Hair and scalp oils not recommended
Hair and scalp oils not recommended
The common cultural practice can cause scalp problems and should be avoided or limited to the hair shaft away from the scalp (1,085 words, 5.5 minutes)
While the use of hair and scalp oils is common practice among individuals of some cultural backgrounds, the process can have detrimental effects on hair and scalp health. Dr. Renée Beach made that observation during a live discussion at the virtual Colloquium on Black Skin on Saturday, Aug. 21.
The colloquium was presented as part of the Skin Spectrum Summit’s Summer of Dialogue on Black and Brown Skin.
“It is almost a wrestling match of words with patients,” said Dr. Beach. “I think a lot of the time culturally Brown- and Black-skinned patients, especially African diaspora or South Asian patients, are taught that [hair and scalp] oil is essential. They would much rather put oil on their hair, frankly, than shampoo the scalp.”
Dr. Beach practices medical and cosmetic dermatology in Toronto and is an assistant professor at the University of Toronto.
“I have a very frank conversation with patients, and I even draw the pilosebaceous unit,” she said, detailing how she explains the way the scalp’s natural oils lubricate the scalp and first third of the hair shaft.
Adding additional oil to the scalp can cause significant problems, she said. “We think about seborrheic dermatitis, we think about product buildup, we think about itch. And the follow-up for all that is when we are scratching, and we are flaking, we are fracturing the hair shaft.”
Many patients experiencing dry and flaking on the scalp believe they then need to apply further oil to the scalp, which continues the vicious cycle, Dr. Beach said.
For patients who insist on using hair oil, Dr. Beach had some recommendations:
Apply it only to the mid- or distal hair shaft to provide some resilience against breakage.
Lighter, less-dense oils such as Argan oil or almond oil are recommended.
If an individual is going to apply hair oil, they also have to be prepared to shampoo it off to prevent buildup—shampooing the scalp weekly in tightly-curled, afro-textured hair, or more frequently in straighter hair types.
Bottom line:
The buildup of hair and scalp oil products on the scalp can start a vicious cycle of itching, flaking, and further oil application. The skin’s natural oil is all that is needed for the scalp and proximal hair shaft. If patients insist on applying hair oil for cultural reasons, it should be used away from the scalp, and the scalp should be shampooed regularly.
From the literature on hair and scalp dermatology
Does scalp cooling have the same efficacy in Black patients receiving chemotherapy for breast cancer?
The authors of this study note that the Paxman scalp cooling (SC) device is the U.S. Food and Drug Administration (FDA)-approved to prevent chemotherapy-induced alopecia, with the literature reporting 50% to 80% success rates and high patient satisfaction. However, there have been no studies of SC in Black patients. This phase II feasibility study investigated Paxman SC in Black patients receiving chemotherapy for stage I-III breast cancer. The study intended to enroll 30 participants but was stopped after 15 due to a lack of efficacy—only one participant could prevent significant hair loss. At the same time, the other 14 lost more than 50% of their hair.
Central centrifugal cicatricial alopecia: Challenges and treatments
This review article examines the recent research on central centrifugal cicatricial alopecia (CCCA). The authors note the existing research supports the idea that many factors contribute to CCCA, including genetic variations, hair grooming practices, and associations with other systemic conditions. They also review recommended treatment approaches.
A retrospective cohort study and clinical classification system of acne keloidalis nuchae
The authors of this paper set out to develop a systematic classification system for acne keloidalis nuchae (AKN). To accomplish this, they looked at data from 108 men who had been diagnosed with AKN between July 2009 and Nov. 2020 in an outpatient dermatology setting. Working from this data they developed a three-tier classification system for AKN based on: lesion distribution, lesion type, and the presence or absence of folliculitis decalvans or dissecting cellulitis.
The use of natural ingredients in the treatment of alopecias with an emphasis on central centrifugal cicatricial alopecia: A systematic review
This literature review examined papers evaluating treatment of alopecia—including central centrifugal cicatricial alopecia (CCCA)—with natural ingredients. Specific ingredients included azelaic acid, peppermint oil, pumpkin seed oil, garlic supplements/shampoo, Black castor oil, jojoba oil, argan oil, olive oil, horsetail plant oil, lavender oil, coconut oil, chamomile oil, thyme oil, tea tree oil, sulphur oil, menthol, and rosemary oil. The review authors found no clinical trials that evaluated the treatment of CCCA with natural ingredients. Some evidence of efficacy was seen for several natural ingredients in treating alopecia areata, androgenetic alopecia, and psoriatic alopecia.
VIDEO: Hair and Scalp Disorders in Patients of Color
At the intersection of skin and society
A new Indigenous futurism exhibit titled Rooted and Ascending has opened at the Prince of Wales Northern Heritage Centre in Yellowknife, NWT.
According to a report by the CBC, the exhibit will showcase art pieces that project their creator’s culture into the future, in contrast to expectations that those cultures are static in forms from the past.
“Indigenous futurism is like creating artwork like either fashion, comic books, graphic design [or] video games with the intent of projecting what culture or what people would look like in the future based on basically sci-fi,” Davis Heslep, technical coordinator for Western Arctic Moving Pictures, and one of the collaborators on the art installation told the news outlet.
He said that Indigenous futurism is a social and cultural movement that celebrates the power of imagination, technology and self-determination.
“It's really challenging us further in our imagination, which I think is a really important thing when we're talking about being self-determined as Indigenous people in our communities,” added the exhibit’s curator, Melaw Nakehk'o.
The Indigenous Futures Exhibit includes works from Kablusiak, Margaret Nazon, Riel Stevenson Burke, Robyn McLeod, Siku Allooloo, Casey Koyczan and Cody Fennel.
It will be on display at the museum until the end of November 2021.
Something to think about in the week ahead...
Looking Ahead
This week on Tuesday, Sept. 21, Drs. Rachel Netahe Asiniwasis and Jaggi Rao will be hosting a Zoom webinar on the practical management of atopic dermatitis (AD) in Canada’s Indigenous communities. The webinar will begin at 7:00 p.m. and run to 9:00 p.m. EST.
Topics to be covered include the pathophysiology of AD, the current treatment landscape and related challenges to treating Indigenous patients, and how to practically manage AD in this population.
Physicians and other health care practitioners are invited to register for the webinar using this link.