A bad hair day could be more than a style problem.

It could signal an autoimmune condition, or it could mean something has changed with your medications.

Hair isn’t just about fashion, said Dr. Nana Duffy, presently the only black dermatologist in Rochester.

Changes in the texture, thickness or appearance — your hair becomes curlier, or harder to manage and you haven’t changed hair-care products — could indicate a change in overall health.

Dermatologists take care of skin problems and they also cover hair and nails.

Duffy is scheduled to be the keynote speaker at the second annual Hair and Health Symposium, 8:30 a.m. Sept. 18 at the Rochester Educational Opportunity Center, 161 Chestnut St. The free event is for barbers, stylists and anyone interested in the link between hair and overall health.

Shawndel Lewis, co-owner of Another Level Barbershop on Portland Avenue, said when he was learning the craft, the health attention was on hygiene. Lewis, who is a community health educator trained by Trillium Health through the Get it Done initiative, said he’s now learning about the interaction of medication and hair and how to talk to clients about health.

“It’s important to know the basics, maybe check with your doctor and see about the medication,” he said.

The free event is an extension program of Get It Done, which teaches hair care professionals how to provide education and blood pressure and HIV screening to clients.

Duffy answered some questions about what our hair says about what’s happening on the inside.

In general, what does our hair tell us about the rest of our body?

It’s about informing someone about underlying medical conditions. Autoimmune conditions is a huge one. It can give you a sense of whether or not someone has vitamin deficiencies. Certain medications can affect your hair.

What changes should we pay attention to?

Patients with low thyroid describe brittle hair, hair that breaks easily. They describe hair shedding more than usual. Some patients will describe a change in texture.

Can changes in hair indicate things such as heart disease, cancer or arthritis?

Heart disease, generally not. There is an exception, and that’s a genetic condition that affects the heart and is associated with ‘wooly hair.’

As for cancer, it’s possible. There is a condition called alopecia neoplastica, where cancer (breast cancer for example) becomes metastatic to the scalp skin and patients get round areas on the scalp where no hair grows. I saw this once in residency and this was the way that we found out that the patient’s breast cancer had spread. There is also an autoimmune condition called dermatomyositis, which commonly presents with itchy scaly red areas on the scalp, specifically the back of the scalp. Women with this condition are at higher risk for cancers like ovarian cancer, so when we see this condition on the scalp we always check for certain cancers.

As for arthritis, only if the arthritis is associated with an underlying autoimmune condition such as lupus, Sjogren’s disease or dermatomyositis. Hair loss would not be indicative of regular osteoarthritis. 

Can hair loss mean a person has lupus?

The frontal hairline can get very thin, almost like the hair on a baby. Superfine, like a 1-month-old baby’s hair.

Another type of lupus is discoid lupus, which means disc-shaped. If a stylist sees this (patch of skin) on someone’s scalp, maybe on the back of the scalp that the person can’t see, the stylist can send the patient to a dermatologist, who will then do a biopsy and coordinate with the primary care doctor to get the patient worked up for systemic lupus, which is lupus on the inside of the body.

Are there gender or racial differences?

Hormonal disturbances and vitamin deficiencies are across the board and can affect the hair in all races. There’s a type of hair loss that women get related to hormones. It tends to affect the top of the scalp and leaves the frontal hairline intact.

Lupus disproportionately affects the black community. It’s not that white patients don’t get lupus. They do. The prevalence of lupus is higher among African-American women. I saw a young man with newly diagnosed discoid lupus.

Low thyroid tends to affect mostly women.  

Can changes in hair indicate high blood pressure?

No. But there is a lot of misinformation that blood pressure medication across the board will cause you to lose your hair. I’ve heard of patients refusing to take blood pressure medication because they worried about hair loss. There are very particular kinds of antihypertensive medication that can cause hair loss. It’s not across the board all anti-hypertensives.

How are health-related changes different from changes because of products?

If hair breakage is associated with other signs of low thyroid — such as dryness of hair, dryness of skin, change in texture of the hair, thinning of hair — we would think about an underlying medical condition. If it’s just pure breakage (we call it trichorrexis nodosa) that is typically from too much heat or too many chemicals that damage the hair shaft

What are the limits to what our hair can tell us?

The only thing that limits us is our ability or inability to be curious about the body and to treat the body as a whole unit and not the sum of individual parts. 

How can we not obsess over uncooperative hair and think it means we’re ill?

The best thing to do if you are worried about your hair being connected with an underlying medical condition is to seek the advice of a board-certified dermatologist.  

PSINGER@Gannett.com

If you go

What: Hair and Health Symposium. For barbers, stylists and the public.

When: 8:30 a.m. to 2 p.m., Sept. 18.

Where: Rochester Educational Opportunity Center, 161 Chestnut St.

Cost: Free, but registration is required.

For more: Call Jackie Dozier at (585) 210-4126 by Sept. 13.