Two-thirds of the hair follicles on my scalp are permanently damaged, presumably from repeated pulling, and my hair grows only sparsely on the top and sides of my head while simultaneously a triangular-shaped patch of hair grows luxuriantly and healthily at the back of my head where I don’t have a history of pulling. Even as my pulling subsided, shaving my head made sense as a way of hiding in plain sight: I found that no hair looks better on me than some hair.

This past July I decided to grow my hair out just to see what would happen, and I am committed to sticking it out for a full year. Now in December, the hair at the back of my head is more than 2″ long. Six months has given me opportunity to look at the hairs on the crown of my head that really struggle to grow and time to ponder the question of what healthy hair really is. Hair may be dead keratin without any nerves, but yet we all recognize healthy hair when we see it.

The hairs at the crown of my head are shorter. The length caps out at less than an inch. Some are still stubble after all these months. They are lighter colored. They are thinner in diameter. If I attempt to pull them out, they tend to snap before the root comes out. These are only the hairs that grow at all. The hairs are so few per square inch that they can individually counted.

As a lay person (who studied French for eight years and not any branch of medicine) I came up with a list of observations about my own hair that make me question its health. Keep in mind that I am speculating only.

The diameter should be uniform for the area that the hair is in. I would imagine that arm hairs may have a slightly different average diameter than, say, scalp hairs, but the the diameter should be consistent for each part of your body.

The strand should not have split ends. As a high-schooler, I had chronic split ends and one my body-focused repetitive behaviors was to seek out all of my split ends and split them apart.

Healthy hair should hurt when you yank it out by the follicle.

Healthy hair should not bleed when it is extracted.

Healthy hair should fall out naturally at a uniform rate, 50 to 100 per day being within the normal range, I hear.

Healthy hairs should not be ingrown. The common belief (popular science all over the Internet) will tell you that ingrown hair is caused by external forces such as clothing rubbing against your skin. In my experience, however, ingrown hairs are a reflection of the health of the follicle. When I experience an increase in pulling in my scalp I also, without fail, see an explosion of ingrown hairs in my calves.

Healthy hair should neither be too oily nor too dry. Mine, like my mother’s, is chronically and excessively oily. I MUST wash my hair daily (and sometimes twice a day), and have found that controlling oils on my scalp plays a role in controlling my pulling.

Some other points I am unsure about. For example, I wonder what it means when individual rogue hairs are significantly different from their neighboring hairs: kinkier, lighter colored, thinner or thicker in diameter, excessively short, or freakishly long.

I also wonder what a healthy hair has at its root. The classic trichotillomania hair has the jelly-like translucent sheath around it, which I believe personally to be unhealthy and abnormal. I also have hair roots that have nothing on the end, that are dry and seem to almost tear out of the follicles. Other hair roots look moist but without any greasy substance on the end. The hair roots that I avoid pulling out (because they hurt) have rock-like nubs on the end.

I have no idea of the veracity of any of the above statements, but if you are an authority on the matter I would value what you have to say.