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Hair represents a valued aspect of human individuality. The possibility of having an easy to handle hairstyle and changing it from time to time promoted an increasing search for chemical hair transformations, including hair straightening. Hair straightening is the process used to convert curly into straight hair. The desire for straight hair used to be associated with the standards of the “universal beauty.” Currently, the preference for this style is more for the ease of handling and the simpler daily care routine [1]. Straightening may be physical or chemical processes and temporary or permanent, regarding its duration.

We performed a literature search in the scientific database MEDLINE through PubMed until July 15, 2020, using the terms “straightening” AND “hair” (125 results), “straightening” AND “alopecia” (22 results), and “straightening” AND “human hair” (103 results). We limited the search to articles available in English and considered those mentioning alternatives to straighten the hair. After excluding duplicate titles, we had a total of 33 relevant articles.

Anatomically, the hair shaft has 3 layers: cuticle, cortex, and medulla [2, 3]. The outermost part is the cuticle, which is composed of keratin and consists of layers of scales overlapping 1 and other, just like tiles on a roof. The cuticle protects the underlying cortex and acts as a barrier [3-5]. The normal, undamaged cuticle has 6–8 layers according to the ethnicity, a smooth surface, allowing reflection of light and limiting friction between shafts [5]. The outer surface of the cuticle’s scale cells is coated by a thin membrane, the epicuticle, and each cuticle cell consists of 3 layers of protein: the A-layer, a resistant layer with high cystine content; the exocuticle, also rich in cystine; and the endocuticle, low in cystine content. The cortex accounts for most of the hair shaft and is responsible for the hair. The cortex is comprised of microfibrils, long filaments oriented parallel to the axis of the fiber. Each microfibril consists of keratin intermediate filaments, also known as microfibrils, and the matrix, constituted by keratin-associated proteins [4]. It is the thickest layer located around the medulla, which is the innermost part of the hair, has melanin granules which composition is related to the shades of hair color. It is also responsible for hair volume, the great tensile strength, and mechanical resistance of the shaft, as it contains the most part of keratin [3-5].

The primary component of the hair fiber is keratin. The remaining constituents are represented by other proteins, water, lipids, pigments, and trace elements. Because of its specific conformation and chemical bonds, keratin is responsible for hair stiffness, strength, and insolubility. Among the amino acids that make up keratin, cystine is one of the most important. Each cystine unit contains 2 cysteine amino acids from different portions of the peptide chains that are connected by 2 sulfur atoms, forming a strong bond named disulfide bridge [3-5]. Another important structural component of the hair shaft is the 18-methyl eicosanoic (18-MEA) acid. It forms a hydrophobic layer that retards water from wetting and penetrating and changing the hair shaft physical’s properties. Removal of the fatty acid layer decreases the brightness of the hair, making it more susceptible to static electricity and frizzing induced by humidity [4].

The spiral shape of the hair is determined by the asymmetric protein expression in the hair follicles [2]. As it is not possible yet to modify the shape of the follicle, the only way to change hair appearance is by modifying its physicochemical properties [6].

This method was developed in the late 19th century and became popular in the early 20th century by Madame C.J. Walker, who combined hot comb with pressing oil. It is a temporary straightening since it changes only weak hydrogen bonds, in a process named keratin hydrolysis. The initial technique was the application of a petrolatum ointment base in the hair, followed by straightening it using a heated metal combing device. Over time, the technique was improved. However, with the introduction of new methods, the hot comb went out of use [1, 5, 7, 8].

Physicochemical techniques combining mechanical and thermal straightening, as hairdryer and flat iron, are temporary solutions that last until the next washing. The hair needs to be wet, so hydrogen bridges break and there is the transitional opening of the helical structure of the shaft, relaxing it. The combined use of the dryer and the flat iron dehydrates the hair, keeping it straight [1].