Hair Care Products: Waving,
Straightening, Conditioning, and
Coloring
CHANTAL BOLDUC, MD, FRCPC
JERRY SHAPIRO, MD, FRCPC
H
air is a very important and distinctive feature
that plays a major role in self perception. To
some extent, it expresses our personality and
who we are. Hair is one of the few physical features that
we can easily change. Its length, color, and shape can be
modified to create a totally different style. All those
different styles can be used to seduce, conform, or even
make a statement. Although hair has no vital function,
its immeasurable importance is usually brutally discov-
ered by those affected by alopecia.
Although hair cosmetics are widely available, the
medical literature is rather scarce, and specialized liter-
ature is not readily accessible to most of us. The aim of
this article is to give a practical and simple overview of
the different hair cosmetic treatments available. Know-
ing how they affect the hair will enable the physician to
better assess different problems secondary to cosmetic
treatments and will also provide some answers to com-
monly asked questions.
Hair Shaft Anatomy and Stucture
The knowledge of hair anatomy and structure will
greatly facilitate the understanding of the physical and
chemical reactions underlying hair cosmetics. The hair
is an appendage derived from the epidermis. It can be
divided into two major parts: the hair follicle and the
hair shaft. Because all cosmetic procedures affect only
the hair shaft, the focus of this chapter will be on the
hair shaft itself.
The terminal hair shaft, despite its shine, body, and
texture, is a dead structure. From the outside to the
inside, the hair shaft is divided into layers known as the
cuticle, cortex, and medulla. The cuticle is composed of
keratin and consists of layers of scales overlapping one
and other, just like tiles on a roof.1 The cuticle protects
the underlying cortex and acts as a barrier. The normal,
From the Division of Dermatology, University of Montreal, Montreal,
Quebec, Canada (CB), and the Division of Dermatology, University of
British Columbia School of Medicine, Vancouver, British Columbia, Canada
(JS).
Address correspondence to Chantal Bolduc, MD, 835 West 10th Avenue,
Vancouver, BC, Canada V52 4E8.
© 2001 by Elsevier Science Inc. All rights reserved.
655 Avenue of the Americas, New York, NY 10010
undamaged cuticle has a smooth surface, allowing re-
flection of light and limiting friction between shafts.2
The medulla is not always present within the hair
shaft, and it plays little or no role in hair cosmetics.
Therefore, it will not be discussed here.
The cortex accounts for most of the hair shaft and is
responsible for the great tensile strength of the hair. It is
localized around the medulla and is composed of elon-
gated cortical cells packed tightly together and oriented
parallel to the fiber direction.1 The organization of the
cortex cells allows them to be stretched extensively.
These cells contain amorphous sulfur protein matrix
and keratin filaments.1
Keratins are a group of protein complexes. The as-
sembly of one acid keratin polypeptide with one basic
keratin polypeptide results in a protofilament. The
gathering of multiple protofilaments leads to the for-
mation of keratin filaments. The distinguishing feature
of keratin is the presence of a large proportion of cys-
tine. Cystine can bond two adjoining keratin polypep-
tide chains forming disulfide bonds. These crosslinks
give a high degree of physical and chemical stability to
the keratin fiber. Other weaker bonds also link the
polypeptide chains such as Van der Waals interactions,
hydrogen bonds, and coulombic interactions referred to
as salt links. These weaker bonds result mostly from the
attraction of positively and negatively charged groups.
They can be easily broken just by wetting the hair.1
Keratin itself is colorless. It is the presence of melanin
in the cortex that gives hair color. Melanin is derived
from melanocytes present in the hair bulb. Either one or
both types of melanin (eumelanin and pheomelanin)
can be present in an individual’s hair.1
Waving
Permanent hair waving is a complex process that is not
yet completely understood.3 As we have seen earlier,
different types of bonds keep the hair in its original
shape. To illustrate this, the hair has been compared to
a ladder of protein strung together by rungs of cystine
sulfur-sulfur cross-links.3 Weaker bonds, such as hy-
drogen bonds, can be easily broken and reconnected
0738-081X/01/$–see front matter
PII S0738-081X(01)00201-2
432 BOLDUC AND SHAPIRO
simply by styling wet hair using a brush or curlers.
Such waves, however, are only temporary. Hair will
gradually absorb moisture from the air or will be
washed again, allowing the hydrogen bonds to break
and reconnect.4
To permanently modify the shape of one’s hair, a
certain number of disulfide bonds must be altered.3,4
The new growing hair will not be affected by these
alterations, so the new root will grow with its natural,
original shape. Individuals wishing to maintain a curly
hairstyle will need to perm their hair regularly; other-
wise the perm will eventually grow out.
Different types of perms are available. Permanent
waving solutions are mostly based on two classes of
reducing agents: thioglycolates and bisulfites. Home
and professional permanent waving solutions are very
similar in composition but differ mostly in concentra-
tion of the different components.3
The chemical principle involved is similar in all
perming solutions. The perming process can be sum-
marized as follows:
1. The hair is initially washed and then placed on curl-
ers according to the degree of curl desired.
2. Once the hair is set, the perm solution (pH around 9)
is meticulously applied on the hair. To alter the
disulfide bonds, perming solutions must reach the
cortex through the cuticle. This is achieved by using
alkaline reductive solutions, which lift the scales of
the cuticle. The pH usually varies from near or above
neutrality up to a pH of 10. Home preparations
usually have a weaker pH. The most popular alkali
agents are ammonia and ammonium hydroxide.3
3. The reducing agent (thioglglycolates or bisulfites)
cleaves some of the disulfide bonds. This reduction is
based on an equilibrium process, that is, only a cer-
tain number of bonds are cleaved and then the reac-
tion stops. If too many disulfide bonds are cleaved,
the hair will not recover sufficiently recover.3
4. Once the bonds are broken, there is a molecular
rearrangement where new bonds will be created ac-
cording to the new shape of the hair.3
5. The perm solution is then rinsed off, and the bonds
are solidified by re-oxidation using a neutralizing
solution. Neutralizing solution contain an oxidative
agent, most often hydrogen peroxide. The cuticle
scales return to their original position.3
Other changes result from permanent waving. Un-
desired physical effects have been observed, such as
swelling and longitudinal contraction. These can re-
main even after the perm solution has been rinsed and
neutralized. Another change that usually does not go
unnoticed is the characteristic odor that persists for
days, sometime weeks, after the process.3
Permanent waving of negroid hair is slightly differ-
ent compared to caucasoid hair in that the hair must
Clinics in Dermatology Y 2001;19:431– 436
first be straightened before it is curled. The perming
process in these individuals is known as redox.5 The
initial straightening is done using a reducer (ammoni-
um thioglycolate) with an alkaline pH. Following the
initial straightening, the hair is treated with another
reducer (thioglycolic acid) and wrapped around rollers.
The rest of the processing is similar to regular perming
with rinsing of the perming solution and application of
a neutralizer. Sodium bromate is used as a neutralizer
because it will not effect the natural color of the hair,
which can happen with hydrogen peroxide.5
Straightening
Hair straightening can be achieved mechanically by
pressing or chemically using relaxers. This is particu-
larly popular among black individuals.
Pressing
Pressing was first developed by Madame C. J. Walker in
the late 1800s when she introduced hot combing. Hot
combing provides temporary straightening since it only
modifies the weaker hydrogen bonds. Only a small
percentage of individuals still use pressing nowadays.5
The initial technique involved the application of an
ointment on the hair followed by pressing with a hot
metal device. The technique has been refined with the
design of more suitable devices (such as combs, flat
irons, or curling irons), and the use of a marcel stove as
well as other electric implements to heat the metal
devices. Pressing oils have been improved leaving hair
soft and non-greasy.5
Hair is first shampooed and dried before the appli-
cation of the oil or petrolatum-based ointment.5,6 Sub-
sequently, a hot metal comb is passed from roots to
ends section by section until all the hair is straightened.6
The hair is then curled with a hot metal curling iron.5
The heat of the hot comb reaches 300 –500°F.6 Hot comb
alopecia can occur following this process.6
Chemical Relaxing
Chemical relaxing (lanthionization) is currently the
method of choice for straightening very curly hair and
is widely used in some ethnic groups. Hair relaxing is
somewhat similar to permanent waving except curly
hair is permanently straightened instead of curled. Di-
sulfide bonds are cleaved using an alkaline reducing
agent; then the hair is mechanically straightened using
a comb during the reducing phase to restructure the
position of disulfide bonds between new polypeptide
keratins. Finally, these new bonds are consolidated us-
ing an oxidizing agent.7
For permanent waving, liquid solutions are more
practical because they allow thorough application de-
spite the rollers. A cream formulation would make this
task almost impossible. This problem does not exist
Clinics in Dermatology Y 2001;19:431– 436
with relaxing since the hair remains loose to allow
combing and straightening. Furthermore, the heavy
texture of a cream helps keep the hair straight during
the procedure.7
Many different hair relaxers are available on the
market. Different relaxing agents can be used such as
sodium hydroxide, guanidine hydroxide, potassium
hydroxide, and lithium hydroxide. Sodium hydroxide
and guanidine hydroxide are the most effective. Gua-
nidine hydroxide containing relaxers is less irritating
and is usually preferred. Unfortunately, they necessi-
tate the mixing of two separate components before
application. The mixture must be used the same day to
avoid chemical alteration.5
Chemical relaxers are applied on clean hair as fol-
lows. The hairline and ears are protected with petrola-
tum. The relaxer is applied with a small brush on
separate sections of hair starting at the nape of the neck
and working toward the forehead. Only new growth is
processed unless the hair has never been straightened
before. Once the cream is applied, it is smoothed sec-
tion-by-section until the hair is straightened. The cream
is left on for 10 to 20 minutes before it is rinsed off with
water. Finally, a neutralizing shampoo is used to bring
the pH back to normal.5
Different concentrations of relaxing agents are avail-
able for different types of hair, and they are classified as
mild, normal, and resistant.5
Hair straightening needs to be repeated every 4 to 6
weeks. The emphasis should be only on new growth
since repeated treatments can lead to hair breakage,7
which usually occurs at the junction of the new growth
and previously treated hair.6 Breakage most often is
seen on the occiput and nape of the neck,6 possibly
because the treatment is first applied there and thus
remains longer. Careful application to new growth only
and serious conditioning can help prevent excessive
breakage.6 New technologies should provide more gen-
tle straightening, which will minimize damage to the
hair shaft.
Conditioning
Hair conditioners were developed to restore the man-
ageability, glossiness, and softness normally provided
by sebum. They were introduced following the avail-
ability of shampoos with good detergent action, which
removes excessive amounts of sebum from the hair
shaft. They are also used to recondition the hair follow-
ing chemical treatments, such as waving, straightening,
and coloring, and following physical trauma induced
by hair drying, brushing, and styling. Most of these
procedures often lead to decreased tensile strength,
brittleness, and porosity.
Conditioners give hair manageability by decreasing
static electricity and by reducing friction among hair
HAIR CARE PRODUCTS 433
shafts, which can lead to tangling. Static electricity is
decreased by depositing positively charged ions on the
hair shaft, which counteract negative charges induced
by combing or brushing. Friction is reduced by smooth-
ing cuticle scales by increasing their adhesion to the
shaft. Smooth hair cuticles reflect more light, resulting
in glossier hair; they also result in softer hair.
Different types of conditioners are available includ-
ing instant conditioners, deep conditioners, blow dry-
ing lotions, and hair glaze.
Instant Conditioners
Instant conditioners are the most common. They are
applied immediately after shampooing and are left for
a short period of time before rinsing. Instant condition-
ers contain water, a conditioning agent, lipids, and
thickeners. Conditioning agents can be either cationic
detergents, film formers, or proteins. Cationic agents
(quaternary ammonium compounds) are positively
charged, and they are attracted by the negative charge
of damaged hair. They are often used for processed
hair. Film formers are composed of polymers (e.g.,
polyvinylpyrrolidone), which fill hair shaft defects,
smoothing the hair. They are also positively charged,
reducing static electricity. Proteins conditioners (silk
protein, hydrolyzed animal protein) are thought to be-
come linked in the keratin, restoring damaged protein
structure.
Deep Conditioning
Deep conditioners are similar to instant conditioners,
but they are available as creams instead of lotions or
liquids and are more concentrated. They are usually left
on the hair for 20 to 30 minutes, and heat may be
necessary to increase penetration. They are usually
used for extremely dry hair and are sometime used as
“filters” before chemical treatment such as coloring and
waving. By restoring the damaged hair, they are
thought to ensure that the treatment will affect the hair
evenly.
Blow Drying Lotions
Blow drying lotions contain again the same agents as
instant conditioners, but they do not contain oil and
therefore can be left on the hair. They are applied after
toweling the hair dry and before styling.
Hair Glaze
Hair glazes are also known as hair thickeners. They coat
hair shaft, increasing their diameter and giving the
illusion of thick hair. They usually contain proteins and
are available as liquids. They are applied on towel-
dried hair before styling and are left on.
434 BOLDUC AND SHAPIRO
Coloring
Hair coloring is widely used by both men and women.
Many products and techniques are available, and the
chemistry involved varies depending on the type of
dying agents. Hair dyes are usually classified, accord-
ing to the time the color will remain on hair, as gradual,
temporary, semi-permanent, and permanent.
It is impressive to see the wide variety of natural
colors that can be obtained by varying the amount and
proportion of melanin content, although it takes many
different coloring agents to obtain just one specific
shade. Although hair coloring is widely available, there
is still much to be learned regarding the underlying
biochemistry.8 Different coloring agents, both natural
and synthetic, are available. The most commonly used
natural dye is henna, which colors the hair with a
orange-reddish shade. Other vegetable dyes, such as
chamomile, are seldom used for dyeing. Extract of nut-
gall, logwood, and brazilwood are used in some Asian
countries to blacken graying hair. Natural coloring of-
fers a limited color range and it is difficult to predict
intensity. Most consumers prefer the use of synthetic
dyes, which allow a great variety of color and give more
predictable results.8
According to FDA regulations, statutory warning
statement and instructions to perform a skin-patch test
before use may be present on the package of some
products depending on the agents used in the coloring
preparations (mostly coal tar derivatives).8 There have
been different issues regarding the safety of coloring
agents, but the available data suggests that hair dyes
are safe.8 –10
Gradual Hair Coloring
Gradual hair coloring uses metallic dyes such as salts of
lead, bismuth, or silver.8 This type of coloring can only
darken the hair (brown-black), with a limited shade
range.8,11 The metal particles are believed to interact
with cysteine residues within the cuticle to form metal
sulfides.8 Thus, the particles slowly accumulate on hair
shafts. The chemical reaction with sulfur-containing
substances results in a characteristic smell.11 The hair
gradually changes over a few weeks from gray to yel-
low-brown to brown-black.11 Continued use is neces-
sary.2 These dyes are thought to be safe and the risk of
contact dermatitis appears to be minimal.
The advantages of these dyes are that they are inex-
pensive and can be applied at home.2,11 Nevertheless,
the color quality may be poor and unpredictable.8 Fol-
lowing the use of metallic dyes, the hair often becomes
stiff, dull, and brittle.2 Other chemical treatments can
usually not be performed because of the pre-existing
damage to the hair and because trace metals present on
the shafts will interfere with other treatments providing
poor results.11 Professional products are available to
Clinics in Dermatology Y 2001;19:431– 436
remove metal from hair shafts, but the procedure is
very damaging to the hair.2 It is usually necessary to let
the hair grow out before considering any procedure.
Gradual hair coloring is mostly used by men who wish
to achieve subtle darkening of their hair.
New products using conventional dyeing technolo-
gies have been marketed recently in an effort to respond
to men’s need. Most men do not want to spend 30 to 45
minutes dyeing their hair on a regular basis, and they
are usually looking for more subtle changes. These
products dye the hair in only 5 minutes or so, but they
do not offer the same color quality and longevity as do
regular products.8
Temporary Coloring
Temporary dyes are acidic textile, water soluble dyes of
high molecular weight. These large molecules cannot
penetrate the hair shaft and are only temporarily de-
posited until they are washed off. Unless the hair has
previously been chemically treated, the dye is mostly
removed after one shampoo. Chemically treated hair is
more porous, allowing the dye to penetrate somewhat
into the shaft. Longer lasting results are expected. These
products are usually safe and seldom cause irritant or
contact dermatitis.2
Temporary dyes are available as rinses, gel, mousses,
and sprays.2 They can be used for different purposes: to
create special effects, to brighten a natural or dyed
shade, to remove yellowish tones from gray hair, and to
cover small amounts (⬍15%) of gray hair.2 Individuals
with totally gray hair can also use these products with
good results.8 Those with great amount of gray hair
mixed with colored hair usually need to use permanent
dyeing to achieve satisfactory results.8 Different colors
are available to create styles such as red, blue, yellow,
brown, purple, and green.2 Light purple or blue rinses
are usually used for yellowish gray hair, which brighten
it to platinum or white.2 Shades of yellow and brown
are used to cover gray hair. Many individuals only need
weekly application despite the fact that the dye fades
after the first shampoo. Rinses are applied after sham-
pooing and are rinsed immediately.2 Gels, mousses,
and sprays are applied on toweled-dry hair and are left
on.2 Application of dye on chemically processed hair or
application of the wrong dye can result in odd colors.2
It is usually recommended to choose a shade somewhat
lighter than the natural color to start with.8
Semi-permanent Coloring
Semi-permanent dyes are mostly synthetics.2 Natural
vegetable dyes such as henna are sometimes used, but
these dyes have been largely replaced by synthetic hen-
na-type products. They are composed of low-molecular
weight coal tar dyes and may contain para dyes (dia-
mines, aminophenols, phenols). Therefore, they can
cause allergic contact dermatitis.2 The small molecular
Clinics in Dermatology Y 2001;19:431– 436
weight of the molecules allows them to diffuse freely in
and out the cortex. This explains why their effect re-
mains longer than temporary dye, although they can be
washed off after 4 to 6 weeks.2 Despite their penetration
into the cortex, these dyes are minimally damaging to
the hair shaft. Again, the effect may be prolonged and
somewhat unpredictable on previously chemically pro-
cessed hair.
Semi-permanent dyes are available as lotions and
mousses. They are applied on wet, shampooed hair and
left on for 10 to 40 minutes before rinsing.2,8 Semi-
permanent dyes are used to cover gray hair, add high-
lights, or rid hair of unwanted tones.2 They can only
darken the hair, usually no more then 3 tones. They
allow tone-on-tone coloring rather then drastic color
changes.2 Up to 30% of gray hair can be covered with
semi-permanent dyes.2 Again, individuals with totally
gray hair can also use these products with good re-
sults.8 It is suggested to use a slightly lighter color than
the natural hair color to cover gray hair. The color
usually lasts through 6 to 8 shampoos.8
Different agents such as solvents, surfactants, thick-
eners, and alkalizing agents are added to the dye prep-
aration.8
To ensure constant, homogenous coloring between
newly grown hair and weathered ends, several dyes of
the same approximate color are used. The molecular
size of these different dyes varies, allowing larger mol-
ecules to enter only the damaged tips and not the root,
while smaller molecules enter the root and diffuse
freely in and out the damaged ends.8
Permanent coloring
Permanent dyes account for 70% of hair dye sales.11
They can either lighten or darken natural hair color and
can cover any amount of gray.2 The dye is permanent,
that is, it will remain until the hair grows out. Re-dying
is necessary every 4 to 6 weeks to color new proximal
growth.2 This procedure is irreversible.8 Unsatisfied
customers must either wait for the dye to grow out or
reprocess the hair with a different dye, which, of course,
will cause further damage to the hair.
Permanent dyes may cause damage to the hair.2 The
color results from an oxidation reaction that takes place
within the hair shaft.2 The permanent oxidation dyeing
relies on three major components: primary intermedi-
ates, couplers, and oxidants.8 The primary intermedi-
ates form color on oxidation. The most commonly used
agents are ortho- and para-aminophenols and phe-
nylenediamines, but others are also available. Couplers
will react with the products of oxidation of the primary
intermediates to form dyes. Typical couplers used in-
clude phenols, meta-aminophenols, and meta-diamino-
benzenes. The oxidant used is almost always hydrogen
peroxide.
HAIR CARE PRODUCTS 435
For those who wish to color their hair to a much
lighter shade of blond the oxidative dyeing described is
not sufficient, and a two-step procedure is necessary.
The hair must first be bleached using a preparation
containing potassium and ammonium persulfate and
hydrogen peroxide. Once the hair is bleached to the
desired shade, a toner or dye is applied to achieve the
final blond color. This two-step procedure is very dam-
aging to the hair. Therefore, only the new outgrowth is
processed during subsequent coloring.8
Permanent dyeing is performed with alkali solutions
to allow penetration of the chemicals through the cuti-
cle. Again, ammonia is most commonly used to reach a
pH of approximately 9 to 10. The solution is left on the
hair for 20 to 40 minutes; then it is rinsed off with water.
Preparations with lower pH are available, which are are
less damaging to the hair, but the resulting coloring is
not as strong. The permanent oxidative dye preparation
contains other agents—surfactants, solvents, thickeners,
antioxidants, and metal chelating agents—that ensure
easy use and safe storage. The preparations also often
contain a conditioner to reduce hair damage. The hy-
drogen peroxide is packaged separately and is mixed
with the dye preparation just before use.8
Many factors can influence the intensity of coloring,
such as concentrations of dye and peroxide, and higher
temperature and pH.8
It is important to know that although peroxide al-
lows the formation of color, it is also able to destroy it.
Destruction of existing dye with subsequent coloring
sessions ensures that color intensity remains stable and
homogenous between the newly colored growth and
the already colored shaft. Otherwise, the color would
gradually darken along the previously dyed hair shaft.8
It is usually recommended to perm or relax hair
before coloring since these procedures can produce ir-
reversible color loss. It is also recommended to wait
several days between the initial processing and color-
ing.8
Bleaching
Bleaching involves partial or complete de-coloring of
the existing natural melanin content of the hair. Red
hair is more difficult to bleach than brown hair.8
The most commonly used method involves the use of
an alkaline solution of hydrogen peroxide of up to 12%.
Hydrogen peroxide is usually stored in acid solution
and is mixed just before use with an alkali-containing
base. The alkaline solution is necessary since bleaching
decreases with acidic pH; ammonia is most commonly
used as an alkali as it appears to give the best bleaching
results. Thickeners are usually added to give a thicker
yet easy-to-spread consistency to the preparation. The
degree of bleaching will vary with contact time and is
difficult to control; Darker hair will necessarily need
436 BOLDUC AND SHAPIRO
more time. Long bleaching times, however, such as 1 to
2 hours are very damaging to the hair.8
The color resulting from bleaching is usually some-
what flat and drab. Most often, a toner will be used to
attenuate this bleached look.8
Bleaching involves two different steps. First, there is
a dispersion and dissolution of melanin granules. This
dissolution is associated with a change in color from
black to brown. This reaction is responsible for the
resulting reddening that is often seen during the bleach-
ing of dark hair. Following this dissolution phase, there
is a much slower de-coloring phase. The exact biochem-
istry underlying these processes is not completely un-
derstood, but it is thought that the dissolution phase
involves the destruction of different bonds maintaining
the pigment particles while the de-coloring phase in-
volves the breakdown of the polymeric structure of
melanin.8
The oxidation reaction associated with bleaching not
only alters melanin. It will also destroy some disulfide
bonds within the keratin, which will leads to a weak-
ening of the hair structure. Damage also occurs to the
cuticle and will make the hair more porous. Following
bleaching, the hair will often be different in texture, will
break more easily, and will be more susceptible to
humidity. To palliate these problems, a conditioner will
often be used either within the bleaching solution or
after bleaching.8
Conclusions
Hair cosmetics are widely available. Most procedures
involving hair cosmetics are safe; however, there is
Clinics in Dermatology Y 2001;19:431– 436
significant potential to damage the hair. It is important
to understand the basic science behind the use of hair
cosmetics to better appreciate the potential complica-
tions.
References
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