Problems After Using Hair Conditioner Prompt An FDA Warning

Hair products aren't at the top of most people's health worry list, but the Food and Drug Administration is investigating a surprisingly high number of reports of problems after people used a particular cleansing conditioner.

As of July 7, the FDA had received 127 complaints of "hair loss, hair breakage, balding, itching, and rash" after people used Wen by Chaz Dean cleansing conditioner products — more reports than the agency has ever received for a cosmetic hair product.

"This kind of report is very rare," says Paradi Mirmirani, a dermatologist in Vallejo, Calif. "For the most part, shampoo products out there are all very safe." The agency's safety alert says it has not determined a possible cause for the problems reported.

Late last year, mediation began for a class-action lawsuit in California against Guthy-Renker, the company that markets and manufactures Wen.

The FDA doesn't approve cosmetics before they go on the market, though it does set upper limits for bacteria in cosmetics and hygiene products. Instead, says Linda Katz, director of the FDA's Office of Cosmetics and Colors, the agency monitors consumer complaints for many factors to decide whether to investigate a product.

In this case, the sheer number of complaints played a role in the decision. The agency says it is investigating more than 21,000 complaints reported to Chaz Dean Inc. and Guthy-Renker. (Gianna Cesa, a PR representative for Chaz Dean, says the company did not receive this number of complaints.)

Katz says she can't discuss any working hypotheses associated with the investigation, though she did say investigators have no reason to believe the product was contaminated with something foreign, like microbes. For now, the FDA is still gathering information. Officials will look at the product's quality testing and whether there have been any changes to how the product is made.

In an email, a spokesman for Chaz Dean said the company stands behind its products and that "the brand has consistently cooperated with the FDA and will continue to do so."

Dermatologists say hair care products can cause these sorts of symptoms. One common reason is allergy.

"There are thousands of ingredients that are in personal hair products," says Bruce Brod, a clinical professor of dermatology at the University of Pennsylvania. "While most people in the population won't react to them, there's a small subpopulation that will."

Common allergy triggers include surfactants, the ingredients in shampoos and conditioners that make them sudsy, as well as preservatives that increase shelf life and chemicals used to create fragrances.

These allergic reactions can occur regardless of whether a product is "all natural," says Mirmirani. "Lots of plants give people a reaction as well," she says, citing poison oak as an example. And because allergic reactions can take a while to occur, people may not immediately realize a hair product is causing issues.

But there are also causes of scalp problems that have nothing to do with cosmetics, says Nicole Rogers, an assistant clinical professor of dermatology at Tulane Medical School. For example, she says, male-pattern or female-pattern baldness are both common causes of hair loss. Or a patient could suffer from alopecia areata, a disease in which the immune system attacks hair follicles. She says she believes it's unlikely the consumers' complaints are tied to Wen.

Stress, changes in diet and pregnancy can cause hair loss as well, says Anthony Rossi, a dermatologist who serves as a consultant to Chaz Dean's PR firm.

That said, all the doctors told Shots that people with scalp problems should visit a dermatologist and discuss hair products, along with other possible factors. Doctors can do allergy tests on patients to analyze as many as 55 potential allergy triggers. It's important, says Brod, to look at all potential causes of symptoms, rather than looking at Internet chat rooms alone.

"Often, there's a suggestive herd effect," he says. "If somebody says, 'I'm using something and it itches my scalp,' the person next to him will say, 'You know what? Me too.' "

Katz of the FDA also urges people to visit doctors in addition to reporting complaints to the FDA. And if someone decides to switch from Wen to a different conditioner, Mirmirani says, "There's plenty more out there."