Prepare for the worst, hope for the best: Understanding unusual salon claims

Beauty Parlor Stroke Syndrome (BPSS) recently became a hot topic when Elizabeth Smith, 48, of California had her shampoo horror story picked up by Buzzfeed. Days after a normal trip to her hair salon, Smith felt weak on the left side of her body and couldn’t balance properly, until she eventually began vomiting and had to be rushed to the ER where she was told she’d had a major stroke.

How does a trip to the hair salon result in a stroke? Although extremely rare, with just a handful of cases reported since the first in 1993, the position in which patrons lean their head back for a shampoo is the culprit. The temporary strain is enough to cause a torn artery wall in a vertebra, which can eventually release a blood clot. When this clot travels to the brain, as Smith’s did, it causes a stroke.

Beauty Parlor Stroke Syndrome targets those with atherosclerosis, which is a buildup of plaque in the arteries that is a risk factor for a stroke in itself. Older people are especially vulnerable to neck motion that causes certain degrees of hyperextension and rotation. The first five cases reported in 1993 were all women between the ages of 54 and 84. Four of those cases experienced permanent neurologic damage.

An incident like this, as rare as it may be, is terrifying for a salon to have to address.  Receiving news of a client’s stroke shifts your focus from the relatively carefree concerns of day-to-day business to the well-being of your client, as well as a damaged reputation and an unexpected claim.

Claims like this are unusual, but they do occur, and fortunately, there are measures you can take now to protect your clients and your business:

  • Does your shampoo chair have good neck support for patrons? If not, you can use a rolled-up towel to prop the patron’s neck up so it is in a straight line with their spine and not bent backward.
  • Asking the client if he/she is comfortable before shampooing is a quick and easy way to protect both yourself and your client.

As with many safety measures salons can take, preventing problems like this is relatively straightforward. However, rest assured that incidents like this—though scary—are rare.


Sean Brownyard is executive program manager for SASSI, the Salon and Spa Specialty Insurance program at Brownyard Group. He can be reached at

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