AAD
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  • Presentation

Hair Care, Hair Loss and Health in Black Women

Description

The session on hair care, hair loss, and health in Black women covered various aspects of hair health and treatment strategies. Vicki Barbosa, an associate professor at the University of Chicago, opened the discussion by emphasizing the unique characteristics of Black hair, including curl patterns and porosity, which affect hair care practices. She outlined common conditions affecting Black women's hair, such as traction alopecia and central centrifugal cicatricial alopecia (CCCA), highlighting their prevalence and potential triggers. The session included insights on medical management options, with topical and systemic treatments being discussed, and the importance of educating patients about the potential risks of certain hair products, notably those containing chemical relaxers and formaldehyde. Barbosa stressed the importance of understanding patients' hair care routines and how cultural practices may influence their hair health. She encouraged practitioners to offer tailored advice and treatment plans, considering patients' preferences and comfort levels. The presentation also aimed to foster open communication with patients, particularly about sensitive topics like scarring and hair loss, as well as the overall need for continual monitoring and support in managing these conditions.

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Conclusions

  • Traction alopecia is a significant and preventable issue, particularly among Black women, due to the common practices of tight hairstyles.
  • It's essential for dermatologists to be culturally sensitive when discussing hair care and treatment options with Black women.
  • Alopecia areata is more prevalent among Black women compared to Caucasians, indicating a greater need for targeted diagnosis and management.
  • Central centrifugal cicatricial alopecia (CCCA) is under-reported, and more awareness is needed to facilitate early diagnosis and treatment.
  • Hair care practices and the use of certain products may pose health risks, necessitating further research and patient education.
  • Women diagnosed with traction alopecia need education about modifying hairstyles to prevent further damage.
  • There is a pressing need for diverse treatment options for alopecia that take individual patient preferences into account.
  • Medical management, including topical steroids and minoxidil, shows promise in treating different types of alopecia, but access and compliance remain challenges.
  • New treatments like JAK inhibitors are proving effective for various alopecias, but many patients remain hesitant to use them due to concerns about side effects.
  • Grayson et al. An Approach to Examining Tightly Coiled Hair Among Patients With Hair Loss in Race-Discordant Patient-Physician Interactions. JAMA Dermatol. 2021 May 1;157(5):505-10
  • Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Hairdressing and the prevalence of scalp disease in African adults. Br J Dermatol. 2007 Nov;157(5):981-8.
  • Rucker Wright D, Gathers R, Kapke A, Johnson D, Joseph CL. Hair care practices and their association with scalp and hair disorders in African American girls. J Am Acad Dermatol. 2011 Feb;64(2):253-62.
  • Lee H, Jung SJ, Patel AB, Thompson JM, Qureshi A, Cho E. Racial characteristics of alopecia areata in the United States. J Am Acad Dermatol. 2020 Oct;83(4):1064-1070.
  • Thompson JM, Park MK, Qureshi AA, Cho E. Race and Alopecia Areata amongst US Women. J Investig Dermatol Symp Proc. 2018 Jan;19(1):S47-S50.
  • Dlova et al, JAAD 2014. Studied 14 families with 31 family members; pedigree analysis suggested AD inheritance.
  • Suchinwanit et al, IJD 2016. 38 women with bx proven CCCA; Severity was correlated with duration; Androgen related conditions were prevalent.
  • Malki et al, NEJM 2019. Mutations in PADI3 which encodes peptidyl arginine deiminase, type III; Post-translational modification of proteins involved in hair shaft formation.
  • Balazic E, Hawkins K, Choi J, Konisky H, Chen A, Kobets K. Traction alopecia: assessing the presentation, management and outcomes in a diverse urban population. Clin Exp Dermatol. 2023 Aug 25;48(9):1030-1031. doi: 10.1093/ced/llad154. PMID: 37098178.