And It’ll Come Back Real Baby Fine: Black Women’s Experiences With Hair Loss and Regrowth After Chemotherapy for Breast Cancer Treatment

Abstract

In this study, I use a modified grounded theory, intersectional approach to understand the wellness-illness experience for black women experiencing breast cancer. I use interviews from 38 breast cancer survivors from Nashville, Durham-Chapel Hill, and Atlanta conducted between 2014 and 2015 to explore variations in perceptions of hair loss and regrowth. Universally, hair loss from chemotherapy treatments is a stressful experience, which cause women to question their health and femininity. Hair loss is a crisis in which women feel less beautiful and more sick. Interesting patterns steeped in race and beauty emerged from women’s narratives as they experienced hair regrowth. Black women’s stories of hair loss associated with chemotherapy are influenced by values associated racialized ideologies about beauty. Good, baby fine, soft and thick, loosely curled, straight, wavy, and beautiful are just some of the words many women chose to describe their chemically altered hair. The dialogue around hair regrowth and texture is problematic given Eurocentric standards of feminine beauty, notions that coincide the long ties between chemicals and hair straightening in the black community.

Redefining the “crown”: Approaching chemotherapy‐induced alopecia among Black patients with breast cancer

“…Cranial prostheses can serve as acceptable alternatives in the setting of CIA. However, as previously illuminated in a prior qualitative study of Black breast cancer survivors, 11 most cranial prostheses targeted to breast cancer patients may not mimic the natural hair texture of Black patients, making the patient's medical condition even more apparent. Many Black CIA sufferers may turn to their local beauty supply store for a more “natural”‐looking wig.…”

“…Hair loss, therefore, can be a devastating experience, perhaps even more so when associated with a breast cancer diagnosis. Research demonstrates that chemotherapy‐induced alopecia (CIA) is associated with low body esteem, low self‐efficacy, and negative coping behaviors related to cancer diagnosis among women, 7–9 with some declining cancer treatment altogether to avoid hair loss 10,11 . Although most of the data on CIA include predominantly White cohorts, there is a paucity of research regarding the specific impact of CIA among Black women, who are disproportionately affected by more aggressive disease in which chemotherapy (particularly neoadjuvant chemotherapy) is more likely to be administered 12–17 .…”

“…One literature review only showed four studies specifically characterizing CIA outcomes among African American women, with data suggesting that this group may be at higher risk of diffuse, permanent alopecia and may achieve poor results in hair preservation interventions 18 . A qualitative study of 38 Black survivors of breast cancer revealed disturbing implications of CIA, such as hair loss being perceived by participants as more traumatic than the loss of breast tissue and experiencing physiological side effects of illness stemming from the loss of patients' hair, 11 sentiments also echoed by patients in other CIA studies 9,19,20 . Perhaps distinctive to Black women were the concerns about the inability to wear wigs that were not designed for Black hair color or textures, with the author highlighting the need for practitioners to better understand such unique psychological effects of CIA on Black women 11 .…”

“…A qualitative study of 38 Black survivors of breast cancer revealed disturbing implications of CIA, such as hair loss being perceived by participants as more traumatic than the loss of breast tissue and experiencing physiological side effects of illness stemming from the loss of patients' hair, 11 sentiments also echoed by patients in other CIA studies 9,19,20 . Perhaps distinctive to Black women were the concerns about the inability to wear wigs that were not designed for Black hair color or textures, with the author highlighting the need for practitioners to better understand such unique psychological effects of CIA on Black women 11 . Given the racial and gendered context of CIA, the aim of this commentary is to illuminate the cultural relevance of Black hair to the breast oncology community and explore how therapeutic options for CIA may uniquely impact Black breast cancer survivors.…”

“…African American women in this cohort also experienced more diffuse hair loss 27 . Another study demonstrated that many Black survivors of breast cancer were conflicted about their new hair growth and texture after CIA, partly because of historically racialized perceptions of Eurocentric beauty 11 …”