Hair has played a longstanding role in race relations in the US and is particularly relevant as US legislators seek to address discrimination on the basis of hair. Dermatologists should be aware of the historical context of hair to optimize communication with patients and to advance inclusivity efforts in the field and in society more broadly. This Viewpoint provides a review of hair in US Black-−White race relations, informed by historical texts, to improve delivery of culturally sensitive dermatologic care.Hair texture has been used as a mode of racial categorization in the US since as early as the 19th century. 1 People of sub-Saharan African descent commonly have curly or kinky hair texture that differs from the straight hair texture common to individuals of European (predominantly White) ancestry. 2 Reflecting pervasive societal views in the 1800s, kinky hair texture, much like skin tone, symbolized African ancestry and identified Black people as an inferior race in the US. 1 Even after the US abolished slavery in the 1860s, race relations underpinned perceptions of Black hair textures. 1 White-centric standards of appearance limited job opportunities and social mobility for Black Americans in the late 19th and early 20th centuries. To avoid discrimination and demonstrate commitment to being assimilated US citizens, Black Americans thought carefully about how to present themselves in society. 3 Additionally, based on traditional gender roles, women shouldered the weight of societal beauty ideals, and as such, many Black women pursued interventions such as skin bleaching and hair straightening. 1 In the early 1900s, Black women commonly used straightening combs to achieve straightened hairstyles, but the results were temporary. 1 A few decades later, chemical lye−based hair treatments were developed to offer longer-lasting results. 2,3 These treatments, used on average every 4 to 8 weeks, permanently altered existing hair texture by weakening its chemical bonds, so curly hair types became straight. 2,3 Achieving higher income-or trying to-meant looking the part, and as early as the 1920s, straightened hairstyles came to represent middle-class status among Black Americans. 1,4 As hair straightening became more widespread, critics in the Black community suggested that the practice was a rejection of Black heritage and identity. 1 However, supporters of straightening believed that straightened hairstyles were the style of choice for modern women, and many were hopeful that if their appearance mirrored that of White Americans, they would be perceived as more refined and would have better social mobility. 1,4 Important cultural shifts in Black−White race relations were underway by the mid-20th century, and hair
ResearchHair loss disorders are largely under studied, and the role of hair care practices in the development and