Hair health is part of our overall health and in a recent episode of Ask Nurse Alice, Nurse Alice sat down with Dr. Khris Upshaw, (find her at @drkhris and @creationsbykhris) a Trichologist, cranial prosthesis specialist, scalp micropigmentation practitioner, custom wig designer and owner of Creations by Khris from Long Beach, CA, to discuss all things health and hair. 

The pair talked about how illness manifests in our hair, medical treatments that cause alopecia, and various options to manage the appearance of hair loss like scalp micropigmentation, and even how patients can qualify for a medical cranial prosthesis through insurance. Here’s more from their conversation and how nurses can incorporate more hair care into their patient care as well. 

Listen to Dr. Khis on the Ask Nurse Alice podcast!

The Science of Hair Care

Dr. Kris explained that she is a Trichologist (the Greek word for hair is “trikhos”), which is a specialist who focuses solely on diseases and problems relating to the scalp and hair. As a specialist, Dr. Kris offers the following services: 

• Medical wigs (that are covered by healthcare insurance) 
• Wig care
• Hairline restoration for men
• Scalp micropigmentation 
• Custom wigs 
• Specialized hair and scalp treatments, such as oxygen and light therapy 
• Hair care product line

Each and every one of Dr. Kris’s visits begins with a hair consultation, in which she uses a special microscope to examine the hair follicles to determine what’s happening at a scalp-level. She described how hair and scalp hair is about “so much more than shampoo and conditioner” and even explained how some people shouldn’t even be using shampoo at all.

Nurse Alice and Dr. Kris discussed how important the hair and scalp are—not only as an indication of our overall health—but as a stand-alone feature as well. For instance, hair provides protection, sensory input, thermoregulation, and communication. 

“A lot of people fail to realize that your hair is one of the telltale signs that something's going on internally inside your body,” Dr. Kris said. She pointed out that if your hair starts to shed or break out of nowhere, it’s important to speak to a healthcare professional and get checked out. 

Dr. Kris also touched on how important hair is to mental health. Because while things like your clothes or make-up can be changed, your hair is often fundamental to who you are and if your confidence over your hair is taken away, it can have a disastrous domino effect. 

Getting Patients the Hair Care They Deserve

If you haven’t heard of a trichologist before, Dr. Kris also gave us an education on exactly how and where to access a specialist if you have a patient you believe can benefit from it. For example, she said that any patient who has a diagnosis of alopecia or other hair-loss-related conditions, can be referred to a dermatologist, who will often work hand-in-hand with a trichologist to actually treat the patient. 

In-hospital, the pair also discussed the lack of attention that patient hair care is given, especially for women of color. Women of color have very specific hair care needs and as Nurse Alice pointed out, even one day of neglect can lead to a situation so serious the hair may need to be cut completely. For instance, they talked about a situation when a Black woman went into surgery for her hand and came out and found her hair had been braided—only to discover the Black male doctor on staff had done it for, telling her he had three daughters of his own and knew what kind of situation her hair would have been without being able to be combed. 

They discussed solutions, such as incorporating hair care into the nursing care plan, putting together a specialized hair grooming kit for textured hair, educating staff on wig care, or even placing the hair into a protective hairstyle if adequate daily grooming is not an option. 

Beyond the Braids

Next, they dug into a sometimes tough topic: how hair loss impacts people and how specialists like Dr. Kris can help with wig solutions. She explained how she works with a lot of alopecia, autoimmune, chemotherapy, radiation, cancer patients and has worked with men, women, and children in all walks of life. 

She works hard to create a calming, safe, private, and secure environment for her patients and noted that the majority of her clients will shed tears, because hair loss is such a sensitive topic. However, fortunately, for those individuals who will need some type of hair replacement product, the range that Dr. Kris offers is truly remarkable—she has everything from lined wigs for people who have sores on their heads from radiation or being sensitive from chemo to tape-ins for those who still have some of their own hair. 

“I have every different type of hair extension and attachment that can help whoever situation is needed,” she said. 

And not only that, but Dr. Kris has her own experience with hair loss as well, going through the experience with her own mother, who is a two-time breast cancer survivor who lost all of her hair. 

“I cut all of my hair off with my mom, so I experienced that,” Dr. Kris said. “And so I know that hurt. My mom had a double mastectomy, you know, and it's inevitable when it's coming for you. And what you can do is just handle it the best you can and that's what I'm here to try to help ease the transition.”

The cranial prosthesis that Dr. Kris offers are also covered by medical insurance in certain cases, so as a nurse, you can educate patients about that option if they are facing a diagnosis that involves hair loss, or you notice they are suffering from hair loss. Dr. Kris explained that any alopecia diagnosis will have medical wig coverage through insurance, as does any type of medication that causes hair loss (called antigenic fluke). If your patient has alopecia or has to take a medication that will cause hair loss, a medical wig can be covered by their health insurance. 

Another service that Dr. Kris provides is scalp micropigmentation (SMP, which is done on those who have hair loss on their scalp. She explained that it’s a lot like tattooing—she delivers micro pigment to the hair follicle, so it gives the appearance of hair follicles wherever the hair is thinning. This can be done in both men and women. It’s non-invasive, no recovery, and can be done and the patient can go to work the same day; plus, the results last 6-8 years. 

In the end, Dr. Kris said she is on a mission to help anyone who has hair loss, whether it’s through a product like a wig or a hair care product, or through a service when hair re-growth is not an option. 

“I'm trying to embark on that path [in] providing treatment and therapy for anyone experiencing hair loss on any level,” said Dr. Kris. “I had to come up and think outside of the box so I can cover everyone and I don't want to tell anyone I can't help their hair loss problem.”