Ask the Doctors by Eve Glazier, M.D. and Elizabeth Ko, M.D

Getting Shampooed at Salon Not as Hazardous as Headlines Imply

Dear Doctor: The back of my neck hurts when I have my hair shampooed at the salon. This worries me because I've read that some people have strokes when they have this type of shampoo, due to the arteries in the neck. Is there truth to this?

Dear Reader: While it's true that some individuals have experienced strokes after spending time in a shampoo chair at a hair salon, it's actually quite rare. And don't worry -- there's more to it than simply leaning one's head back for a few moments.

An early take on the topic appeared in the Journal of the American Medical Association in 1993. Since then, additional research and case studies have been published, and occasional cases of women -- and a few men -- suffering strokes after a visit to the shampoo chair have made a splash in the headlines.

Most recently it's been in the news because a woman filed a lawsuit against a hair salon in San Diego, claiming a neck injury she suffered while getting a shampoo led to a stroke two weeks later. Specifically, she said an artery in her neck was damaged when she angled her head back and rested her neck against the hard surface of the sink. This reportedly caused bleeding, which led to a blood clot, which caused a stroke.

In media coverage, the injury goes by the name "beauty parlor stroke syndrome." In reality, though, what we're talking about is cervical artery dissection. That is, a rip or tear in one of the arteries in the neck, which supply blood to the brain. And despite what the injury's colorful nickname implies, it has multiple causes outside of the shampoo chair.

The injury begins with the anatomy of the neck, which includes arteries that run along the back of the vertebrae and deliver blood to the brain. In the people who experienced the so-called beauty parlor stroke, either one of two things appears to have happened: An artery was damaged by pressure from a vertebra, or pressure from the rim of the sink or the back of the chair squeezed the artery shut. In either scenario the result was the same -- a lack of blood flow to the brain, which is the definition of stroke.

This same injury has been seen in individuals undergoing prolonged dental work, receiving anesthesia, having chiropractic manipulations of the neck, and even painting a ceiling or doing yoga. In each case, hyperextension of the neck played a part.

If you're worried about your safety while getting a shampoo, talk to your hairdresser. Make sure the chair is adjusted properly for your height. Ask for additional towels for padding and support. Don't allow your neck to hyperextend. Or skip the backward approach entirely and ask to stand up and lean forward while your hair is washed.

Neck pain is not necessarily a sign that something is wrong. However, if you experience symptoms like loss of muscle tone in the face, weakness or paralysis on one side of the body, slurred speech, impaired vision or loss of coordination, you should definitely -- and immediately -- seek medical attention.

(Send your questions to, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)