Hair Loss and Hair
Transplantation in Women of Color
Common Causes of Hair Loss in Women of
Color
There are several causes of hair loss in
women - hereditary causes, crash dieting (inadequate protein), childbirth,
birth control pills, medications, medical illnesses (thyroid disease,
anemia), surgery, cancer treatments and improper hair care. The most common
type of hair loss in all women, regardless of race, is female pattern hair
loss (FPHL) or hereditary thinning. It occurs in approximately 30 million
women in the United States. Most women are 50-60 years of age, but younger
women can be affected as well. Although, not surprising, that the younger
the women is with hair loss, the more devastating it can be to her. Studies
have shown that hair loss in women can negatively impact their self-esteem
and social interactions. FPHL presents as a diffuse thinning of hair at the
top of the head (crown) and may extend to the front of the scalp. Medical
treatment with topical Minoxidil 2% (Rogaine) is available over-the-counter,
but must be used continuously in order to maintain the new growth.
Two
of the most common types of hair loss in black women, both which are
associated with hair grooming practices, include traction alopecia and
central centrifugal cicatricial alopecia (CCCA). These conditions can lead
to permanent hair loss and hair restoration is the only answer.
Traction Alopecia
Traction alopecia occurs in both children and
adult women. It results from various hairstyles and hair grooming practices
that are unique to women of color. These include pony tails, braids, weaves,
locs and hair rollers that pull the hair tight and eventually, hair loss
develops. The areas of hair loss are usually symmetrical and occur along the
temples and the above the ears. If caught early on, medical treatment and
changing the damaging hairstyle can stop this condition from becoming
permanent.
Central Centrifugal Cicatricial Alopecia (CCCA)
CCCA, or formally known as hot comb alopecia
and follicular degeneration syndrome, is an inflammatory scarring form of
hair loss that is becoming an epidemic in the black female population. The
cause of this condition is unknown; however, many of the women have a
history of chronic use of hair chemicals (relaxers, jheri curl, texturizers,
and bonding glue used for hair weaving) or heat (hot comb or hot curler
use). CCCA is a progressive and destructive scalp condition that commonly
goes unnoticed. It usually begins at the top of the scalp (crown or vertex)
and the most common early signs are hair breakage, itching, scalp tenderness
in the affected area. Again, if addressed early, medical treatment along
with changing the current hair grooming methods can stop the progression of
the hair loss and in some cases, hair regrowth can occur. Unfortunately,
most women seek treatment too late and the hair loss becomes permanent.
Hair Transplantation
Hair transplantation or hair restoration is a
popular cosmetic procedure that is commonly performed in Caucasian men with
male pattern baldness. According to the American Academy of Cosmetic
Surgery, hair transplantation was the most popular cosmetic surgery among
men, with 177,998 procedures performed in the year 2000. Most of us have
seen the late night infomercials, highlighting the fabulous results of hair
transplanting in men, restoring their youth and good looks. However, women
of color are never seen in these advertisements, as if this surgical
procedure is not indicated for their hair loss. With the increasing
incidence of hair loss in black women, the surgical correction of hair loss
is an important and necessary component to the overall treatment regimen for
this emotionally devastating condition.
What is Hair Transplantation?
Hair transplantation involves removing
healthy hair or grafts from the back of the scalp (donor site) and
transplanting them into the area of hair loss (recipient site). It is an
in-office surgical procedure that is performed under local anesthesia and
minimal sedation; so hospitalization is not required. There are various
techniques used to remove the hairs from the donor site. The most common
technique involves removing a strip of hair bearing scalp (6-8 inches long x
1 inch wide) and then dissecting it into follicular units (1-3 hairs). This
procedure is called follicular unit transplantation (FUT) and produces a
natural appearing hairline. This technique is extremely important in
patients with traction alopecia and female pattern hair loss. In contrast,
women of color with CCCA have better results with transplanting larger
grafts, containing more hairs, rather than follicular units. Because the
area of hair loss occurs on the crown and not the hairline, larger grafts
are used to provide better coverage and create an illusion of density.
Racial Differences in Hair
Restoration
There are several racial differences in hair
transplant surgery. These include (1) reason for the procedure; (2) the
shape of the hair; and (3) risk of keloid formation. Most women of color
seek hair restoration for the treatment of traction alopecia and CCCA,
whereas male pattern baldness in men and FPHL in women is the reason in
Caucasians. In general, black hair is curly with a curved hair follicle and
removing donor hairs can be very difficult and extremely challenging.
Transection of the hair follicle is a constant problem even for the best
hair transplant surgeon or surgical assistant. So finding a hair transplant
surgeon with experience in black hair is particularly important. And
finally, the risk of keloid formation is increased in the black population
and therefore the risk of developing a keloid from hair transplant surgery
is a possibility. If a history of keloids is present, the procedure should
not be performed. In addition, if a keloid scar develops at the surgery
site, then topical corticosteroids or cortisone injections can be
administered to flatten the scar.
For additional information on hair loss and
hair transplantation, please schedule a consultation with our office.
