Salon shampoos can compress spinal arteries and cause strokes in rare cases

Most of us view a salon shampoo as a relaxing time, where we can relax and let the stylist wash and rinse our hair.

But for a very small number of people, this harmless posture can trigger a cascade of vascular damage 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 cases 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. Of these, 42 cases began in beauty salons, eight in dental establishments and four in other settings.

Leaning back into a living room sink can strain the arteries in your neck in rare cases, according to a 2025 study published in the American Journal of Emergency Medicine. (iStock)

The most affected patients (around 80%) were women, ranging in age from adolescence to elderly.

A 2018 review in Journal of Neurosurgery: Spine stated that BPSS occurs when the neck is held in an extreme backward or twisted position during a washout or treatment, stretching or compressing the vertebral arteries that run along the spine to the brain.

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In rare cases, this posture can cause a tear in the artery wall, called a dissection, which can then form a clot and block blood flow to the brain.

Most beauty 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. Indeed, occasional head tilt can briefly limit blood supply to key parts of the brainstem and cerebellum.

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Symptoms usually appear during or a few days after a triggering posture, according to the American Journal of Emergency Medicine review.

Common warning signs include dizziness, lightheadedness, neck pain, or visual disturbances. More severe cases may cause weakness, numbness, or difficulty speaking.

Supporting the neck with towels or cushions while shampooing can minimize the risk of arterial compression, experts say. (iStock)

Diagnosis usually involves an MRI or CT angiogram to confirm the arterial dissection. As with other types of stroke, doctors often treat patients with antiplatelet or anticoagulant medications, although some require vascular stenting or surgery, experts say.

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Health researchers writing for the American Council on Science and Health in New York point out that BPSS is very rare and known largely 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 more upright while washing.

Experts also recommend that clients speak up immediately if they feel neck tension or dizziness.