Even hair in perfect condition is prone to tangling, especially when wet. Obviously, short hair is not affected. Severe tangling or matting, which may be impossible to unravel, can occur in hair approaching shoulder length or longer and is an indication of both poor hair condition and poor handling of the hair. As seen with all chemical treatments the hair becomes more hydrophilic. Wet keratin is higher in friction. Progressive damage, subsequent to chemical treatments, makes fibers higher in friction and rougher to the touch. Consequently the hair is more likely to tangle or mat. In extreme cases it is termed “bird’s-nest hair.” Unfortunately, there is little point in attempting to unravel the tangles as it will take an inordinate amount of time and the condition of the hair means it will be prone to further matting. The best approach is to advise on a high quality cut and counsel on the time it will take to regrow the hair.
Matting that requires a patient to present to a clinician is a single catastrophic event. It will suddenly occur and may, or may not, coincide with a change in cosmetic products. Low conditioning shampoos, while not a cause, can exacerbate the situation. However, the patient may have had some degree of pre-warning with small tangles or knots appearing at the ends of their hair during routine shampooing and grooming. These are typical in chemically damaged hair and appear to be “understood” by most consumers. Matting typically affects a single location but involves many, many adjacent fibers and hence may have extensive involvement on the head. The site of matting is invariably at the back of the head and typically occurs during the washing or conditioning step and only when the hair is wet. The location is due primarily to the difficulty in reaching and handling the hair when shampooing, such that the hair is piled up leading to massive fiber-to-fiber interactions.
Investigation: Matting is always obvious to the naked eye and requires no further investigative techniques. The initial predisposing factor, e.g., chemical or thermal treatment leading to hair damage, may have occurred many months before. In and of itself it is unlikely to cause the hair to mat. However, it is possible that there is no history of such treatments as even poorly handled normal hair will mat. The actual matting event is unlikely to be related to any particular product use.
