Understanding Hair Loss Caused by Grooming Part1
Wesley S. Wilborn, MD

Alopecia is a general term that refers to hair loss from any cause. There are many causes of hair loss including, infection, scalp diseases, chemicals, trauma, medications and natural aging. Most scalp hair loss, in males, is caused by natural balding. In African American females, it is more commonly caused by trauma and chemicals.

A major cause of hair loss in African American females is tight ponytails, rollers and braids. This is referred to as “Traction Alopecia”. This can occur in young children and is most likely due to pulling the hair back too tight in ponytails. Repeated styling of the hair in this manner will eventually result in loss of hair in the temples and occasionally, the nape of the neck. With the use of rollers especially “sponge rollers” the hair is affected in the forehead area as well. Quite often many or all females in a family may have this condition and may think it is hereditary. This is far from the truth. It is a cultural phenomenon that has to do with the practice of pulling the hair too tight along the margins to make it appear straight or to “hold a set”. This type of hair loss is entirely preventable and this practice should be discontinued. The following photo is an example
Of the consequences of this practice.

Treatment of this problem is problematic. Most Dermatologists would consider this problem untreatable except by hair transplants. Hair transplants themselves re problematic in African Americans because of the potential for scarring. I prefer to treat with preparations containing minoxidil the active ingredient in “Rogaine”. One problem with the minoxidil solutions that are currently available is that they are very drying to the hair. Use with a moisturizer can help to alleviate this. Treatment should be continued as long as there is evidence of new hair growth,

Next month Understanding Hair Loss Part 2
Dr Wilborn is an Associate Clinical Professor of Dermatology of The Emory University School of Medicine, Atlanta, GA., and member of the advisory board of the Circumscribed Cicatricial Alopecia Foundation. He has been in private practice for
50 years.

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