Introduction and Background:Cosmetic procedures for hair, such as bleaching, dyeing, and straightening, are commonly used around the world. It has been suggested that excessive use of such procedures can cause damage to the hair shaft. We aimed to assess hair shaft changes using scanning electron microscopy (SEM) in female volunteers who frequently use hair treatment procedures such as bleaching, dyeing, or straightening.Methods:A cross-sectional, controlled study in a sample of 25 female volunteers (19 study group and 6 controls) in the age group of 18–45 years. The study group was composed of volunteers who regularly used different cosmetic hair treatment procedures such as bleaching, dyeing, and straightening (any one of these or a combination). The control group had never used any specific hair treatment procedure. The hair shaft damage as seen on SEM was assessed using a standardized scoring system and compared among the two groups statistically. The hair shafts were also examined clinically and with light microscopy.Results:No significant differences were seen between the test and control groups with regard to normal clinical examination and light microscopy findings. A higher degree of hair shaft damage was evident under SEM in the study group as compared to the control group. This difference was statistically significant.Conclusions:Regular use of procedures such as bleaching, dyeing, or straightening can lead to subtle changes in the hair shaft which can be detected early by SEM.