Dermatologist on Hair Loss: Tips for Fragile Hair

Ep 50: Going Au Naturel- Dermatologist Talks Hair Loss due to Breakage

This episode is all about bringing out the natural beauty of hair. Perfectly healthy hair is beautiful hair. In this episode, Dr. Teo Wan Lin covers hair shaft defects and how these contribute to hair loss due to fragility. Grooming practices that involve the use of heated tools, excessive styling products and tight hairstyles can all contribute to a mechanical form of hair loss. Also, she will be spilling her secrets for shiny, smooth, soft and most importantly resilient hair. The Conscious Mask Bar is a home hair spa system I designed which incorporates the elements of deep conditioning hair treatment with the CutisCool Biological Gel Cap for hair strengthening thermal therapy.

Dr. Teo: Hi guys and welcome to my podcast, Dermatologists Talks: Science of Beauty. I’m Dr. Teo Wan Lin and today we’re going to be talking about au naturel hair. Au naturel is a term that is derived from the French language, also known as au naturel, when used in its anglicized form. It refers most commonly to a type of beauty. A state that is natural, raw, referring to unadulterated pure beauty. For the purposes of today’s podcast, we’re going to talk about au naturel hair.

All about healthy hair

From a scientific perspective, as dermatologists are the accredited specialists in the specialty of not just the skin but also hair, we are in the best position to explain what healthy hair should be about. We know that if your skin is healthy, it will look great in its natural state without makeup. The same should be said of hair – healthy hair requires minimum styling products.

The 360 Conscious Mask Bar for Hair is developed with a focus on environmentally conscious, science-backed botanical ingredients for a deep-conditioning home hair spa treatment. Our haircare formulation delivers salon-results, without the toxic chemical runoff associated with the traditional haircare industry.

History and significance of hair

Chelsea: A little bit about the history and significance of hair. Traditionally, hair has symbolized many things for women throughout history. A symbol of femininity, identity, freedom and beauty, maintaining beautiful hair has always been a large part of many cultures around the world. Depending on the significance of hair color or texture, as well as prevailing trends, different cultures approach hair care differently. But there is a universal truth to what it means to have healthy, au naturel hair. Shiny and smooth, well nourished, good elasticity, and minimum breakage. 

I actually have a question that might sound silly. But it is something I have always wondered about: is our hair dead or alive? I’m always so cautious to do anything to ‘harm’ my hair, just in case it never grows back haha. 

Is hair dead or alive?

Dr. Teo: Hair, unlike your other organs, is actually made up of dead materials. The hair shaft, which is the hair that grows from your scalp, consists of dead keratin extruding from the follicles. This is relevant because many people seem to think that hair itself is living. Sometimes individuals who suffer from hair loss, may refrain from washing or combing their hair. This is due to the fear that even more hair will come out. Understanding the scalp as the living organ and the hair as the associated keratinous material that is going out from the follicles, is very important. Because, it affects how we treat it, how we learn to condition it and also groom it. 

Chelsea: I guess I’ve never really thought of hair being something dead. And I have never really paid attention to my scalp – which really is also very important.

What does it really mean to have au naturel hair?   

Dr. Teo: Starting with the basics of what au naturel hair should be like. To me, that really translates into hair that is in the perfect state of health. Healthy hair is best embodied by the term virgin hair. When I first started modeling, which was my first real job after junior college while I was waiting for admission into medical school. I remember my first agency looking at me and telling me to keep my hair as it was. Not not to dye it, perm it or straighten it. They told me that clients prefer virgin hair. That was my first memory of the term ‘virgin hair’. Two decades later, I have a different perspective because of my training as a dermatologist. But the fundamental concept is surprisingly the same. This bodes well for all of us, because the core philosophy is that beauty is always healthy.

What is virgin hair?

Chelsea: This concept of ‘virgin hair’ is so interesting to me! For our listeners, virgin hair is untouched hair that has never been chemically processed or color treated in any way. To be more specific, it’s hair that has never been permed, bleached, gone through color treatments or dye. Virgin hair is also a hair stylist’s dream because it is stronger and less prone to damage as it has not been chemical treated. And yes I totally agree! When you do have healthy hair and skin, it really does make you glow. 

What are some problems associated with the hair shaft?

Dr. Teo: I am going to share what the commonest hair shaft problems look like. I will also share my tips on how if you have the correct hair grooming and styling and treatment protocols, and if you have some idea of what your hair shaft needs to stay healthy, then you can have au naturel virgin hair that is not just beautiful, but also healthy.

We start first with the structure of a normal hair shaft. The hair shaft is derived from something known as the hair follicle. It is actually a part of the skin on the scalp. It grows from the second layer of skin known as the dermis. From which the germinative cells  arise in the hair bulb. This follicle is lined by inner and outer root sheaths, which help to protect and shape hair that grows out. This is the reason why, genetically, individuals have different types of hair.

What is our hair made of?

Curly hair, tight curls, loose waves, straight, fine, coarse hair, all these are predetermined by your genetics. A single hair shaft grows out of a single hair follicle and the hair shaft is the hair that we see growing out on our heads. It consists of three main parts. The medulla, the cortex, and the cuticle starting from the inside, all the way to the outside.

It is probably helpful to know that it actually is the pigment in our medulla and cortex that is responsible for our natural hair color. The cuticle is the outer and the strongest part of the hair shaft. It is made up of flattened cells that overlap each other- what we call keratinization. This is because these specific cells that are on the cuticle are made of a protein called keratin. This is the same protein found on our skin and nails. Finally, the hair follicle is associated with the sebaceous gland, which produces sebum or oil. This sebum protects the hair shaft. It also acts as a natural emollient for the cuticle, ensuring that hair remains shiny and smooth.

Disorders of the hair shaft

For the purposes of this podcast, we’re going to zoom in on disorders or defects of the hair shaft. This is not often talked about because we attribute a lot of hair shaft problems to styling issues. Use of styling products is often touted as a cure to a lot of these problems like frizz or untamable hair.

Chelsea: The key here is redistributing the grease, the natural sebum on the scalp throughout your hair shaft. So that it serves to coat the cuticle. This way, your hair is kept smooth and shiny. I guess this is also the purpose of us making sure we brush our hair daily. 

I’m also guilty of perpetuating that misconception as well. I have always thought that the solution to frizzy hair,  which is pretty common here because of the high humidity in Singapore’s climate, can be fixed easily with different types of salon hair treatment. I also do know lots of people who have come up with their own ‘hacks’ on how to tame their locks. 

Are DIY hair hacks safe?

Dr. Teo: Something to address here is an incident this year. I think we did a podcast episode on the Gorilla Glue girl. It was in a very unfortunate incident where an African American lady was experimenting with using glue spray when she had run out of her favorite hairspray to get her usual sleek hairstyle. This of course was really a tragedy because it had permanently glued her hair to her scalp. At the end of the day, necessitating surgery, and a chemical solvent to remove the glue. This was highlighted to potentially lead to scarring hair loss or scarring alopecia as we know it. 

Chelsea: Yes I’m sure we all remember that whole incident playing out in social media. It really emphasized the dangers of diy beauty “hacks”.

How to have healthy hair

Dr. Teo: Au naturel hair is actually the way to go because there are two important messages that we are sending with my au naturel hair campaign messaging campaign.  Firstly, embrace what you are born with. All types of hair as long as it is in your natural state, is to be considered beautiful. The second thing is you need to have a healthy hair shaft. A healthy hair shaft means that your hair follicles and hence, your scalp must also be healthy. We’ve touched on important ways to keep your scalp healthy in a previous podcast episode, which we will link in the transcript. 

However, for the purposes of the health of the hair shaft, we want to say that if you can go au naturel, your hair is truly healthy. There is nothing wrong with any treatments of perms that you feel you want to do to achieve a certain look. As long as you understand that you are damaging your hair. Because where chemicals and heat are used, the bonds in the hair shaft will be broken, leading to hair fragility. It is also very liberating to have that feeling of being absolutely yourself. 

Beauty standards associated with hair

I say that because as I was growing up, I felt that there was a standard of beauty that I had to live up to. As I grew older, being so absorbed in my personal projects and intellectual endeavors, I’ve also stopped caring as much about how people view me. Of course, as a dermatologist, I believe in ensuring your skin and hair is healthy. That alone to me is beauty.  We’re not talking about grooming, which I think is a basic standard. Combing your hair and making sure you do wash your hair and condition it. What I mean is really trying to alter the way your natural hair is.

Beauty is a state of mind

I’ve always thought I had to have my hair a certain color or a certain style when I was younger. I actually have had the same hairstyle since I was 19 until now. Initially, it was really because as a model, a standard hairstyle was required to make sure you were versatile enough. Additionally, a consistent look that fit your pictures in the portfolio was important. Later on I became comfortable with my hairstyle. It had become part of my identity, and it was a lazy way to keep the same hairstyle.

I feel that at the end of the day, we reach a stage in terms of our maturity and self perception, and we realize that beauty is a state of mind. But we must not forget that the health of our hair shaft matters a lot in terms of it’s manageability. Grooming practices may end up being a vicious cycle for someone with damaged hair, and having to use more styling products to hide flyaways, split ends. That can damage your hair further, especially if there’s excessive use of heating tools involved.

Benefits of natural hair

Chelsea: Yes, a lot of us can also relate to your experience. So much of who we are is determined by our sense of comparing ourselves with the people around us, and what they would think of us. So I can see how it can be very freeing to move past that, but instead, focus on how to love ourselves in our natural state. 

I mean, there are so many benefits of natural hair: it’s healthier in the long run for your hair, as it does not expose you to harsh salon chemicals, you definitely save money on expensive hair treatments, and it can be fun and versatile too! Well moving on you did talk about disorders of the hair shaft, tell us more about that. 

Hair loss dermatologist shares on hair shaft defects

Dr. Teo: Going back to hair shaft defects, we want to define it. For dermatologists, this really refers to a structural abnormality of the hair shaft. A lot of what we see as common hair shaft disorders are readily seen even by lay persons, and definitely spotted by seasoned hairstylists. But of course there are rarer genetic hair shaft disorders which are beyond the scope of this podcast which dermatologists are aware of.

We’re going to zoom in on the commonest causes of hair shaft defects. External injuries to the hair shaft is the commonest cause of hair fragility. How do you know if your hair is fragile? There is a test which you can do to your loose hair that you can pick up. As you stretch it, if you find that your hair has good elastic strength, it returns to its original length. But if your hair has poor tensile strength, which is a marker of fragility, you find that the hair strand actually breaks with just minimal stress on it.

How can I take care of fragile hair?

Hair fragility is due to excessive grooming practices that can involve harsh combs and tools that break the hair. It’s important to look at the type of comb you use, I always recommend a wooden comb. Wood reduces static, and absorbs the oil from the scalp, redistributing to your hair ends. I don’t recommend plastic combs and those with metal bristles as that can snag and break hair.

hair loss dermatologist

The ORZAT4 Infusion Treatment Comb is a wooden paddle brush with anti-static bamboo bristles impregnated with Sandalore®, which has been scientifically proven to stimulate hair regrowth.

Chelsea: I was actually just trying that hair elasticity test while you were talking about it- with a stray hair of course. It looks like my hair does return to its original length when I stretch it so that’s good news for me! I guess I also have never really thought about the type of comb or brush I use and how that can make a difference to my hair so that’s very interesting! Apart from that, what else can lead to hair shaft defects? 

Traction from tight ponytails and various hairstyles

Dr. Teo: Certain occupations, such as being in the entertainment and the media industry where you have to use a lot of styling products as well as heat related grooming, can be a reason for your hair shaft becoming fragile. Traction, from certain hairstyles such as braids or very tight ponytails or cornrow type of braids, are very harmful because they can even cause a form of hair loss in the form of traction alopecia. We see this in certain sports, such as ballet, figure skating.

Chelsea: I’ve always wondered how these athletes can keep their hairs so tightly tied up for long periods of time, and even look at celebrities like Ariana Grande, who is known for her high ponytail. I’ve kept my hair short for as long as I can, so I’m only getting used to having my hair up now that I have slightly longer hair. But it’s good tip to know that having a very tight ponytail like that may not be the best thing for your hair, so if your job/sport does necessitate that, make sure to give your hair a rest whenever possible, leaving it down. 

Dr. Teo: The use of hair dryers that have high heat levels can also damage the hair shaft. Modern hair dryers are actually very well calibrated. A good practice to apply a hair serum. I use hair oil from safflower oil and sea buckthorn, which helps to restore the strength of the hair elasticity by mimicking the natural physical properties of scalp sebum. External injury can also be in the form of chemical induced breakage.

hair loss dermatologist

The LipiSilk™ Serum Intensive Hair Treatment contains purified seed oil of Hippophae rhanoides (Sea Buckthorn Oil) for damaged, chemically-treated, split ends.

Harmful salon hair treatments

Salon treatments, involving breakage of physical bonds that change the natural structure of your hair can damage the hair as well. For example, if you have naturally wavy or curly hair, and you rebond it to become straight; or if you have naturally straight hair and you want to perm it to become curly. The process by which this occurs is by breaking physical bonds between the individual strands of your hair. Hair dyes and bleach as well can cause chemical induced hair breakage and fragility.

Chelsea: I mean I guess it’s no surprise to find that doing all these hair treatments like heat styling, dyeing and bleaching, can really damage your hair. Well when you say au naturel, do you mean just leaving the hair alone and keeping our hair free of any hair care products? 

Dr. Teo: At this stage, I feel that we want to address this practically. If you go au naturel, that does not mean that you are not using any hair care products. We are not talking about leave on conditioners or using hair care. Instead, what we mean is not using styling waxes or even hair sprays on a daily basis. While not directly harmful to hair, it does increase residue on your hair, and can cause hair to become ‘crispy’. This is due to the constituents of the sprays, which over time, will damage the hair shaft.

The CutisCool Gel Cap is specifically engineered with the thermal capacity allows comfortable home use of effective heat treatment used normally in salons to increase penetration of hair treatment products. When refrigerated in the mask bar, it produces temperatures more cooling but without the discomfort of ice for sealing of hair cuticles for shine.

Summing up

Au naturel hair, I feel, is going to be the right approach for a long time. Because now we are all about self care right now. Secondly, realistically, a lot of our work patterns have transitioned to work from home because of the COVID pandemic. Frankly, we are in our most natural state when we are home, and it is an extra bonus if we naturally look good as well.

Chelsea: You are right, I mean apart from the basic detangling and combing, now we’re at home so much, it is probably more important to focus on hair care rather than hair styling. Well in this episode we’ve covered what au naturel hair should look like, commonest causes of hair shaft damage and how to avoid hair breakage or fragility, and the importance of embracing your natural, healthy hair. Well that’s it for today’s episode. Stay tuned for the next episode in our series on au naturel hair to hear dermatologist tips on how to achieve smooth, shiny hair. You may follow Dr. Teo on her instagram @drteowanlin for the latest podcast updates, and remember to head to our website at for the full transcript.