Hair disorders: Aesthetic approaches for patients of African ancestry

Hair loss is a common, distressing dermatological condition estimated to affect more than half of Black women at some point in their lifetime. The psychological impact and frustration of hair loss is often substantial, with negative effects on self-esteem, confidence, and overall quality of life in these patients. The prospect of hair restoration can be significant and encompasses several important considerations, especially in patients of African descent. As with all patients independent of race or ethnicity, adequate medical management and treatment of hair loss is important in helping patients achieve hair regrowth and increased follicular density. For patients of African descent, this includes consideration of the unique properties of tightly curled or coiled hair and cultural hairstyling practices in the selection of appropriate treatment vehicles and procedural techniques. This chapter will focus primarily on four subtypes of hair loss that are predominant in patients of African descent: androgenetic alopecia, traction alopecia, acquired trichorrhexis nodosa, and central centrifugal cicatricial alopecia. This chapter will also discuss the medical, procedural, and special treatment considerations required in the management of these conditions.