Not only is African-American hair unique in appearance, its unique structure makes it especially fragile and prone to injury and damage. More than half of African-American women will cite thinning hair or hair loss as their top hair care concern. Fortunately, dermatologists can offer hair care tips to minimize damage.
BEST PRACTICES/HAIR CARE TIPS:
- Hair should be washed once a week or every other week to avoid build-up of hair care products, which can be drying to hair.
- Conditioners should be used every time hair is washed. Special attention should be paid to the ends, which are the oldest and most fragile part of the hair.
- If you work out regularly, it is a good idea to rinse the hair with water to remove sweat and salt buildup between washings. You can follow with a conditioner. Also, water is good for hair and adds moisture.
- Dr. Gathers recommends hair care products that contain natural ingredients, such as olive oil, shea butter, aloe vera juice or gel, or glycerin, because they help dry hair maintain moisture.
- Shampoos that contain sulfates can be drying for some hair types, especially if hair is washed frequently.
- Conditioners that contain wheat proteins, amino acids, hydrolyzed proteins or panthenol are recommended by Dr. Gathers.
- Hot oil treatments should be used twice per month to add additional moisture and elasticity to the hair.
- Heat protectants should be used on hair after washing and before hair is heat styled to minimize heat damage.
- Relaxers should be applied by a professional hair stylist to ensure they are applied safely and to minimize hair damage.
- Touch-ups with relaxers should not be done too frequently (every eight to 12 weeks to new hair growth is recommended), because they can cause hair breakage. Never apply relaxer to hair that already has been relaxed.
- Ceramic combs or irons should be used when pressing (thermally straightening) hair. It is best to use heat no more than once weekly.
- A straightening device with a dial temperature is preferred to ensure the device is not too hot.
- Braids, cornrows or weaves should not be too tight. If it hurts while hair is being styled, tell the stylist to stop and redo it. Pain equals damage.
- Even the slightest bit of noticeable thinning can be the start of hair loss, so women should see a dermatologist immediately if they notice any changes in the texture or appearance of their hair.
CENTRAL CENTRIFUGAL CICATRICIAL ALOPECIA (CCCA):
Hairstyles can lead to hair loss
- Central centrifugal cicatricial alopecia (CCCA) is the most common permanent form of hair loss seen among African-American women and is thought to be associated with excessive pulling (traction) of the hair, particularly with braided hairstyles.
- Certain chemicals applied to the hair also may play a role in the development of CCCA, but a study conducted by Dr. Gathers found no association between the chemicals used in relaxers and hair loss.
- Although there is no conclusive evidence showing that relaxers can contribute to hair loss, Dr. Gathers noted that most dermatologists would err on the side of caution and recommend that women stop using relaxers, or at least limit their use, if they are being treated for CCCA.
Key is to catch and treat hair loss early
- If not treated early, CCCA can be disfiguring and permanent. Hair follicles are replaced by scar tissue.
- Anti-inflammatory medications, such as intralesional coricicosteroid injections or topical corticosteroids, often are used in combination to treat CCCA.
- Styling the hair differently and avoiding harsh styling techniques sometimes can help slow or reverse the progression of CCCA.
AMERICAN ACADEMY OF DERMATOLOGY EXPERT ADVICE:
“Since African-American hair is very dry, it is important to add moisture to hair by using products that either preserve or add moisture and to avoid hair styling regimens that can remove moisture from the hair,” said Dr. Gathers.
STATISTICS AND FACTS:
- Under a microscope, African-American hair appears elliptical in cross-section and looks like a twisted rod — with frequent twists and random directional reversals.
- African Americans only constitute 13 percent of the nation’s population, but they account for at least 30 percent of all hair care expenditures.
- It has been estimated that hair loss or balding is the fourth-most-common reason for African Americans to visit a dermatologist, so dermatologists often are the first line of defense in helping African-American women with hair problems
Raechele Cochran Gathers, MD, FAAD, senior physician at the Multi-Cultural Dermatology Center of Henry Ford Hospital Department of Dermatology