INTRODUCTION
Recently, a new kind of salon has become popular in many communities throughout the US. As the popularity of these salons, called head spas, has increased, dermatology patients have begun to report trichologic evaluations in these community salons. Some patients have even brought these images to their dermatology appointments for confirmatory diagnosis. Head spas are spas that focus on services designed to massage and cleanse the scalp, often marketing services that are both spa treatments and potential therapeutic options for common dermatologic scalp conditions, ranging from alopecia to psoriasis. Appointments typically consist of a scalp analysis, followed by scalp cleansing, scalp massage, and finally hair styling. Scalp analysis is not a ubiquitous component of the appointment for each head spa, and the type of trichoscopy device is not uniform amongst facilities.
Treatment and product recommendations are often offered by individuals working at head spas, raising concern that those with medical scalp conditions may be given inappropriate advice from untrained head spa workers rather than seek care from board-certified dermatologists. Head spa technicians may obtain a certificate in trichology through a national or international organization, though this is neither required nor a common practice.1 Furthermore, products that are recommended by individuals working at head spas can be costly and may facilitate predatory pricing. As accessing care from dermatologists may be limited or delayed, particularly for uninsured and underinsured individuals, this may drive potential patients to seek care in the community for scalp conditions that impact their quality of life.2,3
In order to better understand the prevalence of head spas within major cities and the nature of the scalp photographs being captured by trichologists or head spa technicians, an internet search was conducted using Google.
Treatment and product recommendations are often offered by individuals working at head spas, raising concern that those with medical scalp conditions may be given inappropriate advice from untrained head spa workers rather than seek care from board-certified dermatologists. Head spa technicians may obtain a certificate in trichology through a national or international organization, though this is neither required nor a common practice.1 Furthermore, products that are recommended by individuals working at head spas can be costly and may facilitate predatory pricing. As accessing care from dermatologists may be limited or delayed, particularly for uninsured and underinsured individuals, this may drive potential patients to seek care in the community for scalp conditions that impact their quality of life.2,3
In order to better understand the prevalence of head spas within major cities and the nature of the scalp photographs being captured by trichologists or head spa technicians, an internet search was conducted using Google.
MATERIALS AND METHODS
The search for head spas was conducted using Google between July 24, 2024, and August 24, 2024. The search strategy targeted 4 major urban areas within the United States due to the increased popularity of head spas within these regions: New York, Los Angeles, Miami, and Dallas. The following search terms were utilized in the Google search engine: "head spa Miami, FL"; "head spa Dallas, TX"; "head spa Los Angeles, CA"; "head spa New York, NY." Websites that were listed within the first 10 pages of results were evaluated. Websites that were promoted as "Featured," exclusive hair salons, or located out-of-state from the search city were not evaluated. Additionally, websites marketed as offering autonomous sensory meridian response (ASMR) were excluded, as most do not include the trichoscopic scalp analysis component of the head spa service.
For those head spa websites matching search criteria, screen-captures of scalp photographs were obtained from their website or their Instagram® social media page. The research team collected and categorized screen-captured photographs from these websites, as well as from their Instagram® posts, stories, and reels. Tagged photographs that were not reposted by head spas were not evaluated. Furthermore, photographs sourced from TikTok® or Facebook® social media pages associated with websites were not evaluated.
For those head spa websites matching search criteria, screen-captures of scalp photographs were obtained from their website or their Instagram® social media page. The research team collected and categorized screen-captured photographs from these websites, as well as from their Instagram® posts, stories, and reels. Tagged photographs that were not reposted by head spas were not evaluated. Furthermore, photographs sourced from TikTok® or Facebook® social media pages associated with websites were not evaluated.
RESULTS
A total of 165 photographs were collected from 30 head spas (Figure 1). The city with the highest number of head spas was Los Angeles (15), and the lowest was Dallas (4). Of the 30 head spas evaluated, 3 of these included personnel described as trichologists. These head spas with at least 1 trichologist listed were located in Los Angeles, CA (2) and Dallas, TX (1). The average lowest to highest price point for head spa services was a range in United States dollars (USD) from $103 to $195, respectively. Head spas with trichologist personnel had a higher average cost associated with the highest price point services,
