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Geisler AN, Taye M, Larrondo J, Mayo TT, Aguh C, McMichael A, MacKelfresh JB, Krueger L. Updates on disorders in curly hair. Int J Dermatol 2024; 63:1145-1154. [PMID: 38622785 DOI: 10.1111/ijd.17184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/17/2024]
Abstract
Hair disorders, including central centrifugal cicatricial alopecia (CCCA), traction alopecia (TA), and acquired trichorrhexis nodosa (ATN), commonly occur in individuals with curly textured hair. Curly textured hair in individuals of African descent has unique properties and can present diagnostic and therapeutic challenges. CCCA has been linked to uterine leiomyoma and type 2 diabetes mellitus, as well as fibroproliferation. TA often presents with a fringe sign and can arise from high-tension hairstyles presumed to be protective. Trichoscopy is useful in establishing a diagnosis; perifollicular halos are more commonly seen than perifollicular erythema or scale in CCCA. In TA, miniaturized follicles, hair casts, and "flambeau sign" can be seen. Hairstyling practices likely contribute to TA and ATN; however, the data are mixed on the role of chemical relaxers and heat styling in CCCA. Unique considerations in the presentation of frontal fibrosing alopecia in curly textured hair have also been published recently. This review provides a comprehensive, up-to-date summary of these disorders with an emphasis on their unique properties, as well as considerations in hair care for curly textured hair.
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Affiliation(s)
- Amaris N Geisler
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Marta Taye
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Jorge Larrondo
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Tiffany T Mayo
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, USA
| | - Crystal Aguh
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, USA
| | - Amy McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Jamie B MacKelfresh
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
| | - Loren Krueger
- Department of Dermatology, Emory University School of Medicine, Atlanta, USA
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Vander Does A, Larrondo J, McMichael A. Flambeau sign: A trichoscopic finding of traction alopecia in Black patients. J Am Acad Dermatol 2024:S0190-9622(24)00909-5. [PMID: 38880480 DOI: 10.1016/j.jaad.2023.12.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 06/18/2024]
Affiliation(s)
- Ashley Vander Does
- Dr Phillip Frost Department of Dermatology and Miami Itch Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Jorge Larrondo
- Department of Dermatology, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile; Department of Dermatology, Hospital del Salvador, Santiago, Chile
| | - Amy McMichael
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
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Enokenwa MG, Okoro UJ, Cho S, Norton SA. Military Grooming Standards and Black Hairstyling Practices. Mil Med 2023; 188:e1996-e2002. [PMID: 36251302 DOI: 10.1093/milmed/usac313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Throughout history, armies of the world have codified grooming standards for their members. In the USA, the Department of Defense (DoD) provides overall guidance for grooming standards and each uniformed military service develops, promulgates, and enforces its own grooming standards. The specific details of each service's grooming standards are revised regularly to conform to contemporaneous notions of professionalism and operational necessity. In light of growing recognition of and respect for the diversity of people serving in the military, specific language used to describe certain hairstyles and hair textures as well as associated grooming policies have gained attention. Efforts have been made to modify the policy and language to be more inclusive, especially of minority groups with physiologic and cultural differences that influence grooming practices. Initial efforts in the DoD toward this endeavor were made possible with advocacy from members of the Congressional Black Caucus. MATERIALS AND METHODS We obtained service-specific documents, current and former, from the Army, Navy, Air Force, and Marine Corps that regulate the grooming standards for military personnel. We then examined the documents for text that addressed hair and hairstyles, specifically noting language describing and regulations regarding traditionally Black or African American hairstyles (i.e., afros, dreadlocks/locks/locs, braids, twists, etc.) for female and male soldiers. We also examined recently introduced legislation which seeks to end discrimination based on a person's hair texture or hairstyle, "Creating a Respectful and Open World for Natural Hair Act," abbreviated as the CROWN Act in the context of current grooming standards. RESULTS Our examination of the grooming regulations of four branches of the U.S. Military shows recent modifications of the language governing female hairstyles, particularly natural hairstyles seen among African American women, such as cornrows, braids, and locs (or locks). Changes made to grooming standards demonstrate a shift in language used to describe natural hairstyles. Words with negative connotations (i.e., "matted," "unkempt," and "dreadlock") have been removed. These have been replaced with more descriptive language that provides a more objective definition of certain hairstyles. While these hairstyles have some level of regulation as to exact dimensions and styling rules to fit with the goal of uniformity in appearance and do not extend to male service members, recent updates in grooming standards have expanded to be inclusive of these natural hairstyles. Recent changes in language and policy in the military have been noted as positive examples in the CROWN Act. CONCLUSIONS The DoD has recognized that former grooming standards, specifically regarding hair and hairstyles, may have introduced inequities in the treatment of military personnel. The DoD and its component military services have long been engaged in programs to ensure equal protections among its workforces. The re-examination and clarification of grooming standards related to hair and hairstyles is another effort to ensure equity and inclusion. The military services are working with great sincerity to implement policies that promote inclusiveness broadly. Steps to remove discrimination on the basis of hair and hairstyle can make the overall work environment more inclusive for people of color. Passage of a federal CROWN Act will promote similar or parallel changes for federal employees outside the military services.
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Affiliation(s)
| | - Uzoamaka J Okoro
- Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Sunghun Cho
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Scott A Norton
- Department of Dermatology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Pleasant VA, Purkiss AS, Merjaver SD. Redefining the “crown”: Approaching chemotherapy‐induced alopecia among Black patients with breast cancer. Cancer 2023; 129:1629-1633. [PMID: 37158640 DOI: 10.1002/cncr.34732] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
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Zhou Y, Jia L, Zhou D, Chen G, Fu Q, Li N. Advances in microneedles research based on promoting hair regrowth. J Control Release 2023; 353:965-974. [PMID: 36549392 DOI: 10.1016/j.jconrel.2022.12.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
Alopecia is the most common and difficult-to-treat hair disorder. It usually brings a significant psychological burden to the patients. With the growing popularity of alopecia, the study of alopecia has gained more attention. Currently, only minoxidil and finasteride have been approved by the FDA for the treatment of alopecia, but the efficacy has always been unsatisfactory. As a new form of transdermal drug delivery, microneedles have been widely used in the treatment of alopecia and have proven to be effective. Microneedles delivery can improve the efficiency of local drug delivery and patients' compliance, which can achieve better therapeutic effects on hair-related diseases. Therefore, microneedles have gained much attention in the field of alopecia and hair regrowth promotion in recent years. This review summarizes the last decade of research on the microneedles delivery design for the treatment of alopecia or promotion of hair regrowth and provides a comprehensive evaluation of this field.
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Affiliation(s)
- Yanjun Zhou
- School of Traditional Chinese Materia Medica, Key Laboratory for TCM Material Basis Study and Innovative Drug Development of Shenyang City, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Luan Jia
- School of Traditional Chinese Materia Medica, Key Laboratory for TCM Material Basis Study and Innovative Drug Development of Shenyang City, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Di Zhou
- School of Traditional Chinese Materia Medica, Key Laboratory for TCM Material Basis Study and Innovative Drug Development of Shenyang City, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Gang Chen
- School of Traditional Chinese Materia Medica, Key Laboratory for TCM Material Basis Study and Innovative Drug Development of Shenyang City, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Qiang Fu
- Wuya College of Innovation, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang 110016, PR China.
| | - Ning Li
- School of Traditional Chinese Materia Medica, Key Laboratory for TCM Material Basis Study and Innovative Drug Development of Shenyang City, Shenyang Pharmaceutical University, Shenyang 110016, PR China.
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Fabi SG, Callender VD, Lee WW, Dayan S. Aesthetic considerations for treating the North American multi-ethnic patient: Thriving in diversity international roundtable series. J Cosmet Dermatol 2022; 21:6976-6984. [PMID: 36176035 DOI: 10.1111/jocd.15422] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/27/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The United States is becoming increasingly diverse, and between 2016 and 2019, an increase of 945 832 aesthetic procedures was recorded for Hispanic, African American, and Asian American patients combined. In aesthetics, where outcomes are technique dependent and tied to the clinician's ability to tailor treatment to the needs of individual patients, a knowledge of ethnic differences in anatomy and how aesthetic issues can be safely and effectively addressed in different groups is paramount. AIMS To discuss similarities and difference in anatomy and treatment preferences of patients from a variety of ethnic and racial backgrounds and how these differences may influence the products or techniques utilized to achieve natural-looking results and minimize side effects. PATIENTS/METHODS In support of clinicians who wish to serve a diverse patient population, a 6-part international roundtable series focused on diversity in aesthetics was conducted from August 24, 2021, to May 16, 2022. RESULTS The results of the first roundtable in the series, the North American Multiethnic Patient, are described here. CONCLUSIONS A diverse range of patients can benefit from the tailored use of fillers, fat transfer, neuromodulators, lasers, and energy-based devices, as long as differences in structural support, skin, and aging patterns, are appreciated.
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Affiliation(s)
| | - Valerie D Callender
- Dermatologist at Callender Dermatology & Cosmetic Center, Glenn Dale, Maryland, USA.,Howard University College of Medicine, Washington, District of Columbia, USA
| | - Wendy W Lee
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Steven Dayan
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, University of Illinois at Chicago, Chicago, Illinois, USA
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Abstract
Hairstyling trends among Black women fluctuate with social, cultural, and environmental pressures. Dermatologists should be aware of current trends and their associated risks in order to provide the best care to this population. In order to summarize the updated trends and associated health risks for the most common hairstyles worn by Black women, a literature review was performed. PubMed and EMBASE were used to identify articles related to hair styling practices, studies on the effects or risks of various styling practices, and magazine articles citing current styling trends among women of African descent. All hairstyles were found to have associated health risks; however, natural styles had the fewest adverse associations of all styles reviewed. Central Centrifugal Cicatricial Alopecia (CCCA) is the most cited hair disorder in this population, possibly linked to both chemical relaxants and traction styles. Additional studies are needed to further establish causality between these styles and CCCA. Additionally, while acceptance of natural hairstyles is on the rise, there is more work to be done throughout society to help protect and encourage women who choose to wear Afrocentric styles. Dermatologists should be well versed in these hairstyles and ready to lend appropriate advice to patients when it is requested.
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Murase JE, Murrell DF. Heralding change within dermatology: Response of the International Journal of Women's Dermatology (IJWD) to the twin pandemic of racism. Int J Womens Dermatol 2021; 7:125-126. [PMID: 33937475 PMCID: PMC8072453 DOI: 10.1016/j.ijwd.2021.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Jenny E Murase
- Dept of Dermatology, University of California, San Francisco, CA, USA
- Dept of Dermatology, Palo Alto Foundation Medical Group, Mountain View, CA, USA
| | - Dedee F Murrell
- Dept of Dermatology, St George Hospital, UNSW Faculty of Medicine, Sydney, Australia
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