Scalp massage for hair growth: what the evidence shows

Losing 50 to 100 hairs a day is normal, according to the American Academy of Dermatology (AAD). The AAD separates two problems that look alike in the shower drain. Excessive shedding, called telogen effluvium, is when the body sheds significantly more than that each day. It usually shows up a few months after a stressful event such as childbirth, losing 20 or more pounds, a high fever or illness, surgery, stopping birth control pills or a period of high stress.

That kind of shedding is temporary: once the stressor passes, hair tends to regain its normal fullness within 6 to 9 months. Hair loss is different: it happens when something stops the hair from growing, and the medical term for it is anagen effluvium. A dermatologist can tell you which one you have, which matters because shedding after a hard stretch often settles on its own while hair that has stopped growing needs a cause found.

It found slightly thicker hair on the massaged side, with no increase in hair count and no change in growth rate. The study, by Taro Koyama and colleagues, was published in Eplasty in 2016. Nine healthy Japanese men aged 25 to 46, none with obvious hair loss, used a handheld scalp massage device on one side of the scalp for 4 minutes a day for 24 weeks. The matching spot on the other side was left alone as a control.

On the massaged side, average hair thickness rose from 0.085 mm at the start to 0.092 mm at 24 weeks, a gain of 0.007 mm, or roughly 8%. That is the figure most head spa pages quote. The rest of the results get quoted less often:

The paper also included lab work. Stretching human dermal papilla cells, the cells at the base of a hair follicle, in a dish changed the activity of thousands of genes, including some linked to the hair cycle. That points to a possible mechanism, which still has to be shown in people with hair loss.

Most people who answered it said their hair loss had stopped or improved, but those answers are self-reported and were never checked against a comparison group. The survey, by Robert English Jr. and James Barazesh, was published in Dermatology and Therapy in 2019. Between October 2016 and October 2017, 1,899 people who believed they had pattern hair loss (androgenetic alopecia) read about standardized scalp massage online and watched a video showing two 20 minute sessions a day of presses, pinches and stretches done by hand.

In December 2017 they were contacted once for a survey. Of those, 340 completed it and 327 said they had tried the massage; of the 327, 296 were men and 29 were women. They reported a median of 11 to 20 minutes of massage a day for an average of 7.4 months, and 68.9% said their hair loss had stabilized or regrown. On average, people noticed a change after about 36 hours of total massage.

The authors list the limits themselves. The survey was retrospective, with no placebo or control group, so there is no way to know how many people would have reported the same change without massaging. Answers relied on memory and self-assessment, and not every participant had a dermatologist's diagnosis. The first author also disclosed that he runs a commercial website offering education and services on these ideas.

A head spa visit is a much smaller dose. The 2016 trial used a device every day for 24 weeks, and the survey routine called for hand massage twice a day for months. A professional session every few weeks is nowhere near either schedule, and neither study tested occasional spa treatments.

The people studied also differ from most head spa guests. One study enrolled young and middle-aged men without visible hair loss; the other was mostly men who diagnosed themselves. Women, people with other types of hair loss and anyone having a scalp massage once a month fall outside what either study can tell us.

What you can reasonably expect from a head spa is a thorough scalp cleanse, warm water and a long massage of the head, neck and shoulders. Massage in general may help people feel less stressed, and that is a fair reason to book. Any change in your hair should be treated as unproven.

Hereditary hair loss is the most common cause worldwide, according to the AAD. Men and women both get it: in men it is called male pattern hair loss and in women female pattern hair loss. Inherited genes cause hair follicles to shrink and eventually stop growing hair, and neither study above tested massage against that process in a controlled way.

The AAD lists 18 causes in all. Several are worth knowing because no scalp treatment reaches them:

See one when you first notice it. The AAD's guide to diagnosis and treatment says that with hair loss treatment, the earlier you start, the more likely you are to see regrowth. Hair loss has many possible causes, and treatment depends on finding the right one, which is the part a board-certified dermatologist is trained to do.

At the visit, the dermatologist asks how long you have had hair loss and whether it came on quickly, examines your scalp, nails and any other area with hair loss, and may gently pull on a few hairs, which is called a pull test. Blood tests or a scalp biopsy are used when a disease, a deficiency, a hormone problem or an infection is suspected.

Proven treatments take time as well. The AAD notes that minoxidil usually takes about 6 to 12 months to show results, which is a useful check on any promise of fast regrowth from a spa or a product.

For dandruff, the AAD's advice starts with an over-the-counter dandruff shampoo. Its dandruff guide describes the condition as small pieces of dry skin flaking off the scalp and names 6 active ingredients to look for: zinc pyrithione, salicylic acid, sulfur, selenium sulfide, ketoconazole and coal tar. Some need to stay on the scalp for 5 to 10 minutes before rinsing, and if one shampoo doesn't work, you can alternate with one that has a different active ingredient.

How often to wash depends on your hair. With fine or straight hair or an oily scalp, the AAD suggests shampooing as often as daily and using dandruff shampoo twice a week. With coarse, curly or coily hair, wash when needed and use dandruff shampoo about once a week. If the flakes don't clear or become severe, a dermatologist can check for seborrheic dermatitis, psoriasis, a fungal infection or eczema and prescribe something stronger.

A deep scalp cleanse at a head spa may lift product buildup and leave the scalp feeling fresh, and some guests book it for that alone. For true dandruff it works alongside a medicated shampoo rather than in place of one.

All four scalp packages at O2 Head & Beauty Spa in Arcadia build on Package D, a Classic Scalp Treatment of 60 minutes. Its steps, as listed on the booking page, are a pre and post scalp analysis comparison, an aromatherapy oil massage, a head, neck, shoulder and arms massage, deep scalp cleansing, waterfall hydrotherapy and meridian therapy, nano steam therapy, a scalp serum spray and high frequency ozone comb therapy. The waterfall rinse, scalp analysis and steam together are what people usually call a Japanese-style head spa.

Package C adds a step the menu calls "hair growth / strengthening nourishment", along with a phototherapy meridian comb treatment and a hand, arms, neck, shoulder and head massage. That wording is the menu's label for the step, not a promise of regrowth, and neither study above tested it. If you are losing hair, see a dermatologist for the cause and treat Package C as scalp care alongside that. Every package has a regular and a member rate; ask the front desk how membership works.