Dermatology Book


Hair Disorders in Black Patients

Aka: Hair Disorders in Black Patients, Hair Conditions in African American Persons, Hair Care Practices in Persons of African Descent
  1. Physiology
    1. Characteristics of hair in black patients
      1. High degree of curl
      2. Fragile
      3. Dry with less sebum production
    2. Hair care practices have developed to manage the unique hair characteristics and may result in adverse effects
      1. Hair Shampooing is reduced to every 1-2 weeks to prevent excessive drying
        1. May result in an accumulation of styling products with a risk of Contact Dermatitis
      2. Hair greese (Emollient) is used to improve hair manageability
        1. Increases risk of Acne Vulgaris or Seborrheic Dermatitis
      3. Hair straightening is performed with chemical relaxers or heat irons/combs
        1. Risk of Chemical Burns to scalp, over-processing of hair, fragility and breakage
      4. Hair is often woven or braided
        1. Risk of Traction Alopecia
        2. Risk of central centrifugal cicatrical Alopecia
  2. Associated Conditions: Alopecia
    1. Traction Alopecia
      1. Secondary to woven hair or braids
    2. Central Centrifugal Cicatrical Alopecia
      1. Scarring Alopecia that starts at crown
      2. Best outcomes with early treatment with Corticosteroids and oral antibiotics
      3. Discontinuation of hair relaxers and heat application as well as reduction of traction is recommended
  3. Prevention
    1. Wash hair with Shampoo and conditioner at least every 1-2 weeks to prevent styling product accumulation
    2. Avoid exposure of hair Emollients ("hair greese") to face to prevent Acne Vulgaris
    3. Avoid use of chemical relaxers more than every 8 weeks
    4. Avoid use of heat combs or heat irons more than every 1-2 weeks
    5. Avoid excessive traction with woven hair or braids
  4. References
    1. Kundu (2013) Am Fam Physician 87(12): 859-65 [PubMed]
    2. Roseborough (2009) Semin Cutan Med Surg 28(2): 103-8 [PubMed]

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