Black women’s hair: the main scalp dermatoses and aesthetic practices in women of African ethnicity

Abstract

Afro-ethnic hair is different from Caucasian and Asian hair and has unique features. Ethnic hair is more prone to certain conditions or diseases. Such diseases are not only related to the fragile inner structure of the hair, but also to the cultural habits of hairstyles that often exert traction forces upon the pilosebaceous follicle. Women with African hair subject their hair to chemical treatments such as hair straightening and relaxing, and thus modify the structure of their hair shaft, making it more susceptible to damage. For this reason, hair complaints are common among black women and represent a diagnostic challenge to the dermatologist, requiring a thorough clinical examination of the hair and scalp, and a detailed medical history of the patient. The purpose of this review is to warn of the potential side effects and sequelae related to hairstyles and hair treatments used by black women, and to highlight the major diseases that affect this ethnicity.

Reliability of Histopathology for the Early Recognition of Fibrosis in Traction Alopecia: Correlation with Clinical Severity

“…It has been reported that the prognosis of TA is variable depending on how early the traction on the hair is stopped [14]. If the hair technique that exerts traction is stopped early, there can be reversal of the clinical phenotype; however, if traction continues for a prolonged period, chronic perifollicular inflammation may lead to permanent scarring alopecia [14]. We also found good agreement between the identification of extruded hair shafts and the presence of sebaceous glands.…”

“…This also alludes to the benefit of early diagnosis and reversal of TA-precipitating hair grooming and styling habits. It has been reported that the prognosis of TA is variable depending on how early the traction on the hair is stopped [14]. If the hair technique that exerts traction is stopped early, there can be reversal of the clinical phenotype; however, if traction continues for a prolonged period, chronic perifollicular inflammation may lead to permanent scarring alopecia [14].…”

“…We also found good agreement between the identification of extruded hair shafts and the presence of sebaceous glands. Early-phase TA has been characterized by the presence of trichomalacia and increased presence of catagen and telogen hairs, which is then followed by “follicular abandonment,” loss of terminal hair, retention of vellus hair, and sebaceous glands with decreased sizes [14, 15]. Hence, as seen in this study, a decrease in the size of sebaceous glands may be a surrogate indicator for the progression of TA; in contrast with other conditions like telogen effluvium, in which the terminal/vellus hair ratio remains the same, and there is no alteration in the sebaceous gland volume [7].…”

In vitro determination of Mexican Mestizo hair shaft diameter using optical coherence tomography

“…The mean diameter of the hair samples was 0.10 ± 0.01 mm (Tables and ). Of note, upon three‐dimensional imaging, we found that Mestizo Mexican hair resembles Caucasian and Asian hair, in that hair shafts tend to be round‐shaped with homogenous diameters throughout the fibre, rather than elliptical, flattened and irregular, as seen with Afro‐ethnic hair (Figure ) …”

An Overlap of Secondary Cutis Verticis Gyrata, Folliculitis Decalvans, Folliculitis Keloidalis Nuchae and the Use of Dreadlocks: The Role of Inflammation due to Traction

“…Although it seems to be a rare coincidence, the common background of traction as a possible main trigger of the three conditions points to the fact that in African-descent patients, trauma caused by the grooming habits and the use of hair extensions may be a frequent cause for the development of inflammation that can clinically be evident as one or more scalp abnormalities such as those presented in this work. The role of hair care practices in people of color and how it can influence the development of scalp diseases is particularly complex and may involve genetic predisposition [18,19]. …”