Dr. Renée Beach provides five tips for managing Afro-textured hair
The dermatologist offers guidance on protective hair styles, avoiding build-up on the scalp and identifying hair disorders early (1,200 words, 6 minutes)
Maintenance of Afro-textured hair involves different needs and steps than straight hair. To help simplify this maintenance, Dr. Renée Beach provided her top five tips for caring for this type of hair during the 7th annual Skin Spectrum Summit presentation on Nov. 6. Dr. Beach practices medical and cosmetic dermatology at DermAtelier on Avenue in Toronto, and is an assistant professor at the University of Toronto.
Less is more with Afro-textured hair
The curlier, kinkier nature of Afro-textured hair makes it more prone to becoming dry, particularly from one inch above the scalp to the end of the hair shaft, said Dr. Beach. Because of this, she notes that washing and styling this type of hair once a week will reduce snagging and breakage.
Hair products should also be kept away from the scalp, Dr. Beach noted. In Afro-textured hair, products are less likely to travel along the hair shaft to improve suppleness. Instead, if applied to the scalp, they will accumulate there and contribute to the risk of seborrheic dermatitis.
Dry scalp is not a diagnosis
The sort of dry, flaky scaling colloquially called dry scalp is typically seborrheic dermatitis. Therefore, the way to address this condition is to manage the yeast, typically with medicated shampoos for at least four weeks, twice a week. Patients may add conditioner to the shampoo to reduce hair drying.
Protect hair from breakage at all costs
Afro-textured hair is brittle, and steps should be taken to prevent breakage. Dr. Beach recommended hairstyles where the ends of the hair shaft are turned inward and protected by the rest of the hair. Extensions should be limited to no more than doubling the length of existing hair and should not be attached using any glue or adhesives, she said. Protective styles such as braids and crochets should be removed within two months, gently, with the aid of hair conditioners or other products to aid slippage, Dr. Beach said.
Treat hair like a silk scarf to avoid traction alopecia
“The first line [defense] for traction alopecia is adherence to low tension, traction-free hairstyles,” Dr. Beach said. “For example, micro braids are beautiful, but they need to be installed in a way that does not pull on the hairline or any other parts of the scalp.”
Where patients maintain low-traction hairstyles but remain concerned about traction alopecia, Dr. Beach noted that one option is to use off-label topical 5% minoxidil foam for roughly six months in the affected area.
Symptoms of central centrifugal cicatricial alopecia (CCCA) do not necessarily correlate with disease severity
Dr. Beach emphasized that effective management of CCCA, which has a strong genetic component, depends on early detection to avoid expansion and to avoid further hair loss. She also presented several treatment approaches to managing CCCA.
Bottom line
To protect patients’ fragile Afro-textured hair, recommend styles that shelter the ends of the hair shaft, protect the scalp by avoiding product build-up and styles that apply excess tension to the scalp. Early signs of scalp disease and hair loss should be acted on quickly, with recommendations and if necessary, prescriptions to help patients retain hair longer.
From the literature on Afro-textured hair
Counselling about traction alopecia: A "compliment, discuss, and suggest" method
The authors of this paper note that understanding cultural hair care practices, the importance of timely diagnosis and discontinuation of high-risk hairstyles are essential for preventing traction alopecia from progressing to scarring alopecia. To support communication between physicians and patients regarding traction alopecia, this paper presents a method for discussing this hair loss condition in what the authors describe as an empathetic and culturally sensitive way.
Malignant proliferating trichilemmal tumour: A subtle presentation in an African American woman and review of immunohistochemical markers for this rare condition
This is a case report of a 46-year-old African American woman who presented with an ostensibly benign cyst on her scalp. Histopathological examination revealed the lesion to be a malignant proliferating trichilemmal tumour (MPTT). The authors describe these lesions as the malignant counterpart of a benign proliferating trichilemmal cyst, a keratin-filled lesion derived from the outer hair root sheath.
The paper’s authors use the case to discuss how the clinical appearance of MPTTs does not always correlate with the lesions’ histological behaviour. They review the immunohistochemistry markers for MPTT reported in the literature.
Review article: Emerging issues in pediatric skin of colour, part 1
This is the first of two articles reviewing recent literature on skin-related issues of high concern among children with skin of colour. Among the topics covered in this paper are hairstyling and hair-related concerns, including traction alopecia, central centrifugal cicatricial alopecia, and hair[RAR3] loss due to endocrine disruption. It also touches on infectious conditions, including tinea capitis infection.
An in silico approach to the identification of potential proteomic and genomic diagnostic biomarkers for primary cicatricial alopecia
The authors of this paper note that the cause and pathogenesis of primary cicatricial alopecias (PCAs) are not clear. They also add that histopathological examination of biopsies generally does not add to diagnosis and patient care, as most clinicians can diagnose these lesions using scalp distribution examination.
To address this limitation, the researchers explore the possibility of using an in silico approach to identify potential diagnostic biomarkers for PCA in a way that has previously been used for other dermatologic conditions.
VIDEO: Hair loss in women of colour: Central centrifugal cicatricial alopecia
At the intersection of skin and society
A new art history publication titled “War Art in Canada, a Critical History” looks at art and artifacts related to conflict, beginning thousands of years before European contact. It is available online at https://www.aci-iac.ca/art-books/war-art-in-canada/
The publication is written by Laura Brandon, a historian of art and war at the Canadian War Museum from 1992 until 2015.
“Art, like history, tends to favour the victorious, so, until recently, the bulk of Canadian war art has reflected Western traditions and genres at the expense of Indigenous expressions,” Brandon writes in the preface. “This book attempts to redress the balance.”
The publication is in four chapters: Historical Overview, Key Works, Critical Issues, and Materials and Techniques.
Each of the first two chapters covers three time periods, the first of which includes Indigenous art objects as well as the colonial military art in New France and British North America from the pre-contact period to the South African War (1899–1902).
The third chapter, Critical Issues, examines official war art, exhibitions, memorials, identity, women, Indigenous representation, propaganda, protest, violence, and religion in the context of military art.
This week
November is National Native American Heritage Month in the US
Nov. 18 to 24 is World Antimicrobial Awareness Week
Nov. 20 is World Children’s Day
Something to think about in the week ahead…
Next week
Our coverage of the 7th annual Skin Spectrum Summit, held on Nov. 4 and 6, continues. Next week, look for current information on acne in skin of colour from Dr. Renita Ahluwalia.
Recordings of the Summit presentations will soon be available for registered delegates.
Registration will also soon open for the 2022 Indigenous Skin Spectrum Summit, which will be held on June 11, 2022.
Please watch this space for more details.