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Why Are More Black Women Going Bald?

Dermatologists say irreparable hair loss affects black women more than any other ethnicity. Here's how to get to the root of the problem
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Hair loss is no stranger to women. The International Society of Hair Restoration reports that nearly 30 million women in the U.S. are losing their hair (yikes!), and it's an epidemic among African American women in particular. Dermatologists report that they are seeing more and more black women -- of all ages -- complaining of hair loss.

On the surface, it's easy to chalk up the hair loss to the combination of a drier hair texture and damaging braiding and heat-styling practices. Then there's the vicious styling cycle women often find themselves in: Extensions, weaves and braids lead to hair breakage and hair loss, so we turn to damaging weaves and hair extensions to disguise hair loss, which promotes more damage and hair loss. But it's not always about styling choices.

We asked a hair-loss expert and stylists who specialize in black hair care to shed light on the types of alopecia that hit black women the hardest. Click ahead to see what's at the root of your hair loss and what you can do it about it today.

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The Cause: Central Centrifugal Cicatricial Alopecia
Hold on to your seats, because this offender is by far the most frightening. Central centrifugal cicatricial alopecia is inflammation that starts at the center of the scalp and moves outward, scarring hair follicles as it goes. The scariest part of this disease: once a follicle is scarred, hair will never grow from that follicle again. According to Dr. Robert Leonard, chief surgeon and founder of Leonard Hair Transplant Associates, CCCA isn't only a dermatologic disease most commonly seen in black women, it's also one of the most difficult types of hair loss to treat.

Why? Mainly because experts aren't completely sure of the cause. In the 1950s, its prevalence in the black community led many to believe it was the result of using hot combs with petrolatum (hence the nickname "hot comb alopecia"). Today, some experts believe it's genetic and others think straightening procedures and pulling from braids, weaves and extensions lead to the condition. Some say it's a combo of both. Regardless, treatment is possible, as long as it starts early.



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The Fix: Get Evaluated
If you notice a small patch of hair loss that's slowly getting larger or a shiny patch of scalp at the center of your head -- two telltale signs of CCCA -- get to your derm ASAP. "Prevention is very important because this is a progressive condition that spreads," says Leonard. Once you've made an appointment, your derm can diagnose CCCA with a scalp biopsy. A small area of your scalp is numbed and a tiny piece (around 4 millimeters) is removed and sent to a lab to be analyzed for inflammation and scar tissue. A small stitch closes everything up and you'll be out of there in half an hour.

OK, you've been diagnosed. Now what? Hate to say it, but just as there is no agreed-upon cause for CCCA, there is no agreed-upon treatment. You could be prescribed oral and topical antibiotics to stop inflammation, topical steroids or even injectable ones. After about four to six weeks, painful sensations will stop, hair loss will slow, and some lucky patients may notice some new hair growth. However, if CCCA has gone undiagnosed for too long, there is no guarantee that new hair will grow back, so stay on the lookout for suspicious activity on your scalp.

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The Cause: Androgenic Alopecia
Hate to break it to you, but hair loss could just be in your blood. Yep, one of the most common causes of hair loss in black women (and women in general) is simply genetics. "If you're suffering from hair loss, just look back at your family tree and you'll most likely find the same story," says Leonard. The gene for hair loss can be inherited from either of your parents.

How can you tell if genes are at play? In women, genetic hair loss (also affectionately referred to as female pattern baldness) is characterized by an overall thinning rather than that familiar receding hairline we see in men. Unfortunately, there's nothing you can do to prevent this type of hair loss -- we don't choose our family, after all -- but there are ways to get some of your lost hair back.

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The Fix: Get It Back
According to Leonard, there are two medically sound and scientifically proven treatments out there for female pattern baldness: Rogaine foam and low-level laser therapy, like the Capillus LaserCap.

The third and trickiest option is hair restoration surgery, which Leonard says can have great results. Unfortunately, thanks to good ol' logistics, only about 2 to 5 percent of women are candidates for the procedure. During hair transplant surgery, tiny pieces of skin and hair follicles are surgically removed from the back and along the sides of the head to areas of thinness. But most women have thinning all over the head, including the sides and the back -- the main donor sites for the surgery.

But all hope isn't lost. If you suffer from hair loss due to traction alopecia (more on that next), chemical or physical burns or scarring from accidents or incisions, you may be one of those few women eligible for hair restoration surgery. Your best bet is to find a member of the International Society of Hair Restoration Surgery and get a proper diagnosis before you start clearing your schedule.

BY ERICA SMITH | JUN 11, 2014 | SHARES
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