Rare neck condition could make salon hair washing a dangerous stroke risk
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Most of us think of a salon shampoo as a moment of relaxation, when we can lie back and let the stylist wash and rinse our hair.
But for a very small number of people, that innocuous posture can trigger a cascade of vascular injuries known as beauty salon stroke syndrome (BPSS).
BPSS refers to stroke-like events triggered by hyperextension or rotation during hair washing or other activities, which can compress or tear the vertebral arteries in the neck.
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The term was popularized in 1993, when New York neurologist Michael Weintraub described five case reports of patients who developed symptoms after salon shampoo treatments.
A recent review published this year in The American Journal of Emergency Medicine identified 54 documented cases of BPSS over nearly five decades, drawn from 22 studies. Among them, 42 cases began in beauty salons, eight in dental settings and four in other contexts.
Lying on a salon sink can strain neck arteries in rare cases, according to a 2025 review in the American Journal of Emergency Medicine. (iStock)
The majority of affected patients (approximately 80%) were women, ranging in age from teenagers to seniors.
A 2018 review in the Journal of Neurosurgery: Spine stated that BPSS occurs when the neck is held in an extremely backward or twisted position during a lavage or treatment, stretching or compressing the vertebral arteries that run through the spine to the brain.
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In rare cases, that posture can cause a tear in the arterial wall, called a dissection, which can then form a clot and block blood flow to the brain.
Most salon experiences are completely safe, but simple ergonomic adjustments can make them even safer. (iStock)
The same review describes how even minor structural problems, such as bone spurs (osteophytes) in the cervical vertebrae, can worsen compression and increase risk. In fact, a casual tilt of the head can briefly limit blood supply to key parts of the brain stem and cerebellum.
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Symptoms usually appear during or several days after a triggering posture, according to the American Journal of Emergency Medicine review.
Common warning signs include dizziness, vertigo, neck pain, or visual disturbances. More severe cases may cause weakness, numbness, or difficulty speaking.
Supporting your neck with towels or pillows during shampooing can minimize the risk of artery compression, experts say. (iStock)
Diagnosis usually involves MRI or CT angiography to confirm arterial dissection. As with other types of strokes, doctors typically treat patients with antiplatelet drugs or blood thinners, although some require vascular stent placement or surgery, experts say.
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Health researchers writing for the American Health and Science Council in New York City emphasize that BPSS is very rare and is largely known from isolated case reports rather than population data.
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Still, the Pro Beauty Association of Arizona advises stylists to provide neck support, such as rolled towels or pillows, and to allow clients to sit up straighter during washes.
Experts also recommend that clients speak up immediately if they feel neck tension or dizziness.
Khloe Quill is a lifestyle production assistant at News Digital. She and the lifestyle team cover a range of topics including food and drink, travel and health.