Dermatologists Advocating for Inclusive Hair Loss Research and Treatment in the African Diaspora

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Crystal Aguh, MD, FAAD, Johns Hopkins School of Medicine faculty, emphasized the importance of increased grant funding to promote inclusivity and diversity in hair disorder research, particularly for underrepresented populations. She highlighted the American Academy of Dermatology’s (AAD) efforts in sponsoring research grants focused on minority hair loss.

Aguh also addressed the challenge of balancing cultural hair styling practices with hair health in Black women, noting that traction alopecia is common due to styles like braids and weaves. She stressed the need for patient education and social media outreach to help women understand healthy hair practices. Aguh discussed the significant emotional impact of hair loss, especially in the African diaspora where hair is culturally significant, and advocated for dermatologists to be sensitive to the quality of life implications for patients.

This transcript was lightly edited for clarity; captions were auto-generated.

Transcript

How can future research further promote inclusivity and diversity in hair disorder research, particularly in addressing the unique needs of underrepresented populations?

Grant funding is super important. We have seen that as grant funding for this type of work has increased, the number of publications and attention paid to hair loss in underserved communities has dramatically increased.

I'm fortunate to say that the American Academy of Dermatology has actually been great about this. A couple of years ago, they sponsored a set of AAD hair awards that was specifically designed to increase research efforts in studying hair loss in minority populations, and the type of research that has come out from those grants and awards has been outstanding.

The use of certain hair styling practices and products can exacerbate hair loss in women of African descent. How can patients balance the desire for cultural expression with the need for hair health preservation?

I think that hair cell–induced alopecia in Black women is one of my most common complaints that I see in my clinic, and it's really, really tough, because curly hair is so fragile and can require a lot of time and attention to keep it healthy. A lot of my patients opt for braided styles or weave styles because they're more conducive to their busy lifestyle, but then they can pull out a lot of hair, and that hair loss can eventually become permanent.

I think for a lot of my patients, no one's ever talked to them about it, and so I spend a lot of time doing patient education. I spend a lot of time on social media doing patient education because once people understand how to balance the frequency of these hairstyles with kind of healthy hair practices, they end up having much better outcomes.

How do you address the emotional impact of hair loss among women of African descent, who may have strong cultural and historical ties to hair?

I find that within the African American community, in the African diaspora, broadly speaking, hair is super important. It's not just another body part; a lot of women refer to it as their crown. When you lose that crown, it can feel like you've lost a lot of your femininity.

This is similar to women in other racial groups as well. The quality of life impact from hair loss is quite significant. We know from the cancer literature that 10% of patients who have breast cancer will decline chemotherapy or life-saving treatment because of the prospect of losing their hair, even temporarily. When you talk about chronic forms of alopecia, which are very difficult to treat, you can just imagine how much that can impact patients.

I spend a lot of time educating other dermatologists and practitioners about respecting the quality of life impact and taking a really thoughtful approach to talking their patients through it. I will say, as an alopecia specialist, when I am able to regrow patients' hair, it's so rewarding. There's nothing like it, because you really make such a huge impact in their life.