African-American Women Have Specific Hair Issues

What African-American Women Need to Know to Keep Their Hair Healthy

By Kathleen Doheny
WebMD Health News

Reviewed by Laura J. Martin, MD

March 21, 2012 (San Diego) -- If you are a woman of color, you may already know: Your hair can be an issue.

No, it's not your imagination or vanity working overtime, says Amy McMichael, MD, professor and interim chair of dermatology at Wake Forest Baptist Medical Center.

"There is some sort of innate fragility," McMichael says, referring to the hair of African-American women.

That fragility can result in breakage and hair loss, what doctors call alopecia, she says. She presented an update on hair loss and other issues in people of color at the annual meeting of the American Academy of Dermatology held here.

There is much you can do, however, to boost your hair health, she says. Here, she shares her healthy hair tips with WebMD.

1. Hair Loss Is Common in African-American Women

Hair loss is a common reason that women of color see a dermatologist, says McMichael.

She and her colleagues discovered that when they looked at a national database, the National Ambulatory Medical Care Survey, to find the top reasons for visits to dermatologists by African-Americans.

"Alopecia was right up there in the top 10," she says. It was reason No. 7 to see a dermatologist.

2. Kinds of Hair Loss That Affect African-American Women

By looking at where the hair loss occurs, doctors can sometimes decide how it occurs and what kind of hair loss it is.

For instance, braiding too tightly can lead to alopecia, McMichael says. "It is usually a clinical diagnosis made by physical exam," she says. Hair loss usually occurs on the front, temples, and back of the scalp.

Your doctor may take a biopsy to help get the diagnosis correct.

Another type of hair loss is called CCCA -- short for central centrifugal cicatricial alopecia. It can cause scarring on the front and crown of the scalp, McMichael says. It can be inflamed and the scars can be severe, she says.

The exact cause of CCCA is not known, but some experts believe it may be linked with long-term use of chemical hair treatments, such as chemical hair straighteners.

3. African-American Hair Is Unique

Dermatologists have found that the hair shaft of African-American women is structurally different than the hair shaft of women of other races, McMichael says.

The hair shaft is flatter, she says, compared to that of Asian or white women.

In another study, McMichael surveyed 30 African-American women and 30 white women. While 60% of African-American women said their hair was too dry, 67% of Caucasian women said their hair had normal moisture.

That dryness can result in breakage, she says. African-American women are more than three times as likely as white women to have hair shaft breakage, she says.

When McMichael sees a patient with hair loss or breakage, she first rules out other potential problems, such as thyroid disorders. Hair loss is linked to problems with thyroid function.

Often, she says, no underlying medical reason is found. "This is very disturbing to patients, I find. They wish there was some underlying disease and they could take a pill."

4. How to Improve Hair Health

Women can take several steps to improve their hair, McMichael says.

If you have breakage of your hair, McMichael suggests this hair care regimen:

  • Shampoo with a gentle, cleansing shampoo.
  • Use a gentle hair conditioner, ideally a leave-in product.
  • Use a silicone-coating product. (Look for an ingredient such as dimethicone.)
  • Use also an everyday, leave-in conditioner.

This regimen can be good for everyone, even without breakage, she says.

When your hair is especially fragile, she suggests taking a holiday from relaxers, color, or both.

Relaxers aren't the enemy, she says. But a holiday might make all the difference. (For children, relaxers should not be started until after puberty, if possible, she says.)

If your hair is fragile, decrease the use of heat, she says. Take a break from flat irons if there is breakage, McMichael says.

Watch the tightness of braids, she says, as that can hurt hair. "If your hair is braided so tightly it hurts when you chew," she says, "it's probably too tight."

McMichael reports serving as an investigator for Allergan, Intendis, Procter & Gamble, and Abbott. She is a consultant for Procter & Gamble, Johnson and Johnson, Stiefel, Allergan, Galderma, and Guthy-Renker.

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SOURCES: Amy McMichael, MD, professor and interim chair of dermatology, Wake Forest Baptist Medical Center, Winston-Salem, N.C. Annual meeting, American Academy of Dermatology, San Diego, March 16-20, 2012.

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