Hairbrushes: A Guide for Dermatologists

Abstract

Background

Hairbrushes play an integral role in our day-to-day life. As dermatologists, it can be difficult to keep up with this constant influx of new and unique brush types. This article provides a summary of the ten most commonly used hair brushes all dermatologists should know, focusing on their design, suitable hair types, and proper usage.

Summary

There are a wide variety of hairbrushes on the market today ranging from detangling brushes to boar bristle brushes. Improper use of these hairbrushes can lead to trichomalacia, trichorrhexis nodosa, and traction alopecia. This guide aims to summarize the most common types of hairbrushes and their proper use for dermatologists.

Key Messages

Improper use of hairbrushes can lead to trichomalacia, trichorrhexis nodosa, and traction alopecia. Through this guide, we hope to provide helpful information on hairbrushes that can be utilized daily in clinical practice for hair types ranging from straight to coily.

Introduction

Hairbrushes play an integral role in our day-to-day life. The first hairbrush dates back to 8000 BC in Syria, and since then, their wide use and acceptance have led to a global hairbrush market estimated to be worth upward of 4 billion dollars in 2022 [1, 2]. There is continuous innovation in the haircare industry regarding functionality and materials. As dermatologists, it can be difficult to keep up with this constant influx of new and unique brush types. Furthermore, there remains a lack of guidelines on hairbrush recommendations for patients according to their hair type and concerns. This article provides a summary of the ten most commonly used hair brushes all dermatologists should know, focusing on their design, suitable hair types, and proper usage.

Detangling Brush

Detangling brushes (shown in Table 1) feature flexible bristles that vary in stiffness. They are used to detangle hair by loosening knots and tangles. Stiffer bristles are appropriate for curlier hair. More flexible bristles are appropriate for fine hair to minimize breakage. For all hair types, it is easier to detangle moisturized or wet hair starting from the tips of the hair. Curly hair should never be dry when detangling. However, wet hair is more prone to breakage so this brush should be used gently, especially in finer hair to avoid potential consequences such as trichomalacia [3].

Table 1.

A summary of the ten most common hairbrushes

Brush type	Image of brush	Hair type	Purpose	Special considerations
Detangling hairbrush		Straight (wet and dry), curly/coily (wet)	Detangle and loosen knots	Must be used gently on wet and fine hair that is more prone to breakage
Paddle hairbrush		Straight (wet and dry), wavy (wet)	Detangle, smooth, reduce frizz	Incorrect use can lead to breakage and trichomalacia
Round hairbrush		All hair types	Straight – style in volume and loose curls	Appropriately sized barrel and skill are important to style properly and limit breakage
			Curly – straighten hair with a blow-dryer
Teasing hairbrush		Straight, wavy	Section hair, add volume, and tame flyaways	Backcombing should be done with caution because it can potentially lead to fracture of the hair shaft
Wide-tooth comb		All hair types	Detangle	Curly hair – use on wet hair with a moisturizing product like conditioner to prevent breakage
				Straight hair – use on wet or dry hair
Rat tail comb		All hair types	Detangle, apply extensions, part hair for braids, tuck hair under wigs, and section hair during heat styling	Closely spaced teeth make it effective for removing lice and nits
Boar bristle brush		Straight, wavy	Distribute scalp oils, close hair cuticles, and increase blood flow to the scalp	Improper cleaning may lead to harboring of dirt, oils, and bacteria compromising hair and scalp health
				Soft bristles are best for damaged hair
Vented brush		All hair types	Maximize airflow and dry large sections of hair quickly	Long hair – a large vent brush is preferred
				Short or fine hair – a smaller brush head is ideal
Loop brush		Straight, wavy	Detangle and smooth hair extensions	Useful in hair extensions, sensitive scalps, and thinning hair
Edge brush		Curly, coily (wet)	Smooth hairs along the hairline	Risk of traction alopecia

Paddle Brush

Paddle hairbrushes feature a wide and flat head. They are best used for straight and wavy hair to detangle, smooth, and reduce frizz. They also help distribute hair oils from the scalp to the ends for shine. The flexible bristles and large head are easy to use, minimize breakage, and require minimal skill. For straight hair, a paddle brush can be used on wet and dry hair. When used during blow drying, it can create an even sleeker finish. For hair with more curls, it is best used on wet hair with a moisturizing cream such as conditioner or hair mask for detangling. Caution is important when using this brush as when used incorrectly paddle brushes can lead to breakage.

Round Hairbrush

Round hairbrushes feature a circular or oval-shaped head. They can be used for all hair types ranging from straight to coily to style. The curved design enhances control and precision, while closely arranged bristles provide tension and grip on the hair during styling. For straight hair, round hairbrushes are used to style in volume and loose curls. For curlier hair, round hairbrushes can be used with a hair dryer to straighten hair. Choosing the appropriate barrel size, smaller barrel for shorter hair and larger barrel for longer hair, and user skill are important in optimal use of this brush to achieve the appropriate style and limit breakage.

Teasing Hairbrush

Teasing hairbrushes (also referred to as backcombing brushes) feature a tapered handle for sectioning hair and closely arranged bristles that help grip the hair firmly. They are best used on straight hair to add volume by “backcombing” – combing from the distal end to the roots while held at a straight angle. Backcombing should be done with caution because it can potentially lead to a fracture of the hair shaft, trichorrhexis nodosa [4]. This brush can also be used to tame flyaways and create a sleek look during styling.

Wide-Tooth Comb

Wide-tooth combs feature widely spaced and thicker teeth compared to other types of brushes. They can be used for all hair types to detangle knots, but they are especially favored in curly, textured, or thick hair. For straight hair, a wide-tooth comb can be used on wet and dry hair. For curly hair, this brush is best used on wet hair with a moisturizing cream such as conditioner or hair mask in the shower. The wide-tooth comb should be used gently and slowly to prevent friction and abrasion that could potentially lead to breakage.

Rat Tail Comb

Rat tail combs feature a pointed or tapered handle and a head with thin and closely spaced teeth. It can be used for all hair types for a wide range of purposes during styling. It is an essential tool for applying hair extensions and weaves, parting the hair for braids, and tucking the hair under a wig. During heat styling, it can be used to section and hold the hair before gliding a flat iron to achieve a sleeker style. It is also a valuable tool in the management of head lice infestations because the closely spaced teeth are effective when manually removing lice and nits that pediculicides are unable to [5].

Boar Bristle Brush

Boar bristle brushes feature bristles that mimic the composition of human hair and contain keratin that distributes natural scalp oils from root to end more evenly, closes hair strand cuticles, and increases blood flow to the scalp. It is best used for fine to medium hair and should be used on dry hair starting at the ends and moving up to the roots. It is not suitable for curly or coily hair because it may disrupt the natural curl pattern leading to frizz. In addition, these brushes can be difficult to clean leading to the harboring of dirt, oils, and bacteria over time potentially compromising hair and scalp health.

Vented Brush

Vented brushes feature open slots along the brush that help maximize airflow and dry large sections of hair quickly when blow drying. It can be used for all hair textures and types. When choosing the right vent brush, the length of hair is the biggest factor. For long hair, a large vent brush is preferred. For short or fine hair, any size can be used although a smaller brush head is ideal for precision and styling. When used on wet hair, it is important to implement caution because the hair is in its most fragile state.

Loop Brush

Loop brushes feature looped bristles (often nylon or boar) with a round and flexible shape. While this brush can be used on straight hair, it was created for use in hair extensions including clip-ins, sew-ins, and tape-ins because the bristles allow the brush to detangle and smooth out hair extensions without snagging or damaging them while in use. Loop brushes are also useful for sensitive scalps and thinning hair. The soft pull of the brush is thought to decrease the loss of extensions as well as natural hair while being gentle on the scalp. While this brush may be suitable for thin to normal hair, it is important to note some believe it does not penetrate deep enough for thick hair.

Edge Brush

Edge brushes feature a long handle with a small boar bristle brush head. They can be used for all hair types but are most commonly used on damp to wet, curly to coily hair in conjunction with a hair styling product like gel or pomade to smooth out baby hairs along the hairline. A soft bristle version of this brush is suitable for fine to normal hair, while a normal bristle brush is suitable for coarse hair. Since an edge brush is used to manipulate some of the finest, shortest, and most fragile hairs, it carries the risk of traction alopecia [6].

Conclusion

While hairbrushes are not always considered in the world of dermatology, they play an essential role in the management of a patient’s hair. Improper use of hairbrushes can lead to trichomalacia, trichorrhexis nodosa, and traction alopecia [3, 4, 6]. Through this guide, we hope to provide helpful information on hairbrushes that can be utilized daily in clinical practice for hair types ranging from straight to coily. Equipped with this knowledge, dermatologists will be better able to counsel patients in a culturally sensitive manner on the appropriate use of hairbrushes for their hair and scalp concerns limiting the ramifications of improper use.

Conflict of Interest Statement

Dr. Tosti is a consultant for DS Laboratories, Monat Global, Almirall, Thirty Madison, Eli Lilly, Bristol Myers Squibb, P and G, Pfizer, and Myovant. She is one of the editors-in-chief of Skin Appendage Disorders. The remaining authors have no conflicts of interest to declare.

Funding Sources

This study was not supported by any sponsor or funder.

Author Contributions

Kimberly N. Williams, Juwon Lee, Esthefani Robles, and Antonella Tosti were involved in the preparation of the manuscript and read and approved the final manuscript.

Funding Statement

This study was not supported by any sponsor or funder.