Hair Today, Gone Tomorrow? Understanding the causes and types of Alopecia in Black women
Remember back when the beauty world screamed in shocked horror at the sight of Naomi Campbell’s receding hairless hairline in those unflattering paparazzi pictures? We will never know the truth, but many believed she was suffering from traction alopecia. Hair loss (alopecia) comes in many forms and is a discomforting experience. Additionally, beating hair loss can be a tall order! We spoke to some experts to give us some insights into the different types and causes of hair loss among black women – and how to fix it.
Excuse the irony of our choice of words, but hair loss amongst black women is a problem, which is always just an inch away. And according to experts, alopecia is often just down to your genes – and therefore inevitable.
But there are a whole host of other factors that come into play, including the fact that we can also often be the main culprits for our own resultant bald or thinning hair patches.
“The term alopecia describes any type of hair loss, with the factors attributing to it also dependent on the type of loss you are suffering from,” explains trichologist Anabel Kingsley. “For example, diffuse alopecia – also known as telogen effluvium – is often due to illness, stress, hormonal imbalances, certain medications and dietary deficiencies. Health conditions such as sickle cell anaemia can also be a factor to consider.
“Female pattern hair loss, meanwhile, is largely very much down to your genetics, whereby your hair follicles are predisposed to be sensitive to normal levels of circulating male hormones. However, not all forms of alopecia are genetic, and therefore can often be prevented – or eventually cured – through proper diet and the correct haircare management,” adds Anabel.
While it’s refreshing to hear that there is often a cure for the type of alopecia you may be suffering from, the fact you’ve got the kinkiest, curliest and driest hair type there is, doesn’t always bode well. With its porosity, as well as fineness in diameter and elliptical shape, means that Afro hair is more susceptible to certain types of alopecia due to its structure and configuration.
“Afro hair is more prone to moisture loss, breakage and snapping, taking colour faster than other textures and further increasing the likelihood of damage,” continues Anabel. “One of the most common forms of hair loss found in Afro hair is traction alopecia, due to tight hairstyles causing breakage at the root that can eventually pull the hair out from its follicle. Harsh styling, straightening and chemical processing also play a huge part in the misery of hair loss among women of colour, meaning it’s important you always assess your hair’s condition before embarking on any new hairstyle.”
Which Alopecia…
Unsure of what type of alopecia you might be suffer-ing from and want to know the differences? Here is the New African Woman guide to knowing more about alopecia:
ALOPECIA AREATA
WHAT IS IT? Hair loss that occurs in patches on the scalp but can also affect the eyebrows. The exact cause of alopecia areata is still unknown, however, it is thought to be genetic and autoimmune in nature and is linked to stress and certain medical conditions.
WHAT ARE THE SYMPTOMS? One or more circular patches of hair loss occur on the scalp. These patches, when active, will be surrounded by tiny exclamation mark hairs (they have a bigger top and a tapered end) that are very easily pulled out. Rarely, alopecia areata can progress to what is known as alopecia totalis – where all the hair on the scalp, and sometimes also the eyebrows and eyelashes – is lost. Even more rarely, it can cause all body hair to fall out – known as alopecia universalis. It is not known why this occurs in some people and not in others.
WHAT IS THE CURE? Sadly, there is no effective treatment for alopecia areata, although it can resolve on its own. However, the longer the hair follicles remain dormant, the less likely this is – and it often recurs spontaneously. Local irritants, oral corticosteroids, topical steroids and other medical treatments are sometimes helpful, but it is really a case-by-case basis. Many people who have alopecia areata also find wearing a wig helpful, as it boosts their self-confidence, so experiment with styles and ask your hairdresser for ideas. (Trichologist Anabel Kingsley)
TRAUMATIC ALOPECIA
WHAT IS IT? Traumatic alopecia is closely associated with traction alopecia, as this is essentially a cosmetic disorder associated with sustained tension or damage on the scalp. Onset is gradual and often takes two to three years to become apparent, and it often occurs symmetrically around the front hairline. Over-processing with chemical treatments, such as hair dye, bleach or relaxers is often to blame, as well as sleeping in rollers or over-brushing.
WHAT ARE THE SYMPTOMS? Patchy hair loss, as well as itching, dandruff, headache, redness and inflammation on the scalp are the most common signs. In the initial stages, this hair loss is reversible, however eventually, the hair follicles become weakened to the point where they will not regrow under any circumstances. This results in permanent localised hair loss to those specific follicles, so it is important to recognise the condition and stop your cosmetic practices while it is still reversible.
WHAT IS THE CURE? Reverse the damage as soon as you become aware of it by seeing where exactly you are going wrong. Change your hair type and go natural, avoiding any chemical processes that would only make matters worse. Consult with a trichologist and pay attention to nutrition, as this is paramount to maintain the strength of the follicles. Once your hair recovers, do not return to your previous cosmetic practices, as tempting as it may be. For example, If you do want to relax your hair again, go for longer periods in between having the treatment applied, using heat protection and working with good combs rather than brushes. To be honest, you’ll probably find you’re very happy with your new natural look and won’t look back. (Harley Street trichologist Sara Allison)
TRACTION ALOPECIA
WHAT IS IT? Traction alopecia is a form of alopecia caused by excessive tension on the hair. This tension pulls it out from the follicle over time, resulting in hair loss – think of the time when we all screamed in horror at seeing Naomi Campbell with receding hairline, you get the drift.
WHAT ARE THE SYMPTOMS? Sufferers will normally find bald patches on their scalp in the areas the hair had been held the tightest – usually starting around the outside of the hairline moving inwards over time. It is caused by any action which holds your hair too tightly, such as braids, weaves, wigs and ponytails. Any action holding the hair with a strong tension on the root will inevitably cause traction alopecia over time. Having your hair pulled out can also be classed as traction alopecia – so no catfights, please…
WHAT IS THE CURE? Traction alopecia can only be resolved by loosening the tension on the root of the hair and allowing it to grow back normally. Tie ponytails loose enough so you can’t feel it pulling on the root, while a similar idea with any pinning – whether it is to pin your hair out of the way or pin in a weave – is to always keep the root loose, perhaps using a little backcombing to secure the hair as opposed to tension. Just remember: If you can feel the root pulling or it hurts, you are heading to traction alopecia over time! If your hair has to be tight for that special occasion, make sure you loosen it as soon as you can and do it less often to reduce the damage. (Alter Ego Hair Design’s Nick Mitchell)
CICATRICIAL OR SCARRING ALOPECIA
WHAT IS IT? Cicatricial alopecia is also known as scarring alopecia, covering all scalp conditions that result in the destruction of the hair follicle. Central centrifugal cicatricial alopecia is what used to be known as ‘hot comb’ alopecia – caused by excessive use – and is a condition that only affects the top of the scalp.
WHAT ARE THE SYMPTOMS? Signs of scarring alopecia depend on what has caused it. Continuous traction, such as too-tight braids, weaves, extensions and frequent use of tight rollers will initially cause hair breakage and thinning. However, scarring resulting from the improper use or application of bleaches, hot oils and relaxing solutions can be much more rapid and may cause unpleasant signs and symptoms. For instance, a bad burn can immediately destroy many layers of skin and the hair follicles in the affected area.
WHAT IS THE CURE? Unfortunately, scarring alopecia is permanent, as the hair follicle has already been destroyed. However, skin grafting/stretching, and hair transplants can be very successful if the case is severe. Wigs are yet again a
good option for women who feel upset about the appearance of their hair, and luckily there is a wonderful array of exciting and realistic-looking styles out there for you to choose from. (Trichologist Anabel Kingsley)
ANDROGENETIC ALOPECIA
WHAT IS IT? In women, this is otherwise known as ‘Female Pattern Hair Loss’ (FPHL) and affects many women going through hormonal changes. These may include starting and stopping of hormonal contraceptives like the pill, after pregnancy or when approaching the menopause, or any other factors due to oestrogen ratio changes.
WHAT ARE THE SYMPTOMS? The most common type of hair loss, around 25% of women experience advanced FPHL by age 50. Unlike men, women rarely go completely bald, and instead tend to see a diffuse thinning at the top and a recession at the temples, with the fringe often unaffected. It was traditionally thought to be caused by testosterone, but the real culprit is Di-hydrotestosterone (DHT). It therefore doesn’t matter how much testosterone a woman has – she just needs to have some testosterone, plus inherit the genetic component that makes her receptive to the conversion to DHT.
WHAT IS THE CURE? Unlike most other forms of hair loss, this particular type is irreversible without treatment such as hair transplants. HRT therapy has proved successful for some women who are going through menopause and experience FPHL, however, this is by no means a universal rule to follow. Minoxidil is in fact the only medically-approved female hair loss treatment. However, it can cause excessive shedding when you first start using it and needs to be continued long-term. The exact mechanism of how it works is unsure, but it is a vaso-dilator, increasing the blood flow to the hair follicles, and known to reactivate and prolong the anagen-growing phase to them as well. (Harley Street trichologist Sara Allison)
.
