woman examining her hair in the mirror

Is Your Hair Healthy?

October 25, 2023

If you have hair on your head, you probably spent some time thinking about it today, or at least how it looks. But there’s a lot more to hair than how it’s styled. “Healthy hair is the hair that’s normal for you,” says Lindsey Bordone, MD, assistant professor of dermatology at CUIMC. “If your baseline changes, it’s a sign.” 

Bordone treats people who have issues with their skin, including their scalp. We asked her to explain the basics about head hair health.

How Do You Know if Your Hair is Healthy?

lindsey bordone

Lindsey Bordone, MD, Assistant Professor of Dermatology at Columbia University Irving Medical Center

There is no “one size fits all” when it comes to hair. There is a wide range of colors, textures, and density that is considered healthy. In general, scalp pain, scale, and follicular swelling at the base of the hair follicle are signs of inflammation.

One person can have textured dry hair, and another person may have straight silky hair at their personal baseline (the hair’s condition when they are young and healthy).

Natural changes in hair from the baseline condition can signify internal health conditions. Going from straight, silky hair to coarse hair in a relatively brief period, for example. Healthy hair:

  • detangles easily;
  • does not break; or, if textured at baseline, breaks off at the end, essentially cutting itself, an evolutionary adaptation to help people in hotter climates (close to the equator) cool down (short hair allows airflow on back and shoulders);
  • sheds about 125 strands daily (the number can vary widely; people with short hair often don’t know how much they shed); and,
  • reacts to moisture in the air if textured or curly; does not react to moisture in the air (frizzing out) if straight at baseline.

How do you know if your hair is not healthy?

Changes in the baseline, normal-for-you condition of hair can be a sign your hair is not healthy. If your hair changes from its baseline, and this happens in a short period, look for an underlying cause. A doctor can determine if there is a health condition. For instance, low iron or anemia can lead to increased shedding, thyroid conditions can cause shedding and texture changes, and polycystic ovarian syndrome (PCOS) can cause hair thinning.

When should you see a doctor if you think your hair is not healthy?

If you have hair loss that is not normal for you (much more than usual comes out in one day or week), or if you have a rash, itch, or pain on your scalp that does not go away within 24 hours, reach out to a doctor, nurse, or other healthcare provider.  

What do your patients ask you about their hair?

Many patients ask me which hair products are best. I recommend:

  • avoiding products heavy in botanicals: they can cause scalp inflammation/irritation;
  • not using excessive heat to the scalp: this can damage the hair shaft, and often that damage cannot be treated, only grown out and cut off;
  • avoiding harsh chemicals like straighteners and keratin treatments: they can cause significant damage and breakage

Lastly, eating a healthy diet low in processed foods and getting regular exercise helps with blood flow to the scalp, which then helps with growth.

What should you do to keep your hair healthy?

Advice for one person may not suit another. If a person with textured hair washes their hair every other day, it could cause dryness and breakage. If a person with oily hair follows the same schedule, it could cause too much sebum buildup on the scalp. Know your hair type and embrace it.

That said, here are a few good general rules about hair care.

  1. Wash your scalp, not your hair. Apply shampoo to your scalp, and rinse the bubbles away with water to wash your hair. Washing your hair only can make it rough and take away shine.
  2. Use conditioner every time you shampoo. Conditioner enhances shine, lowers static electricity, improves strength, and protects hair against the sun’s harmful UV rays. Conditioner can be applied to the full length of the hair if needed. People who have more oil production should apply conditioner further from the scalp.
  3. Buy shampoo and conditioner made for your personal hair type. Is your hair dark, light, dyed, frizzy, curly, dry? Note that a more expensive does not mean it is a better product for you.
  4. Wear a cap when you swim in a pool because chlorine damages hair.
  5. Wash hair when it is oily. Wait for oil production. Textured hair will break easily if dried and brittle from washing too frequently.
  6. Wash hair when your scalp is itchy. If your scalp is itchy, it could be due to increased yeast that grows naturally on the skin, especially the scalp, with increased sebum production compared with regular skin. If your scalp is itchy between hair washing, more frequent washings can help.


Lindsey Bordone, MD, is a dermatologist and an assistant professor of Dermatology at Columbia University Irving Medical Center. She treats all conditions of the skin, hair, and nails including acne, psoriasis, eczema, and skin allergies.