Caring for Patients: African American Women and our Hair

There was a firestorm over remarks made when a young star Zendaya showed up with thick braids on the red carpet.  She was beautiful but a fashion critic made a thoughtless comment about her Locs.   Lupita Nyong’o and Viola Davis wore natural styles and the Selma director Ava DuVarney wore Locs.

Over the years, I made my own transition from the hot-combed hair of my teen years to the permed hair of my 20’s to 30’s to the transition to my natural hair in 1994. The freedom to start thinking about exercise and worry less about my hair allowed me to run and sweat.

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I have treated my share of what I call “hair catastrophes.” They were due to the common things we black women do to our hair every day.  Burns caused by dropped hot combs and slipped curling irons were serious.  They healed but left scars.  Chemical burns from lye-based and non-lye permanent kits were the most distressing.  The temporary hair loss was heart-breaking for the patient.  Even Oprah Winfrey was a victim.  In the debut of the  first show she is sporting an Afro.  I remember that show. She has talked openly about what happened.

Hair braiding caused hair loss in young girls.  This was caused by pulling the braids too tightly to make a neat row but pulled on the root of the hair so the hairline receded.  This is called Traction  Alopecia. Some women also got severe scalp reaction to the hair used in extension for braids.  It affects the scalp and the face.  I experienced this condition with my braids.  Since that experience, I refuse to add any natural or synthetic hair that isn’t mine to my head.

Hair weaving also has its problems.  If not done correctly, a woman’s own hair can be damaged. Usually corn rowing and adding the hair is the best method.  It has to be cared for by a professional to prevent fungal or bacterial infections of the scalp.

Women also lose hair due to autoimmune diseases.  Patchy hair loss on the scalp or total hair loss from the scalp and body is distressing.  One patient thought she was allergic to her weave but with the help of the dermatologist, we diagnosed Alopecia Universalis.  Alopecia Totalis is hair loss from the scalp alone. This was not the case for her when we noted loss of eyebrows, pubic hair, axillary and hair from the arms and legs.

After menopause, many African-American women develop Alopecia Areata.  This is the same hair loss pattern men develop.  You either wear a wig or just go natural.  The women in my family who have this condition wear wigs.

The debate this week was much-needed.  Everyone weighed in from Solange to Michaela Angela Davis.  The point is that from now on you will see more natural hair because more women of color are breaking barriers and feel free to display non-permed, non-weaved, and non-wigged hair. You will see short afros , natural curls and locs, This is an important change because we are redefining how we talk about beauty especially on the “Red Carpet.” Now, it has to translate into movies and TV. Thanks to Viola Davis in How to Get Away with Murder and  Tracee Ellis Ross in Blackish we are seeing a breakthrough. Lupita Nyong’o in those Lancôme ads is ground-breaking for all women of color all around the world..  As a physician, it is important because of the medical implications.

4 thoughts on “Caring for Patients: African American Women and our Hair

  1. A great read! My friends generally cannot wait to get their hands on my hair, to make it straight and pretty. I remember being told to keep my eyes shut at any costs as a youngster, while my mom slathered a relaxer on my head, quoting my grandmother: “You must suffer to be beautiful.” I also see some of my women relatives dealing with hair loss now. It’s always a hot topic…what’s safe, what’s stylish, and do i dare let my hair be what it is? Thanks for the post!

  2. Bravo! Sing this loud and clear. When I taught, I couldn’t believe the amount of time and money the African American kids (boys and girls) spent on their hair. And yes, my cyclists friends let their hair go naturally– how else would they be able to do what they do? I’ve stopped coloring my hair for the same reasons– exercise– let’s get the message out that beauty comes from being healthy. I wrote a post ages ago about how I wished Michelle Obama would let her hair go natural as a role model to young women.

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