Balding in black women,

*By Alexis Garrett Stodghill

For many black women, maintaining the perfect hairstyle is a central goal. Using weaves or braids to achieve a look without thinking of the consequences is common, but the damaging results are far from pretty.

Recently, a shocking study reported on by CNN

Dr. Monte O. Harris, a renowned African-American doctor and hair care expert who addresses balding in black women, noted that “black hair has a morphology that makes it more susceptible to damage, because there are many breaks along the shaft of the hair,” he said. “It’s amazing that our hair is probably the most susceptible to trauma and we do the most damaging things to it. It’s like a double hit.”

Our extra susceptibility to CCPA was explicitly linked to traction hairstyles, such as weaves and braids. There was no correlation found for relaxers or hot comb usage. While Harris is pleased with the findings, he is concerned that “people are receiving mixed messages from this study.” He is particularly excited that the study “highlighted the increased incidences of hair issues in black women linked to traumatic grooming practices,” which might help black women rethink adopting potentially abusive styles. At the same time, however, the misconception that weaves and braids are uniformly injurious could cause more harm than good.

“I’m concerned about it because it’s making it seem like relaxers are good and weaves are bad,” said Harris. “Things need to be put into a context, particularly with weaves [since they] are done in a variety of ways.”

Anu Prestonia, president and owner of Khamit Kinks natural hair salon in Brooklyn, has over twenty years of experience observing the many variables that affect the impact of traction styles. She was hesitant about the results of the study. revealed that weaves and braids may contribute to a type of permanent hair loss known as central centrifugal cicatricial alopecia, or CCCA, a form of baldness that begins at the crown of the head and leads to scarring. A staggering 59 percent of black women who participated in the study had hair loss on the top of their scalp.

“I couldn’t agree that it’s primarily braids and weaves,” she said. “It’s bad braids or weaves. I’ve worn natural styles for twenty years and never had any hair loss, and neither have any of my clients who listen to their stylist’s advice.”

Proper implementation is crucial because these styles can permanently damage the scalp if they are not done correctly. Common poor practices include braiding or weaving too tightly, using too much hair, and stylists submitting “to clients who become addicted to a particular style,” Prestonia explained. “They could be having quality braid styles done by someone who is really skilled, but three years down the line they’re getting the same braid style. That will cause traction alopecia,” she said.

Harris concurs. “Having one particular style puts prolonged tension on the hair follicle. You really shouldn’t feel [any tension]. That’s one of the signs that there may be some inflammation.”

Inflammation caused by tight, repeated traction styles leads to subtle hair loss that often goes untreated. “Someone may not have an obvious loss, because it usually takes a decrease by almost 40% to see something visible,” said Harris. “Folks with an invisible loss end up being more susceptible to further damage from traumatic styles.”

Harris added that hair loss could also be related to genetics. For someone with a genetic susceptibility, weaves can exacerbate hair loss. Thus, understanding overall health history and tracking the state of one’s scalp over time is essential to maintaining healthy hair. Both should influence the styles a woman chooses. Seeing a doctor in conjunction with a stylist is necessary to develop an individual sense of one’s particular hair needs. Without this understanding, women seeking to cure a hair loss issue in its nascent stages might use a traction hairstyle, making things worse.

Prestonia agrees that clients often take the wrong approach to significant problems. “In consultations, I see women with devastating damage,” she said. “When you come to me and you have three inches of receded hairline, how could you have not seen that coming? Don’t wait until it gets to the point of no return.”

Harris believes women should work with their doctor, as well as their stylist, from the very beginning. “This way of addressing hair issues is what I consider the 21st century approach to using beauty as a tool for healing,” he said. In his vision, the hair care stylist plays an important role. “My goal is really trying to create a means of elevating the hair stylist to the role of being a health care advocate. And we’ve found a way of doing that here, using hair loss as a point of connection between the doctor, the patient and the stylist.”

Ultimately, a reliance on traction hairstyles can interfere with learning proper hair care. According to Harris, weaves and similar styles create a “point of detachment for women from their hair.”

“It ends up being a crutch for women to not have an intimate understanding of how to care for their hair in a health-conscious manner,” he explained.

Both experts say that focusing on proper hair care should become an ongoing process. This could transform the negative results detailed in the study into a path for more black women to develop holistic plans for health. The horrible result of this lack of involvement – baldness in the form of traction alopecia — can be avoided if we expand our vision of what is beautiful.

But are we ready to be converted?

Black women can work with doctors and knowledgeable stylists to make African-American hair a radiant reflection of overall well-being. Trends in healthier black hair care are increasing, but the inclusion of accurate medical analysis can further enhance this movement. Hopefully, if more black women take the advice of positive leaders in the medical and hair care industry, our hair will become an area of even greater expression and enjoyment.

“I hear this all the time,” said Harris about this regular practice. “‘Put a weave on top of that area because it’s thinning.’ The thought is that underneath, it will grow.  Maybe the third time around, the weave will go in, and then when the weave comes out the hair is gone,” he said.

This is why an open dialogue and persistent communication between the stylist, physician and patient is crucial, or unfortunately, one may end up with an undesired outcome.