The risks behind the clean look: ‘I will surely go bald’

“Abusing the clean look (I will surely go bald),” says one user on the X social media platform. She’s referring to look of the moment on TikTok. The social media platform is full of tutorials with millions of views that show people who wear tight updos that keep hair out of their face. Various dermatologists who specialize in trichology (the study of the scalp and hair) warn of the risks that such a ‘do’ carries: not only can it damage hair, but also cause hair loss in specific zones, such as near the ears or in he forehead area. To understand the risks of the clean look, it’s necessary to first know how to achieve it, says Alba Gómez Zubiaur, a dermatologist who specializes in trichology and hair transplants and who is the director of the hair unit of the Ricart Medical Institute (IMR). One video with more than four million views on TikTok and 186,000 likes is entitled “Tutorial to get the perfect clean look without bumps.” In it, a user says she has discovered an infallible technique. The first step is ironing one’s roots, if you’re hair isn’t straight to begin with. Afterwards, you’ll need to “wet the hair to be able to work with it better”, form an updo with a certain amount of tension and apply fixing products like hairspray, hair gel and wax.

Each one of these steps brings with it certain risks. Ironing one’s hair at high temperatures can modify the bridges and bonds between keratin chains and damage hair fiber, according to Gómez. In many TikTok tutorials, users skip ironing and go straight to wetting down their hair to get the look. The dermatologist says that wet hair is more vulnerable and features a higher risk of frizz and breakage when handled. “Except for curly hair, it is recommended to comb the hair dry and not wet, to avoid causing fractures in the hair fiber,” she says.

In addition, the clean look involves wearing one’s hair pulled back. “If the tension on the hair’s root —known as the hair follicle — is maintained over time, it can damage hair growth,” explains the dermatologist Claudia Bernárdez Guerra. The fact that tight hairstyles can cause damage to the hair roots has become evident among professionals who often wear them, such as gymnasts and dancers.

Alopecia problems

Not to mention that if this kind of hairstyle is worn on a regular basis, it can lead to alopecia, or baldness. David Saceda Corralo, a member of the Spanish Academy of Dematology and Venereology (AEDV), says that this usually happens to people who have fragile follicles and are predisposed to the condition. “It is not a one-off hair loss, or an aesthetic damage, but rather a permanent alopecia. The root can become scarred,” warns Saceda, a specialist in trichology at the Pedro Jaén Group.

He’s referring to what is known as tractional alopecia, which is characterized by hair loss due to continuous, prolonged and repetitive stress on the hair. Cristina Pindado, from the Trichology and Hair Transplant Unit of the same group, explains that hair loss usually occurs in specific areas of the scalp. For example, in the preauricular area (the area located just in front of the ear) or on the forehead if tight buns and ponytails are worn.

The risk of suffering from this kind of alopecia grows according to the intensity and duration of the traction — in this case, the use of tight hairstyles — according to a review of studies that was published in 2017. Gómez says these risks affect both straight and curly hair, as well as thick and fine hair. However, “curly hair will suffer more during straightening, which will require higher temperatures and for longer periods of time.” In addition, fine hair will suffer more than thick hair, as the cuticle and cortex layers are thinner and more exposed to damage.

It turns out to be complicated to know if hair is going to be more or less resistant to traditional alopecia. The AEDV experts consulted for this article explain that if the traction is maintained, it will affect the follicle regardless. Saceda offers as an example Black hair, which is thick, dark and curly. “It is very prone to having this problem. But it’s not because of the type of hair, but because [of traditionally Black] hairstyles like small braids.” Tractional alopecia affects one-third of women of African descent who have high-tension hairstyles over a long period of time.

A risk-free clean look?

Saceda advises against this kind of hairstyle. “It’s best to wear a low bun or a ponytail that allows the follicle to be loose,” she says. Establishing how often the clean look can be worn without putting hair health at risk is complicated. The dermatologist insists on the importance of personal predisposition: “To give you an idea, there are patients who develop this problem by wearing a normal ponytail all their lives.”

If you do opt for this kind of hairstyle, it’s best to only wear it very occasionally: “It should not be worn more than one day a week, or more than a few hours at a time, letting the hair down as soon as you get home. If the scalp hurts when styling, it’s best to change your look,” says Bernárdez. For a clean look that is less damaging to hair, Gómez advises opting for a lower or less-tight updo. She also suggests working with dry hair, which is less prone to breakage. If heat is utilized, it is best to employ a product to protect hair beforehand and avoid bringing straighteners close to the base of the hair.

“The best thing to do is to use thick rubber bands or fabric scrunchies so that they don’t cut the hair and tighten them in an extreme way,” says Pindado, who also advises against the overuse of sewn-in hair for style like dreadlocks, braids and extensions. Fixing products need not damage the hair, according to Bernárdez: “It is not necessary to avoid them if the hairstyle is done occasionally.” However, the expert insists on the importance of washing the hair properly with lukewarm water and “plenty of shampoo foam” to remove the product and to avoid keeping it in the hair all night.

If you do use this hairstyle and notice that you have less hair growing in the preauricular area or that your forehead is widening, experts advise going to see a dermatologist who specializes in trichology. “This type of alopecia is reversible if it is diagnosed and treated early. If it is diagnosed late, it can lead to irreversible alopecia,” says Pindado.

Sign up for our weekly newsletter to get more English-language news coverage from EL PAÍS USA Edition