Health & Wellness
Black Hair Loss:
When Normal
Really Isn’t Normal
by Dr. Alyssa Daniel
H
air loss is a very distressing condition faced in all ethnicities. One of
the major barriers in dermatology,
however, is diagnosing, addressing and treating hair loss, in ethnic populations. Clearly,
there are some genetic predispositions to hair
loss disorders and with Black women, issues
still exist with addressing differences in hair
texture, hair care practices and hair loss. My
goal in writing this article is to empower all
women, but Black women in particular, to
become educated about the specific warning
signs of a bigger problem in regards to hair
loss and to explain avenues of how to properly
get those issues addressed. After all, education is power!
As a dermatologist, when evaluating
any new patient for hair loss, my first question
is, “Is this a process that is scarring?” A scarring hair loss process is caused by an immune
response on the scalp that sets intense inflammation around the hair follicle. This can cause
the hair to shed, and if the scarring is chronic
enough, it can lead to permanent scarring of
the hair follicle.
There are several forms of scarring hair
loss that are seen more commonly in Black
women. The focus of the article is to shine
light on a relatively common but highly under
42 HimPower August 2015
recognized scarring hair loss disorder. Central
centrifugal scarring alopecia may affect up to
6% of women of African descent2. Symptoms
can start with intense burning and itching
of the scalp, more prominent at the crown,
and expand outward over time. There is no
known direct cause, but it is speculated that
contributing factors for this disorder include:
hair care practices such as tight pulling, chemical treatments, and genetic predisposition
to inflammatory conditions. As the disease
progresses, thinning of the hair is noted and
patients can also experience texture changes
to the hair in the affected regions. In late
stages of the disease, a hairless scar replaces
active and growing hair follicles.
The most important information that
someone should take from this piece is that
this is a treatable condition. Early recognition
of symptoms and prompt identification of the
disease by a medical professional are exactly
what is needed to establish the diagnosis and
initiate therapy. Therapy could consist of confirmation of the disorder via biopsy sampling
and pathological examination, initiating topical
anti-inflammatory medications, intralesional
injections of steroids aimed at decreasing
inflammation and possibly oral anti-inflammatory medications. The goal of treatment is to