Daree Allen Nieves, a Chesapeake, Virginia native, has suffered from an itchy, irritated scalp for many years. Her hair became irritated when she began to straighten her tightly curled hair. She explains that she started taking relaxers at the age of 13.
In her late twenties, she started seeing a dermatologist every other month — first a black doctor and then a white one. Each doctor prescribed several treatments for skin irritation and dermatitis. Even after giving her hair a “big chop”, she still had problems with her scalp.
She says she has never been offered a solution or cause for her problems.
Allen Nieves’ experience with hair is not unusual. Tightly coiled black hair can be very fragile and require lots of care. However, sometimes products and treatments can cause more harm than good. Many people may experience flaky scalps, slow growth, or progressive hair loss. However, they don’t know what to do.
Although it may seem natural to go to a stylist to get a haircut or to buy hair supplements, believing that this will help your hair grow faster, the truth is that you should visit a dermatologist who has experience treating Black scalp problems.
Candice Heath MD, a Black dermatology professor at Temple University, Philadelphia, says that trying to fix these conditions yourself, ignoring them or covering them up can only make them worse. Most dermatologists in the United States are not trained to recognize Black skin conditions. They also don’t have any personal experience.
Dermatologists may not be qualified to treat Black patients with tight-coiled hair.
Dr. Heath answers a question about when she sees a Black patient with scalp problems.
Patients must advocate for their healthcare due to the absence of culturally competent dermatologists. It can begin with a greater awareness of the symptoms of many scalp conditions that are particularly prevalent in Black people, such as traction alopecia and trichorrhexis, allergic contact, and seborrheic dermatology.
What is Traction Alopecia?
Traction alopecia refers to hair loss caused by repeated trauma to the scalp due to styling. This is a problem that affects Black women, as well as anyone who wears their hair in tension-producing styles, such as military personnel or ballerinas. Traction alopecia can occur at any age, even in children.
Heath explained that people often talk about losing their edges on social media. However, they are talking about traction alopecia (hair loss from tension) which is most common around the front edges. This alopecia is more common in people with tight braids or ponytails.
Many people react to traction alopecia by trying to hide their thinning hair by using braids and extensions. This can make it worse and lead to hair loss.
Treatment for Traction Alopecia
Heath says that traction alopecia can be reversed very quickly. Heath states that if tight hairstyles can be changed to allow for looser hairstyles, it may be possible to restore your hair. It depends on the damage to your hair and how quickly it grows.
It is possible to reduce the use of chemicals and heat during styling.
According to the Skin of Color Society, a dermatologic non-profit group, a dermatologist might prescribe topical steroids or antibiotics to reduce inflammation. More severe cases of traction alopecia may require oral antibiotics or steroid shots to stimulate hair growth.
Heath states that traction alopecia can be difficult to treat in certain cases. She says that the problem occurs when people keep doing tight hairstyles for many years. Then, permanent scarring can occur because these habits are not changed quickly enough.
What is Trichorrhexis Nodosa, Anyway?
Trichorrhexis Nodosa refers to recurrent hair breaks caused by overuse of heat tools, tight styling, dyeing, excessive washing, or not washing enough. It can appear that the hair isn’t growing, but in reality, it’s growing faster than it’s growing.
Crystal Aguh, MD, is the director of the Ethnic Skin Program at Johns Hopkins School of Medicine. She explains that although many dermatologists might not treat this condition, she still sees at most one case per week.
Trichorrhexis Nodosa may look like thin hair or a visible scalp after prolonged breakage. Itchy scalps can also appear red, inflamed or sore. Some hairs may appear to never grow, particularly at the nape. Patients may notice white nodes along the hair shafts that are split.
These conditions may be exacerbated by stylists who call certain hairstyles “protective” and promote them to people with natural hair. Dr. Aguh says natural hair is often embraced with a looser curl pattern. This can increase the chance of breakage and make it more difficult to maintain, despite the desire for nature.
Aguh says the average person suffering from trichorrhea xis is between 30 and 40 years old. They most likely have curly hair in 4B or 4C and often wear wigs. Heath also suggests that they may have been misdiagnosed as having permanent hair loss by a less qualified physician.
Some hair types like 4C need extra care. Natural hairstyles don’t always work. Aguh suggests that Black women might not be able to moisturize their hair enough. This could lead to hair loss.
According to Aguh’s home remedies for trichorrhea xis, these include shampooing and conditioning your hair more often, applying a protein treatment and adding oil after applying a leave-in conditioner. These are all things that could have been overlooked by someone who wore a wig. A sulfate-free, gentle-sulfate shampoo would be recommended. After a few months, new growth may start to appear.
It is a good idea to limit the frequency of using heat tools. Also, it is advisable only to use heat tools on dry, clean hair. You should wait at least 2 weeks after having your hair waved or relaxed, as these can damage hair.
What is Allergic Contact Dermatitis (Seborrheic Dermatitis)?
Many types of dermatitis can affect the scalp. Allergy contact dermatitis can also be caused by ingredients in hair products such as hair extensions and braids. Seborrheic Dermatitis is caused by an excess of oil and yeast on your scalp. It can lead to dry, scaly patches and redness. Itchy scalp is a hallmark of both types.