Hair Care Practices Research Articles

Knowledge of Traction Alopecia and Hair Care Practices among Adolescents in Keffi, North-Central Nigeria

Background: Traction alopecia (TA) is the commonest cause of hair loss among women, with a prevalence of 46.2% in Nigeria. Adequate knowledge and good hair care practices can assist in its prevention. Objective: The aim of this study was to determine knowledge of both TA and hair care practices among adolescents in Keffi, Nigeria. Methods: This was a cross-sectional survey conducted among 333 female adolescents in 3 senior secondary schools between November 2019 and February 2020. The participants were randomly selected and interviewed using a questionnaire which sought information about the knowledge of TA and hair care practices. The data were analysed using SPSS 25 statistical software. Results: Overall, the knowledge score was poor in 61.4% of the adolescents. Hair plaiting 86.8% (289/333), use of chemical relaxers 68.8% (229/333), and use of hair covers 88.3% (294/333) were the predominant hair care practices. In total, 90.8% had concurrently relaxed and plaited their hair. Cornrows with own hair were the commonest hair grooming style. The use of hair attachments was believed to be the commonest cause of TA. The use of hijab was the commonest form of hair cover used. Conclusions: The knowledge of TA is poor among female adolescents. A large number engaged in risky hair care practices. Interventions to reduce the knowledge gap will reduce the prevalence of TA. Key Message: The knowledge of traction alopecia is poor among female adolescents in Keffi who engage in traumatic hair practices.

28647 Rice products in hair growth

Introduction: Rice bran extracts (RB) derived from Oryza sativa are part of cultural skin and hair care practices in Asia. Cosmetic hair products containing O sativa and its derivatives are heralded to enhance hair growth with limited scientific evidence.

Hair-Loss Perceptions and Treatment Expectations in Young People of Color.

While much research has been dedicated to hair loss in older patients, little has addressed hair loss perception and treatment expectations among young people of color (POC). This study evaluates disease perceptions, willingness to utilize specific therapies, and treatment expectations in younger versus older POC with any form of hair loss. An online survey was utilized to analyze 217 responses to 37 questions assessing perceptions of hair loss, hair care practices, and treatment expectations among others. These parameters were measured on a 1–5 Likert scale. Comparison between groups was be done using Chi-Square tests for proportions and Student t-tests. Included were 52 respondents between the ages of 18 and 29 (POC<30), and 36 respondents greater than 30 years of age (POC>30). The reported average hair loss in POC<30 was 67.0%, compared to POC>30 reporting 60.0% (P<0.05). Average embarrassment was 2.6 for POC<30 versus 3.4 for POC>30 (P<0.001). Average pain was 2.0 for POC<30 versus 1.8 for POC>30 (P<0.05). Average hair thinning was 3.0 for POC<30 versus 3.7 for POC>30 (P<0.001). Average willingness to use topical treatments including creams, solutions, ointments, and gels was 3.0 in POC<30 versus 3.8 in POC>30 (P<0.001). The average perceived effectiveness of topical treatments was 2.9 in POC<30 versus 3.6 in POC>30 (P<0.01). Early identification and appropriate management of young POC with hair loss may facilitate follicular rescue. This, in turn, may help reduce the negative consequences of advanced hair loss, such as embarrassment, as seen in older POC. J Drugs Dermatol. 2021;20(7):746-750. doi:10.36849/JDD.5960.

Counseling About Traction Alopecia: A "Compliment, Discuss, and Suggest" Method.

Traction alopecia (TA) remains a common concern for Black women visiting a dermatologist. Understanding cultural hair care practices, timely diagnosis, and discontinuation of high-risk hairstyles are essential for preventing TA from progressing to scarring alopecia. This dialogue might be difficult for hair-discordant physicians and patients because of a lack of training and shared experiences. We present an empathetic and culturally sensitive method for discussing TA with patients.

Commonly Used Over the Counter Therapies for Hair Growth in Skin of Color: An Evidenced-Based Review.

Given the immense psychosocial effects of hair loss as well as patient preference for treatment type, it is common for patients to turn to alternative medicine to improve their conditions. However, the commonly used alternative treatments can vary greatly between patients and particularly among skin of color populations. In this work, we performed a scoping review of the evidence behind alternative topical treatments for hair loss used by skin of color patients. Methods & Materials: We conducted a comprehensive search using PubMed to identify relevant studies. Results show a diverse variety of hair growth products used; however, only a few are supported by randomized controlled trials, case reports, pilot studies, and animal studies with some important limitations. This information will be exceedingly useful for physicians so they may relay accurate evidence on these haircare practices to their skin of color patients. J Drugs Dermatol. 2021;20(7):726-731. doi:10.36849/JDD.5689.

Treating Afro hair loss: signs, symptoms and specialist interest

This article explores the different types of hair loss that black women may experience more than other groups of patients. Properties of African hair and the impact of hair care practices are discussed, as well as factors affecting the presentation of other hair loss conditions.It is important for the aesthetic practitioner to be able to distinguish between the temporary forms of hair loss that they can help to treat and the permanent or scarring forms of hair loss, which need a prompt referral to a dermatologist with a specialist interest in hair. Prompt recognition and referral can help to delay the progression of hair loss.The symptoms and signs that patients and practitioners should be alerted to are explored, as well as the treatments that can help and where referrals may be necessary. Recent developments and gaps in knowledge are summarised.

Hair Loss in Foreign Medical Students and Alter its Intensity during the Covid-19 Pandemic in Georgia

The current millennial and generation Z are known to experience more stress than any generation before them. A fraction of individuals belonging to these generations is current foreign medical students, where medicine is known to be one of the stressful courses one can study. When this extreme stress is meet with genetic predisposition, nutritional deficiencies, internal diseases, and inappropriate hair care practices hair loss can be quite aggressive. An online survey consisting of 15 questions was conducted to find if these factors contribute to foreign medical students experiencing hair loss at a very young age and if the current chaotic environment of the covid-19 pandemic has accelerated hair loss. 81.7 %( n=156) foreign medical students belonging to ages 17 to 25 years started to experience hair loss (p= 0.0127), where stress (54.5 %( n=85)), nutritional deficiencies and internal conditions (37.5 %( n=58)) have been responded to be contributing factors for their condition. Interestingly, 54.5 %( n=85) students are experiencing hair loss after moving to Georgia (p=0.04). Despite all the acknowledgment of cause for their conditions, 92.3 %( n=144) of foreign medical students have responded to not undergo any treatments to manage and control hair loss. Additionally, 33.3 %( n=52) of students stated that they have noticed more progression in hair loss during this pandemic. If these students continue to ignore undergoing treatments then they might experience more progression in hair loss.

Traction alopecia among adolescents in Keffi, Nasarawa State, Nigeria

Background Traction alopecia (TA) is common among women of African descent. There is limited information on the etiology and predisposing factors for TA among adolescents in Nigeria. This information is fundamental in changing hair grooming habits, which result in the development of TA in adult women.Objective To determine the prevalence, pattern, trichoscopic features, and risk factors for TA among adolescents in Keffi, Nasarawa State, Nigeria.Patients and methods This was a cross-sectional study among 333 adolescents selected from secondary schools in Keffi. The students were interviewed to determine their hair care practices and symptoms of TA. The participants were examined for the presence of TA, and trichoscopy was done for those with TA. The data were analyzed using SPSS 25 Statistical software.Results The prevalence of TA was 15.1%. The temporal pattern (54.9%) was the commonest pattern. The trichoscopic features were the presence of peripilar casts (45.1%) and perifollicular halos (43.3%). TA was associated with many variables, but the identified risk factors after logistic regression were frequency of relaxing the hair (P=0.022), duration of covering hair (P=0.022), family economic status (P=0.023), and self-reported presence of dandruff (P=0.001).Conclusion TA occurs among adolescents in northern Nigeria. Increased frequency of relaxing the hair increases the risk of having TA, whereas the use of head scarfs reduced the chance of acquiring it. Further studies are required to evaluate the effect of hair covers on TA.

A clinical study of hair manifestations in cancer patients on chemotherapy

Introduction: There has been an increase in cancer related morbidities; a significant part of it being related to therapies. Chemotherapy targets rapidly growing cells like skin, hair follicles and nail matrix. Hence a significant number of adverse effects are related to the skin and its appendages. Several factors may contribute to the severity of hair loss including the drug, dosage, schedule as well as hair care practices. Aim: To determine the frequency and significance of hair manifestations in patients on cancer chemotherapy. Materials and Methods: A total of 50 patients attending the oncology outpatient department or those admitted in the oncology ward Yenepoya Medical College Hospital, Mangalore between June 2017 and August 2017 were studied. All hair diseases, frequency and type of hair loss among patients were documented. Findings were tabulated and correlated with the cancer and the chemotherapy. Results: Hair changes were mainly in the form of diffuse alopecia in 68%, anagen effluvium was seen in 52% patients. Conclusion: Though the adverse effects on hair are not serious, it can cause considerable anxiety to the patient. Hence prior counselling regarding the same needs to be advocated to improve the quality of life of the patient. Keywords: Chemotherapy, Anagen Effluvium, Quality of life.

Hair Maintenance and Chemical Hair Product Usage as Barriers to Physical Activity in Childhood and Adulthood among African American Women.

Qualitative studies have identified haircare practices as important culturally specific barriers to physical activity (PA) among Black/African American (AA) women, but quantitative investigations are lacking. Using the Study of Environment, Lifestyle and Fibroids data among 1558 Black/AA women, we investigated associations between hair product usage/hair maintenance behaviors and PA during childhood and adulthood. Participants reported childhood and current chemical relaxer and leave-in conditioner use. Self-reported PA included childhood recreational sports participation, leisure-time PA engagement during adulthood, and, at each life stage, minutes of and intensity of PA. Adjusting for socioeconomic and health characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each PA measure for more vs. less frequent hair product use/hair maintenance. Thirty-four percent reported ≥twice/year chemical relaxer use and 22% reported ≥once/week leave-in conditioner use at age 10 years, and neither were associated with PA at age 10 years. In adulthood, ≥twice/year chemical relaxer users (30%) were less likely (PR = 0.90 [95% CI: 0.79–1.02]) and ≥once/week leave-in conditioner users (24%) were more likely (PR = 1.09 [95% CI: 0.99–1.20]) to report intense PA compared to counterparts reporting rarely/never use. Hair product use/maintenance may influence PA among Black/AA women and impact cardiometabolic health disparities.

LB962 Evaluation of time of presentation of central centrifugal cicatricial alopecia and outcomes of disease

Background: Central centrifugal cicatricial alopecia (CCCA) is a form of scarring hair loss that predominantly affects women of African descent. Although the etiology remains unknown, the pathogenesis involves inflammatory mediated destruction of the hair follicles. The management of CCCA is approached symptomatically rather than through evidence-based recommendations. Since treatment options do not provide a cure and are only aimed at halting disease progression, it is important to understand how time to presentation and symptomatology relates to treatment outcomes. Objective: To assess the relationship between the presentation and symptomatology of CCCA and the outcome of disease. Methods: We retrospectively reviewed the complete medical records of patients seen at the Wake Forest Dermatology Clinic from January 2014-December 2019. Data obtained from the chart review included duration of hair loss reported by the patient and by the provider, duration & type of symptoms, hair care practices, common co-morbid conditions, exam findings, prior treatments and treatments after diagnosis. Treatment outcomes were assessed 1 year after treatment using the Central Scalp Alopecia Photography Scale. Results: A total of 100 patient records were included in this review. Patients’ ages ranged from 26-74. The duration of hair loss ranged from 6 months-25 years. The mean duration of hair loss reported by patients was 6.8, while the mean duration of hair loss reported by the provider was 6.5 years. Symptom duration ranged from 0-16 years, with an mean duration of 4.2 years. History of thyroid disease, sitting under hot dryers, wearing natural hair, use of braids, washing hair once weekly, and scaling were found to have a statistically significant effect on the outcome of treatment. Conclusion: CCCA is a form of scarring alopecia that is progressive in nature. The findings indicate that some factors can have a significant effect on treatment outcomes. This study provides information that can be used to guide treatment approach and inform patients on disease prognosis.

Sweat and Hair: Online Interventions for Improving Physical Activity in African-American Women

Objective: To evaluate the efficacy of an informational website in improving patient knowledge on hair care and exercise. Design: Pre- and post-exposure surveys, focusing on exercise and hair care practices, were administered to subjects after 1 h of browsing a dermatologist-designed hair care and exercise website. Setting: Winston Salem State University, a historically Black university in North Carolina, USA. Participants: 22 African-American women (AAW) aged between 18 and 54 years. Measurements: The outcome measures of the study include patient demographics, hair care practices, knowledge of hair/care disorders, exercise habits, and website feedback. Results: There were 22 women enrolled in the study with 95% identifying as African-American. The average age was 28 ± 12 years. A total of 80% (16/20) of subjects reported exercising less than 150 min per week, and 36% of these patients reported modifying their hairstyle to accommodate physical activity. 85% learned new information about hair and scalp disorders from the educational material on the website, and 81% had increased understanding of their hair health. 91% reported that they would return to the website. Conclusion: An informational website can be an effective tool to educate AAW on hair and scalp disease, as well as appropriate hair care practices and fitness goals.

Primary Care Provider Understanding of Hair Care Maintenance as a Barrier to Physical Activity in African American Women.

African American (AA) women have reported hair maintenance as a barrier to regular exercise; however, to our knowledge, this study is the first to identify primary care provider thoughts, attitudes, beliefs, and knowledge regarding hair as a barrier to increased physical activity among AA females. A 13-question electronic survey was sent via email to 151 clinicians working within a department of family medicine's 8 ambulatory clinics within a large urban academic medical center. A total of 62 primary care clinicians completed the survey, which is a response rate of 41%. The vast majority of respondents (95%) sometimes/often engage in discussions with AA female patients regarding physical activity. However, 76% of respondents have never included a hairstyling or maintenance assessment in that discussion and only 34% noted being comfortable discussing this topic. Among a list of potential barriers to exercise, hair maintenance/scalp perspiration was rarely endorsed as important by clinicians. This study highlights a need for increased education among primary care providers regarding AA hair care and maintenance practices as a barrier to increased physical activity in AA women. If specific barriers to increasing healthy habits among AA women are to be addressed, there must be a baseline knowledge of hair care and maintenance barriers, an understanding of the strong influence of cultural norms and practices as it relates to physical activity and exercise, and an increased comfortability when engaging in difficult cross-cultural conversations to ultimately improve health outcomes in AA females.

Clinical recognition and management of alopecia in women of color.

Certain types of alopecia, such as traction alopecia, discoid lupus erythematosus, and central centrifugal cicatricial alopecia, occur more commonly in African-American individuals than in those of other ethnicities. Both intrinsic hair qualities and hair care practices play a role. Lower baseline tensile strength, hair density, and growth rates, as well as the use of high-tension hairstyles and chemical relaxers may contribute to alopecia in this group. Alopecia can also occur as a result of discoid lupus erythematosus, which involves chronic lymphocytic infiltration and eventual scarring of the hair follicle. Lichen planopilaris is a less common cause of scarring alopecia that can appear clinically similar to other forms of cicatricial alopecia. Lastly, although not classically associated with hair loss, recent evidence indicates that seborrheic dermatitis may play a role in shedding and alopecia. Recognizing and differentiating these alopecic subtypes clinically and histopathologically is important for prompt diagnosis and treatment. This article is based on a chapter in Ethnic Skin and Hair, and intended as a supplemental article to “Current and Emerging Treatment Strategies for Hair Loss in Women of Color.”

Hair care practices, scalp disorders and psychological effects on women in Nigeria

Hair care practices, scalp disorders and psychological effects on women in Nigeria

“Hey Curlfriends!”: Hair Care and Self-Care Messaging on YouTube by Black Women Natural Hair Vloggers

Black women with tightly coiled hair are faced with the unique health challenge of abstaining from exercise or other self-care behaviors to maintain hairstyles that are often expensive, time consuming, and conform with Eurocentric standards of beauty. However, recent YouTube natural hair vlogs have emerged to provide a counter-narrative on “do it yourself” hair care practices for highly textured hair. Through a thematic content analysis of the top 20 viewed natural hair YouTube vlogs, findings suggest that Black women vloggers demonstrate product selection through detangling, shampooing, moisturizing, and styling their tightly coiled hair on camera, using their own lived experiences, as both peer and expert to viewers. These vloggers took the role of digital storytellers to describe their personal experiences with self-care in the forms of exercise, eating healthy food, drinking water, medication use, and stress management while maintaining healthy and stylish natural hair. Black female natural hair vloggers disrupt the myths about tightly coiled natural hair and are credible conduits for the distribution of health information aimed at reaching large masses of Black women through sisterhood supported wellness.

Collecting Hair Samples for Hair Cortisol Analysis in African Americans.

The hormone cortisol is typically assessed in saliva, serum, or urine samples. More recently, cortisol has been successfully extracted from hair, including humans. The advantage of hair cortisol concentration is that it reflects a retrospective representation of hypothalamic-pituitary-adrenal (HPA) axis function over time, much like hemoglobin A1C represents glycemic control. However, obtaining hair samples can be challenging, due to the cultural beliefs and hair care practices of minority participants. For example, African Americans may be reluctant to provide samples. Additionally, few researchers are trained to collect hair samples from African Americans. The purpose of this paper is to present a culturally informed protocol to help researchers obtain hair samples from African Americans. To illustrate the representative results of this protocol implementation, de-identified data from African Americans that participated in a community-based study on chronic stress are provided. Hair practice preferences are assessed. The participants are made comfortable by showing pictures of hair samples prior to cutting their hair. The single strain twist and gently pull method is used to collect approximately 30 - 50 strands of hair from the posterior vertex region of the scalp. This protocol will significantly improve collection of hair samples from African Americans.

“Going natural”: Black women’s identity project shifts in hair care practices

ABSTRACTHair care, a seemingly mundane consumption practice, is packed with sociocultural meanings and constitutes an important realm of identity work for consumers. Drawing upon existing literature on consumer identity projects, this paper investigates the experiences of urban, Black women in Kenya as they disengage from the normative practice of altering their natural hair texture using chemical straighteners (a practice that conforms to Eurocentric beauty ideals of straight, flowing hair), and adopt the non-normative hair care practice of “going natural,” in which they embrace their natural hair texture and hairstyles. This paper traces the historical, sociocultural, and political events that underpin the normative ideology associated with the identity marker of natural Black hair, and how this ideology influences the women’s “going natural” experience. Findings reveal tensions that emerge in the women’s identity project disengagement and reconstruction process, and how the women navigate their position as they reimagine their embodied identity quest.

‘So long as there's hair there still’: displaying lack of interest as a practice for negotiating social norms of appearance for older women

ABSTRACTAlthough women's appearance is theorised as being central to their identity and social currency, much prior research has argued that as women age, other aspects of their lives assume a higher priority than their appearance. Nevertheless, they continue to invest time in appearance practices. In undertaking these various appearance practices, older women have to negotiate a range of conflicting social norms of age-appropriate appearance, such as managing the balancing act between ‘letting themselves go’, on the one hand, and looking like ‘mutton dressed as lamb’, on the other. This paper contributes to the growing literature on older women's attitudes to their appearance and related practices. Drawing on data from a two-year research project in a hair-salon catering primarily for older clients, I examine the question of the importance to women of their appearance through the lens of their hair-care practices. Focusing on a group of nine female clients aged 55–90 in a small hair-salon in southern England, I show how participants in their talk and embodied presentation display shifting orientations of investment/interest (or lack of interest) in their appearance. Comparing participants’ appearance practices, with their talk in two sequential environments in which a possible interest in appearance is made particularly salient, I argue that these shifting orientations reveal participants’ subtle negotiation of competing social norms of appearance for older women.

Defining the impact of attitudes towards hair and hair care practices on physical activity in African American women: A prospective survey study

Defining the impact of attitudes towards hair and hair care practices on physical activity in African American women: A prospective survey study