Black Skin, Black Hair & Black Care
Don’t miss out on this National Hair Loss Awareness Month Q&A with Dr. Kimberly Brown
Today.com recently published an eye-opening piece about how most dermatologists don’t learn about Black skin. It’s due to the fact that Black skin is often left out of medical textbooks and clinical teaching, which causes misdiagnosis, delayed care and more. This is a major cause for concern, and we’re exploring this as well as Black hair care and hair loss topics in today’s post. Below you’ll find insightful perspectives and Black hair care tips and information from Dr. Kimberly Brown, in recognition of National Hair Loss Awareness Month.
Q&A with Dr. Kimberly Brown
Q: When you were in medical school, did you learn about care that was inclusive of all races?
A: I went to school on the island of Dominica, which has a primarily Black and indigenous population. In the classroom, there were little to no distinctions made between how conditions may present in patients of different races. However, we learned that chronic diseases like lupus, sarcoidosis, high blood pressure and diabetes disproportionately affected Black and Latinx patients, with little understanding of reasons why. Thankfully, I had the benefit of studying public health prior to going to medical school, so I personally had an understanding of why disease affects different populations more than others.
Q: Do you think medical schools, in general, could do a better job of teaching students about care specifically for Black people?
A: Absolutely (this goes for not only Black patients, but Latinx, indigenous and Asian patients as well). For a long period of time, people of color were systematically shut out of studying medicine, and even experimented on without knowledge or consent. In fact, the “father of gynecology” also routinely performed surgery on enslaved women, without anesthesia as a common thought was that Black patients do not feel pain. And in 2016, a study showed that 40% of first and second year medical students believed that Black patients feel less pain and have thicker skin than white people. These statements are false. Many Black patients have a fear of doctors and the healthcare system because of these reasons.
Unfortunately, systemic racism and prejudice is a real and regular problem in medicine. To improve the health of our minority patients, medical educators need to identify, understand and own up to this factor, acknowledge their own implicit biases, seek to find and teach truths to future doctors, and actively work to dismantle the system that continues to disenfranchise patients of color.
Q: You’ve had telehealth appointments with patients on Hims & Hers. Can you share some common questions about hair loss/hair care you receive from Black patients that may differ from patients of other races?
A: I’ve had several Black patients ask about how the Hims and Hers minoxidil drops and Hims DHT blocking shampoo would affect their hair. More specifically, I get asked “Will this dry out my hair?” Black hair is naturally coarse and loses moisture easily. It is important to regularly moisturize Black hair. I encourage all Black patients to make sure that they are regularly conditioning, deep conditioning and moisturizing their hair to counteract any drying effects products may have on their hair.
Q: In what other ways can Black people combat dry hair?
A: Healthy hair starts from the inside and shows on the outside. If you have thin or brittle hair, ensuring that you are eating a balanced diet with lots of fruits and vegetables will supply your body with vitamins A, E, D, iron and zinc to encourage healthy hair. Hims & Hers also offers a biotin supplement that will help supplement hair growth. Biotin is also naturally found in fish, eggs, dairy products, nuts and seeds. Drinking water also helps you to grow healthy hair, and can help clear up acne, regulate gut health and help your body to remove toxins. Massaging the scalp encourages blood flow and stimulates hair follicles. Lightly applying a natural oil to the hair, such as olive and avocado can help seal moisture in.
Q: Does race have anything to do with the likeliness of hair loss?
A: Central Centrifugal Cicatricial Alopecia (CCCA) is the most common form of scarring hair loss seen in Black women, but it can occur in men and patients of all races. We don’t know the exact cause of CCCA, but it is thought that it’s likely multifactorial with both genetics and common hair practices in the Black community including heat styling, relaxers and tight hairstyles. In CCCA, hair loss starts at the top of the head and radiates out in a circular pattern. If you are concerned that you have CCCA, you should see a dermatologist. She or he may perform a biopsy and recommend treatment based on findings.
Q: Are there certain hair products/ingredients you’d recommend for Black people to avoid or look for to ensure their hair stays strong and healthy?
A: Sulfates and products that have drying alcohols such as Alcohol denat, Ethanol, SD alcohol 40, Propanol, Isopropyl and Propyl are common in the haircare market. Using shampoos and styling products with these ingredients overtime causes overly dry hair and promotes breakage. It’s becoming easier to find products that are “sulfate-free” and that do not contain any of the drying alcohols listed. When you’re searching for hair products, make sure you read the label to know what is going onto your hair.
Q: Are there certain hairstyles or accessories Black people should avoid with their hair?
A: Black women love to wear our natural hair textures, straighten our hair with heat or chemical relaxers, add extensions, wear wigs or fashion our hair into dreadlocks. Our hair is not only our crown, but showcases our mood or personality. “Protective styles” are common for Black women to use to protect our hair from constant manipulation and over-styling, which can lead to dryness and breakage. It also can allow the flexibility of trying new colors, textures or styles without chemically treating (and possibly damaging) our natural hair.
Relaxers are chemical creams that will loosen the texture of tightly curled or coiled hair and make the curl pattern loose or permanently straight. By using alkaline products or lye, it changes the pH of the hair to loosen the curl pattern. If applied improperly or left on for too long, they can cause painful burns to the scalp. Regular relaxer use has been linked to fibroids in Black women, so more Black women are opting to go “natural” or wear their hair in its state as it grows out of their scalp.
No matter how you choose to wear your hair, making sure that the hair growing from your scalp is cared for is what’s important. If you’re wearing a “protective style” such as a wig, extensions or braids, it’s important to make sure your hair is not styled too tightly underneath. Traction alopecia (alopecia meaning hair loss) is caused by the hair being pulled so tightly, that the hair follicle weakens and breaks at the root, most commonly causing thinning or bald spots around the hairline and at the nape of the neck. When wearing weaves, make sure you’re washing, conditioning and thoroughly drying your natural hair because that will fight bacterial and fungal problems. As well, making sure that you’re keeping a style in for a maximum of 6–8 weeks will discourage matting, tangling and eventual breakage.
