scarring caused by a reaction to the glue.

Below are some questions and answers related to patients who seek treatment in a dermatology practice for problems due to this type of hairstyle.

1. What type of damage are you seeing that you can identify as being caused by improper use of weaves and extensions?
   Wow, this is a loaded question.  The damage I see due to weaves and extensions can occur whether they are used properly or improperly.  One factor that can be associated with whether or not damage and injury to the scalp occurs is related to the way the hair pieces are applied and the second factor can be related to the baseline health of the person’s scalp that the weaves and extensions or being applied to.  For example, applying glue directly to a person’s scalp is a bad idea no matter what. With repeated application and removal, this process can lead to pulling the hair out and triggering an inflammatory response identical to traction alopecia plus the glue itself can be toxic and cause direct injury to hair follicles. The other factor is that up to 30% of the population has seborrheic dermatitis which is a hereditary condition that causes scaling, flaking, and itching of the scalp and the degree of activity can be mild, moderate, or severe. One of the areas that seborrheic dermatitis tends to be most active is around the margins of the scalp, especially the frontal hair line. So, if someone applies glue to an area of scalp that already has underlying inflammation, they are even more likely to develop an adverse reaction. So, the damage I see ranges from itching and local irritation to bacterial infection with pimples and pustules to hair thinning and balding to areas of scarring where the hair doesn’t grow any more.
2. Lace front weaves in particular were never designed for daily use, especially since it involves the use of glue on your hairline. What type of reactions can a woman get from using glue on the scalp?
   The reactions to the glue can range from no symptoms at all to severe itching, pain, and discomfort.  For the individual with no reaction they will usually come in to the office and complain of hair thinning in the areas the glue is applied but on observation, areas of hair loss suspicious for scarring are noted and they have never experienced any itching, soreness, tenderness or discomfort at all. In this case, the problem has silently progressed and the affected person had no idea that their scalp was being damaged and scarred.  On the other end of the spectrum are individuals who have pain, discomfort, itching and can barely stand to touch their scalp and they only decide to seek medical treatment as a last resort. It is also possible for a person to develop contact dermatitis due to glue allergy which would manifest as areas with fine bumps, an eczema rash or blisters; this tends to happen pretty acutely and would cause a person to have to remove the product immediately to get relief.
3. For your clients who love to wear weaves what advice do you give them so they avoid damaging their hair or scalp?
   Knowing how important it is for a person to be able to have the look they want, I try to compromise and help them find a way to have the hairstyle they want and still maintain a healthy scalp.  At this point a number of my patients wear weaves or extensions that are attached to a cap like covering that they wear so that the glue is not directly in contact with their scalp, so this is a possibility.  Other patients get “sew ins” where their hair is braided loosely, never so tight that it will cause traction related inflammation, and the weaved hair is sewn into the braids without creating additional tension on the scalp. I also have patients who decide to get hair extensions applied by the usage of clips that attach the extension to their hair by attaching to strands of their own hair without any direct contact to the scalp at all.

These are examples of issues seen in a dermatology office due to hair weaves and extensions. If you choose to wear these types of hair styles you must be extra diligent to make sure that you seek medical attention at the first signs of any inflammation or hair loss. Pain, itching, pimples, thinning and soreness mean that it is time to get medical help right away.