This Dermatologist's Hair Health Routine Focuses on This One Often Overlooked Area

As a beauty director, I'm ashamed to admit that I've never felt like I had particularly healthy hair—and it's taken a toll on my confidence. My locks can best be described as thin, frizzy, dry, and prone to breakage. I often try to hide these flaws by flat-ironing my hair, wearing a hat, or slicking my strands back into a bun, all of which only makes the damage worse.

My hair health is not due to a lack of effort. I've been slathering on masks to try to add shine, softness, and strength back to my strands for years (including an at-home mayo concoction back in the early 2000s… that I would not recommend). I've tried serums, hot oils, leave-in conditioners, and creams to make my hair stronger and less prone to breakage and thinning, and though I notice a difference initially, nothing seems to stick. According to Heather Woolery-Lloyd, M.D., FAAD, a board-certified dermatologist and Chief Medical Advisor at Nutrafol, this is likely because I'm focusing on the wrong things.

It's a common misconception that hair health is all about our strands, but take it from Dr. Woolery-Lloyd: Healthy hair requires a full-body approach, with a special emphasis on the scalp.

"Most people still focus only on the hair they can see, but a healthy scalp is really essential for healthy hair," she confirms. "The scalp is living skin with its own microbiome and barrier function, just like the skin on your face. When that ecosystem is supported, it creates the right environment for new hairs to form before they even emerge."

When your scalp microbiome is maintained and your scalp feels healthy, you'll experience less irritation and less visible flaking, leading to improved hair quality over time. On the other hand, when this microbiome is disrupted, it can lead to a range of issues, including dryness, excess oil production, and increased susceptibility to sun damage.

Promote Scalp Health

I admit I haven't given much thought to my scalp health, so I needed tips. When I asked how to begin caring for my scalp, Dr. Woolery-Lloyd told me it depends on a few factors.

For one, our scalp can thin as we age. Reduced hydration and hair density can also occur with age.

"Hair health isn't static. It changes with you," she says. "The concerns I see in a patient in her twenties, where breakage and damage are often the main issues, look very different from what I see in someone navigating perimenopause, where hormonal shifts are directly influencing the hair growth cycle. That's why I'm always cautious about a one-size-fits-all approach. The right routine has to meet you where you are."

Scalp health also comes down to your haircare habits. Over-washing your hair with harsh formulas can leave it dry, irritated, and stripped.

What does over-washing look like? Dr. Woolery-Lloyd calls out the "squeaky clean" feeling you sometimes get when shampooing, noting that it often means you've over-cleansed.

"Harsh surfactants can disrupt the scalp barrier, alter pH, and shift the microbiome," she continues. "That can show up as dryness, tightness, redness, or flaking—so instead of helping, it can actually create more scalp issues over time."

Under-washing is also damaging—spraying an oily scalp with dry shampoo can clog follicles and create a less-than-ideal environment for hair growth. Not adjusting your routine during the spring and summer (when temperatures start to rise) can also shift the microbiome.

"One thing people don't think about enough in spring is UV exposure at the scalp," she says. "Thinning areas are especially at risk. Pairing protective habits—like hats and SPF to shield against sun and environmental stressors—with a consistent topical routine (shampoo, serum, and conditioner) is how you give your scalp both the protection and the daily support it needs."

During these warmer months, Dr. Woolery-Lloyd suggests adjusting your routine by cleansing a bit more with gentle, microbiome-supportive formulas to help remove buildup without stripping the scalp.

"Your shampoo should remove excess sebum and product buildup while providing hydration to the scalp, maintaining its pH, and allowing beneficial microbes to continue to thrive," she says.

She also compares washing your scalp to washing your face. "You want a gentle, regular cleanse that removes oil and buildup without stripping, a targeted exfoliation step, particularly for those with excess sebum or residue, and then a conditioner or treatment to support and protect. The exact frequency of each step should be tailored to your hair type and scalp needs. Ultimately, it's a skincare routine—just applied to the scalp instead of the face."

She suggests using a gentle, physician-formulated, microbiome-friendly, myMicrobiome certified formula—like Nutrafol's Root Purifier Shampoo—because it's designed to cleanse effectively while maintaining the scalp's pH balance.

Scalp health really comes down to using the right products. "Choosing scalp products with the microbiome-friendly certification is an important way to support scalp health," Dr. Woolery-Lloyd says. "Formulas that earn this designation are carefully developed to be pH-balanced and to work in harmony with the skin's natural ecosystem. They help maintain the scalp microbiome, and are tested to ensure they do not disrupt beneficial bacteria or promote the growth of harmful organisms. That means avoiding harsh detergents, supporting hydration, and maintaining the scalp’s pH—so you're cleansing in a way that still allows beneficial microbes to thrive."

She also suggests adding a lightweight conditioner like Nutrafol's Strand Defender Conditioner to help strengthen and defend hair against damage.

"Conditioner tends to get treated as an afterthought, but for anyone dealing with visible damage or fragility, it's an important part of the picture," she says. "The goal isn't just softness—it's making sure the hair that's growing in has the best chance of looking and feeling its healthiest."

"Rounding out the routine, I'd also incorporate a serum," finishes Dr. Woolery-Lloyd. "Nutrafol's men's and women's formulas are each tailored to address the distinct factors at play for each population, helping to support visibly thicker, fuller hair at the scalp."

She finds early use of a serum especially valuable if you have any concerns about your scalp health, like the dryness that can come from hormonal shifts.

"It's a targeted step that lets you address what's happening at the scalp surface directly, delivering ingredients right where they're needed."

When asked what she finds compelling about Nutrafol serums in particular, she highlights the proprietary ashwagandha exosomes, which help deliver plant components to the scalp, and Maca Extract, an adaptogenic botanical that helps protect from oxidative stress to support visibly thicker hair. Both play a role in the look and feel of your hair as it grows in.

And before you start shopping, according to Dr. Woolery-Lloyd, not every person needs every product.

"Part of what drew me to Nutrafol is that each formula exists for a reason—it's a lineup built around specific needs. I always tell patients: start with what your scalp actually needs right now. The goal is never more products—it's the right ones."

As for Dr. Woolery-Lloyd's biggest piece of advice? It's never too late to start your hair health journey. "A reset is about removing accumulated buildup—excess sebum, product residue, flakes—without disrupting the microbiome," she tells me. "Maintenance is what you do consistently: gentle, microbiome-friendly cleansing that removes excess oil and provides hydration."

So now that I know the steps to support a healthier scalp microbiome, how do I know when it's finally working?

"Patients often notice improvements in scalp comfort—like less dryness, tightness, or flaking—fairly quickly once the scalp microbiome is supported," Dr. Woolery-Lloyd says. "Over time, maintaining that healthier environment helps support stronger, more resilient hair as it grows.

Take a Whole-Body Approach

Dr. Woolery-Lloyd makes sure to mention that caring for your scalp may not yield results if other factors are at play. "As a dermatologist with a background in lifestyle medicine, I've always approached hair health from a whole-body perspective—looking at nutrition, stress, hormones, and lifestyle factors, not just the strands themselves."

"One of the things I find most fascinating is the relationship between estrogen and the scalp," she tells me. "Estrogen plays a role in prolonging the hair growth phase, which is why so many women notice changes in their hair during perimenopause and postpartum, when estrogen levels fluctuate. And the gut microbiome is part of that picture, too. It influences how estrogen is metabolized in the body, which can have downstream effects on the scalp environment. It's a perfect example of why we have to think about hair health from the inside out.”

She says this full-body approach is exactly what drew her to Nutrafol Hair Growth Nutraceuticals: "I've long recommended it to patients because it's science-backed and delivers real results."

I was initially skeptical—I've tried other supplements to no avail—but Dr. Woolery-Lloyd assured me that she did her research before backing the brand.

"What sets Nutrafol apart is its combination of a whole-body, physician-formulated approach and a commitment to clinical rigor that goes above and beyond industry standards," she clarifies. "Clinical studies aren't required in the supplement space, but Nutrafol continuously tests its final hair growth formulations in the populations they're intended for to ensure real, measurable results." Their 17 clinical studies have been conducted across many life stages, including postpartum and menopause.

Safety is also a top priority for the brand. "Nutrafol is the first and only hair growth supplement to earn NSF Certified for Sport®, demonstrating rigorous testing and ingredient oversight."

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