What to know about the Japanese-style scalp massages catching on in the US

SAN FRANCISCO (AP) — Getting a scalp or face massage is often a relaxing highlight of getting a haircut or a facial. Now, head spas are popping up across the country offering deep cranial and facial relaxation.

“Typically, when you go get a massage, the focus is always like your back, and I always wish there was more on my head, on my face especially, on my neck,” says Karena Kong, a frequent customer of Nen Head Spa in San Francisco. “When I saw that they give 90 minutes of just head, face, shoulder massage, I felt like it’s a great way to just focus on the areas that I love.”

Head spas originated in Japan, rooted in centuries-old practices that combine massage and herbal tinctures. Modern versions began gaining popularity in Japanese salons in the 1990s before spreading throughout Asia and now the U.S.

A typical session lasts 60 or 90 minutes and often begins with a scalp inspection, followed by deep cleansing, exfoliation, steam, and extended head, face and neck massage. Many services also include essential oils, conditioning masks, and aromatherapy in a quiet setting with dimmed lights and soft music.

“The core part of it is actually getting your hair washed,” said Peter Tham, owner of Nen Head Spa, where head massages cost about $100 an hour. “The feeling of getting your head washed, especially on a hot and humid day, feels really good. Combine that with, facial, scalp, neck and shoulder massages, which is kind of where most people, especially those who sit in front of a computer all day, suffer a lot of tension.”

Some head spas make health and medical claims about some of their services, suggesting they can offer stress relief or treatment for scalp skin conditions, hair loss or even alopecia, an autoimmune disorder. Experts caution that people with skin or hair conditions should see a dermatologist or other appropriate doctor for advice and possible treatment.

“It’s important to know and differentiate something that’s done for a health reason or relaxation from seeing a medical expert, a dermatologist, if you are having hair loss,” said Zakia Rahman, a dermatology professor at Stanford University School of Medicine.

Rahman has noticed the rising popularity of head spas and says they are generally fine as a compliment to actual medical treatments if needed — and for people who like the way it makes them feel.

At Sunday Headspa in San Francisco, each session starts with a technician inspecting hair follicles with a magnifying device and assessing their condition. Then customers get a deep clean, said Jolly Mac, the spa’s coordinator.

Many of their clients first discovered head spa services in Asia and are looking for similar services, which start at about $200 an hour.

Customer Crystle Vitari, first visited a head spa while visiting South Korea and finds it “rejuvenating” — and relaxing.

“Every time, I fall asleep and take a nap, actually, because it’s so relaxing," she said.

Associated Press writer Olga R. Rodriguez contributed to this story.

Liz Evans, bottom, wears a warm misting cap, which produces nano mist that hydrates the scalp and hair, as head spa specialist Ha Truong performs a treatment at Sunday Headspa Thursday, April 16, 2026, in San Francisco. (AP Photo/Jeff Chiu)

Head spa specialist Ha Truong applies a halo waterfall device to Liz Evans, left, during a treatment at Sunday Headspa Thursday, April 16, 2026, in San Francisco. (AP Photo/Jeff Chiu)

Head spa specialist Ha Truong, right, applies shampoo to Liz Evans during a treatment at Sunday Headspa Thursday, April 16, 2026, in San Francisco. (AP Photo/Jeff Chiu)

Head spa specialist Ha Truong, right, uses a Red and Blue light brush on Liz Evans to help with hair growth and reduce bacteria while massaging the scalp to help the scalp serum absorb during a treatment at Sunday Headspa Thursday, April 16, 2026, in San Francisco. (AP Photo/Jeff Chiu)

Head spa specialist Ha Truong, right, uses a Red and Blue light brush on Liz Evans to help with hair growth and reduce bacteria while massaging the scalp to help the scalp serum absorb during a treatment at Sunday Headspa Thursday, April 16, 2026, in San Francisco. (AP Photo/Jeff Chiu)

NASHVILLE, Tenn. (AP) — Tennessee officials on Thursday called off the lethal injection of Tony Carruthers, who was convicted of kidnapping and murdering three people in 1994, after his executioners tried and failed for over an hour to establish an intravenous line. Gov. Bill Lee announced soon afterward that the state would not try again for at least a year.

In a written statement, the Tennessee Department of Corrections said medical personnel had quickly established a primary IV line but were unable to find a suitable vein for a backup line as required by the state’s execution protocol. Efforts to insert a central line also failed, and officials called off the execution.

Maria DeLiberato, an American Civil Liberties Union attorney representing Carruthers, said she saw him “wincing and groaning” while officials attempted to find a vein, calling it “horrible” to watch. An Associated Press journalist was in attendance to observe the execution, but a state rule contested by news organizations prohibits media witnesses from observing the IV insertion.

DeLiberato was addressing reporters when the governor's office issued the reprieve. She began crying.

“That’s amazing!” she said. “I’m so grateful!”

Since 2009, six other prisoners in three states — Alabama, Idaho and Ohio — have had executions halted because of difficulties establishing an IV, according to the Death Penalty Information Center. In Idaho in 2024, medical team members tried eight times to establish a line to execute Thomas Creech, one of the nation’s longest-serving death row inmates, before calling it off. Idaho Gov. Brad Little subsequently signed a law making firing squad the state’s primary method of execution.

In Alabama, Gov. Kay Ivey paused executions for several months after officials called off the lethal injection of Kenneth Eugene Smith in 2022. It was the third time since 2018 Alabama had been unable to conduct executions due to problems with IV lines.

“Tony Carruthers’ case raised serious concerns about mental illness, representation, innocence, and access to DNA testing,” the Death Penalty Information Center said in an emailed statement. “The state’s failed attempt today to execute him presents an additional issue surrounding the qualifications of the people tasked with executing prisoners.”

Under Tennessee’s execution policies, blinds between the witness room and the execution chamber are kept closed until the IV insertion team has left. On Thursday, media witnesses sat in a dark room for over an hour, but the blinds were never raised.

Witnesses did hear what sounded like groans through a crack beneath a door connecting the two rooms.

DeLiberato, who was in the execution chamber, said that after establishing an IV line in Carruthers’ right arm, medical personnel tried his other arm, his left hand and his left foot before trying to establish a central line.

Carruthers groaned as a doctor started pushing a needle in, she said. She saw two or three puncture wounds: “There was a lot of blood.”

Unable to establish a central line, the medical team accessed a vein in his right shoulder before the warden received a phone call and announced the execution was off, she said.

The Associated Press is part of a group of media organizations fighting for witnesses to be allowed to see more of the execution process, including the IV insertion.

Carruthers, 57, was found guilty of the 1994 kidnappings and murders of Marcellos Anderson; his mother, Delois Anderson; and Frederick Tucker. Authorities said Marcellos Anderson was a drug dealer and that Carruthers was trying to take over the illegal trade in their Memphis neighborhood.

He was forced to represent himself at trial after repeatedly complaining about court-appointed attorneys and threatening to harm several of them.

There was no physical evidence tying Carruthers to the killings, and he was convicted primarily on the basis of testimony from people who claimed to have heard him confess to or discuss the crimes. The ACLU said it would continue to push for DNA testing on evidence in the case, saying it should have been done long ago.

Carruthers' attorneys have also argued that he has mental health issues that render him incompetent to be executed.

The number of executions in the U.S. surged from 25 in 2024 to 47 last year, driven by a sharp increase in Florida. That state carried out 19 executions in 2025, up from one the previous year, according to the Death Penalty Information Center. So far this year, four states have executed 13 people, and 11 other executions are scheduled including one Thursday evening in Florida.

Tennessee, which carried out its last execution in December, began a new round of executions last year after a three-year pause following the discovery that the state was not properly testing lethal injection drugs for purity and potency.

An independent review later found that none of the drugs prepared for the seven inmates executed in Tennessee since 2018 had been fully tested. The state attorney general’s office also conceded in court that two of the people most responsible for overseeing Tennessee’s lethal injection drugs “ incorrectly testified ” under oath that officials were testing the chemicals as required.

Associated Press reporters Gene Johnson in Seattle and Sudhin Thanawala in Atlanta contributed.

Maria DeLiberato, attorney for death row inmate Tony Von Carruthers, speaks to reporters after the execution of Carruthers was called off because a suitable vein could not found as required by lethal injection execution protocol Thursday, May 21, 2026, in Nashville, Tenn. (AP Photo/Mark Humphrey)

Maria DeLiberato, right, attorney for death row inmate Tony Von Carruthers, speaks to reporters after the execution of Carruthers was called off because a suitable vein could not found as required by lethal injection execution protocol Thursday, May 21, 2026, in Nashville, Tenn. (AP Photo/Mark Humphrey)

Bethany Mann, right, and Pat Halper, left, both of whom oppose the death penalty, greet one another outside Riverbend Maximum Security Institution before the scheduled execution of Tony Von Carruthers Thursday, May 21, 2026, in Nashville, Tenn. (AP Photo/Mark Humphrey)

Rev. Rick Laude enters the area reserved for those in support of the death penalty outside Riverbend Maximum Security Institution before the scheduled execution of Tony Von Carruthers Thursday, May 21, 2026, in Nashville, Tenn. (AP Photo/Mark Humphrey)

People talk in the area reserved for those who are opposed to the death penalty outside Riverbend Maximum Security Institution before the scheduled execution of Tony Von Carruthers Thursday, May 21, 2026, in Nashville, Tenn. (AP Photo/Mark Humphrey)

Guards on horses are posted next to the area reserved for people opposed to the death penalty outside Riverbend Maximum Security Institution before the scheduled execution of Tony Von Carruthers Thursday, May 21, 2026, in Nashville, Tenn. (AP Photo/Mark Humphrey)

This Tennessee Department of Correction photo shows inmate Tony Carruthers. (Tennessee Department of Correction via AP)