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- Presentation
Culturally Competent Hair Care Counseling for Patients with Textured and Tightly Coiled Hair
Description
The speaker emphasizes that hair care and hairstyling are integral parts of clinical treatment for patients with textured and tightly coiled hair, not just cosmetic concerns. She explains that hair is deeply tied to identity and self-image, and that hair loss can be especially distressing. A major focus is the history and ongoing impact of discrimination against Black women’s hair, including workplace and school bias, and support for the Crown Act as a protection against such discrimination. She urges clinicians to recognize the emotional and cultural baggage patients may bring to visits and to build trust through humility, curiosity, and respectful language. Practical counseling recommendations include asking patients how they wear their hair, how long styles are kept in, whether styles cause pain, and what wash routines are realistic, while respecting that wash day is a time-consuming event. She notes that temporary changes in hair care may be needed during active scalp disease, and that explaining this clearly can improve adherence. The talk also highlights the importance of using hands appropriately during scalp exams, avoiding unnecessary gloves, involving patients in parting the hair, and partnering with stylists and community resources to better understand and support hair practices.
View moreConclusions
- Dermatologic care for textured and tightly coiled hair is improved when clinicians treat hair practices as clinically relevant, not merely cosmetic.
- Understanding a patient’s real hair-care routine leads to better diagnosis, counseling, adherence, and trust.
- Hair loss has major psychosocial effects, so clinicians should approach it with seriousness, empathy, and humility.
- Hair discrimination, especially against Black women, is common and can affect employment, education, and self-image.
- The CROWN Act is an important advocacy tool because hair texture and protective styles should not be treated as unprofessional or discriminatory.
- Wash day is a substantial, time-consuming process, so recommendations must account for practical realities rather than assuming simple frequent washing.
- Styling practices can both mask and contribute to scalp disease, so detailed hair history can change management decisions.
- Effective counseling should avoid judgmental language and instead ask open-ended, specific, patient-centered questions.
- Rapport across differences is a clinical skill that can be built through curiosity, respect, and willingness to learn from patients.
- Partnering with stylists and incorporating patient identity and lived experience into care can improve feasibility of treatment plans and outcomes.
- 2023 CROWN Research Study
- VisualDx article on managing hair loss in patients
- JAMA Dermatology