Hair extensions are used in the form of human or synthetic hair. Synthetic extensions are more frequently used due to affordability, and the method of applying these extensions varies based on personal preference (e.g. strand-by-strand, weft or clip-ins).

Hair Disorders

The hair extension market does not report hair complications. However, a study found a link between scalp disease and hair loss in African hair, as well as hair matting in Caucasian hair. Even more concerning, a similar study found that hair loss may not always be noticeable. 12 women with hair extensions—all of whom did not complain of hair loss—were tested for the condition. They were all found to have broken hairs in their scalps.

In addition, hair loss can result from the continued strain on natural hair from the attached hair. The resulting loosening of natural hair follicles ultimately leads to hair fallout. Some users experience tenderness, a pulling sensation, and pain at the site of attachment. Additional complications include hair tangling and loss of shine. Although hair loss caused by extension usage tends to be reversible, there is a chance of permanent hair loss if there is sustained tension at the site of attachment. Experts advise against long-term hair extension use, particularly if you have a history of scalp disorders.

Effects on Skin

Most customers do not know what chemicals are used to produce synthetic hair and the potential impacts on the skin. This is because the information has not been made readily accessible.

Aside from damage at the site of attachment, hair extensions have been shown to cause skin reactions due to the chemicals and substances used to prepare the hair before attachment. A skin condition called dermatitis can arise, which causes itching, burning, and stinging. Certain glues and rubbers used during hair application can further trigger skin reactions. A study found that some women who wore extensions developed dermatitis; following medical advice, they stopped using synthetic hair, and their skin conditions (particularly in the neck and areas of skin in contact with extensions) improved greatly.

Impact On Black Women

Black women use a range of protective styles on their hair and are also the main consumers of extensions in the hair market. Highly toxic chemicals are being used in hairpieces marketed to black women in particular, and these have been found to cause damaging long-term health effects, including cancer.

Hair braiding is an important cultural beauty practice where synthetic extensions are attached to natural hair. Women typically wear these braids for 4–6 weeks, followed by regular re-installation. This means black women are subjected to ongoing exposure to these dangerous materials.

In addition, synthetic extensions have been found to release harmful substances when exposed to heat—for example, when straightening or curling (with an iron) or even when sealing the ends of braids with boiling water, a common practice used by hairstylists in the black community. Considering that black women are already disproportionately affected in the health industry due to ongoing inequalities, it is crucial that there is transparency and stricter regulations in hair and beauty products specifically marketed to black women and girls.

Challenges During Hospital Visits

Some scans carried out in hospitals help determine if a patient may need surgery on their head. However, studies have found that synthetic hair extensions not only impact scan results (unclear images can lead to mistakes in diagnosis) but also have harmful consequences on patients’ health.

The synthetic fibres around the head cause a concerning and unnecessary increase in radiation exposure. Also, new hairstyling techniques currently use metallic microbeads in hair extensions (as shown in the image above), a trend that is becoming increasingly popular across all ethnicities of women. However, data shows that these metallic objects can cause skin irritation, swelling, and even burns during a scan. The metals also affect the quality of the images produced, ultimately impacting patient care and treatment.

How Can You Protect Yourself?

As a customer, there is a tendency to believe that the products you buy are safe. However, as we have broken down in the previous sections, this is not always the case.

Hand-crafted wefts tend to be of better quality and may be worth considering when opting for extensions. One way to prevent serious damage to natural hair when applying extensions is to use minimal tension and an appropriate technique. Always communicate your needs to your stylist to ensure your hair receives the protection it deserves.

Although many extension users prefer extremely long hairstyles, it is advisable to keep the length of the attached hair no longer than twice that of your natural hair whenever possible. Similarly, when it comes to application technique, it is important that the cuticle of extensions is aligned in the same direction as your natural hair (from root to tip). This makes brushing easier, reduces tangling, and gives your hair more shine.

Speaking of shine, if lost, it can be temporarily restored by cuticle stripping and applying silicone, which can be washed out in your next hair wash. If unsure about the procedure, it is advisable to consult an expert.

Additionally, try to keep your extensions away from your face and neck by putting your strands in a high ponytail or a low bun and potentially covering your hair at night. If you develop skin irritation because of your extensions, consult your GP, who may recommend treatments such as steroids in the form of skin creams or other emollients—or both.

Moreover, community advocacy for more transparency in the hair market is crucial for permanent change and to preserve public health. It could also be beneficial to educate hairstylists on the risks of synthetic braids. Similarly, education for hospital staff and patients should include an understanding of hair attachment pieces and their effects on hospital screening processes. This will hopefully avoid delayed or incorrect diagnoses and help patients get the full support they deserve.

References

Intikhab, O., Elliott, E., Scudder, J., Moghekar, A., & Gailloud, P. (2024). Synthetic hair extensions and radiation dose during cranial angiographic procedures.

Dlova, N. C. (2021). Synthetic hair extensions causing irritant contact dermatitis in patients with a history of atopy: A report of 10 cases. Contact Dermatitis.

Hair extensions: A concerning cause of hair disorders. (n.d.). British Journal of Dermatology. Oxford Academic.

Carcinogenic materials in synthetic braids: An unrecognized risk of hair products for Black women. (n.d.). PMC.

Metallic microbeads for hair extensions: Hidden dangers for magnetic resonance imaging. (n.d.). PMC.