Damage caused by high heat hair drying and other damaging hair care practices primarily affects the hair shaft. While it may cause brittleness and split ends, which can make it appear as though the hair is thinning, it is unlikely to permanently harm the hair follicles that lie safely underneath the skin’s surface. You should keep in mind, however, that serious and prolonged trauma to the scalp, either as a result of severe burns that damage the epidermis or the extreme tension that results from certain hairstyles can place enough strain on the follicles to have an effect on hair growth. In extreme cases, patients can experience traction alopecia or even permanent scarring alopecia when the scalp has suffered significant damage. I often recommend that those concerned with hair loss dry their hair using low heat, since preventing breakage and split ends has the effect of making hair appear thicker and fuller. However, for heat to cause permanent damage to the follicles that are deep underneath the skin, serious burning to the scalp surface would have had to have occurred.