Updates in the understanding and treatments of skin & hair disorders in women of color

Abstract

Skin of color comprises a diverse and expanding population of individuals. In particular, women of color represent an increasing subset of patients who frequently seek dermatologic care. Acne, melasma, and alopecia are among the most common skin disorders seen in this patient population. Understanding the differences in the basic science of skin and hair is imperative in addressing their unique needs. Despite the paucity of conclusive data on racial and ethnic differences in skin of color, certain biologic differences do exist, which affect the disease presentations of several cutaneous disorders in pigmented skin. While the overall pathogenesis and treatments for acne in women of color are similar to Caucasian men and women, individuals with darker skin types present more frequently with dyschromias from acne, which can be difficult to manage. Melasma is an acquired pigmentary disorder seen commonly in women with darker skin types and is strongly associated with ultraviolet (UV) radiation, genetic factors, and hormonal influences. Lastly, certain hair care practices and hairstyles are unique among women of African descent, which may contribute to specific types of hair loss seen in this population, such as traction alopecia, trichorrhexis nodosa and central centrifugal cicatricial alopecia (CCCA).

Pathologies du cuir chevelu chez le noir Africain en dermatologie à Cotonou (Bénin): aspects épidémiologiques et cliniques en fonction du sexe et de l’âge

“…Elles sont favorisées par les caractéristiques intrinsèques liées à la structure, la croissance et la densité du cheveu crépu. En effet, on distingue classiquement 3 grands groupes de cheveux: le cheveu asiatique, le cheveu européen et le cheveu africain [ 30 ]. Le cheveu africain est crépu, noir, plus courts et moins denses.…”

Support for dermatological research in Sub‐Saharan Africa: insights from African hair and skin research programs

“…Topics reviewed included laboratory and pre‐clinical models of androgenetic alopecia, 20 appropriate education and public awareness messages to prevent traction alopecia, 1 and Nigerian therapies (natural products, chemical agents, and physical modalities) for hair and scalp disorders 21 . Finally, two collaborative reviews with South African and American authors were on treatment updates in women of color for skin and hair disorders, 22 and specifically CCCA 23 …”

Treatment of traction alopecia with oral minoxidil

“…TA is most commonly seen in women of African descent 1 and is thought largely to result from hair care practices causing sustained traction such as tight braids and ponytails. 1 , 2 Modifying hair care practices to minimize traction can lead to reversal of TA in early stages, but alopecia may become permanent in cases of longstanding traction. While topical and intralesional corticosteroids, antibiotics, and topical minoxidil are often used, 3 there is a paucity of data regarding treatment options for TA.…”