African Americans at Risk for Hair Loss

Traction alopecia is a condition most commonly seen in the African American population and is caused by specific hair styling practices including tight braids

May 2010

According to the Journal of the American Academy of Dermatology, nearly one third of African American women and more than 17 percent of African American girls ages 6-21 will lose their hair due to a condition known as traction alopecia.

Dr. Joshua Fox, leading dermatologist in the New York Area says that by simply changing their hair care and styling practices, many of these girls and women will be able to retain and enjoy their hair for years to come.

Traction alopecia is a condition most commonly seen in the African American population and is caused by specific hair styling practices including tight braids, cornrows or weaves as well as the use of chemical hair straighteners, dyes or bleaches.

An estimated three fourths of African American females straighten their hair. “Ironically, the very hair care and styling practices designed to improve their appearance can actually cause young girls and women to lose their hair and feel that they no longer look as good as they want to,” says Dr. Fox, founder of Advanced Dermatology, PC and founder and president of New Age Research Foundation (http://newageskin.org) and a spokesperson for the American Academy of Dermatology.

Traction alopecia occurs more frequently in children, teenagers and young adults then it does in older women and men, however, it can occur in people of any age or gender. “If diagnosed early, traction alopecia is reversible,”

Dr. Fox says, “but it may lead to permanent hair loss if it is undetected for a long period of time.” Dr. Fox advises that people should see their dermatologist at the first sign of any of the symptoms of traction alopecia so that the condition can be properly diagnosed and treated.

Dr. Fox says the symptoms of traction alopecia include: pruritus, or itching, with or without dandruff; perifollicular erythema, or inflammation; thinning of the hair, with large strands coming out when the hair is combed.

Many may feel a tingling sensation or pain in the area where the hair loss has occurred. Additional symptoms may include hyperkeratosis, a thickening of the skin on the scalp, and the development of pustules and scales.

Eventually, patients may notice many broken hairs. Soon, the hair follicles will atrophy and no longer produce the typical long and coarse hair. Instead, thinner, fine, short hair is generated. Pitting in fingernails is a sign of severe traction alopecia. Most important and commonly, is that the frontal hairline is moved backward in the area being pulled. Other times, the area of the part is thinned-out as this is area of the pulling.

“The key to stopping traction alopecia is detecting it early,” Dr. Fox says. “Most patients do not notice this “slow killer” of hair as it happens so gradually over months and years – much as people often do not notice themselves putting on weight or aging.”

Once traction alopecia has been diagnosed, patients must immediately discontinue any hairstyling practice that causes traction on the hair and switch to looser, gentler styles. “Doing so early can lead to complete reversal of the hair loss and regrowth within several months to a year or longer,” Dr. Fox says.

“In addition, your doctor may prescribe topical or oral antibiotics or cortisone or even give injections to reduce inflammation and prevent infection. Patients should also make sure they get enough iron and protein in the diet to help promote hair regrowth.

“When traction alopecia is not detected early, the hair loss may be permanent and irreversible,” says Dr. Gregory Pistone, Hair Restoration Specialist and on staff at Advanced Dermatology, PC., as well as serving as Associate Clinical Professor of Dermatology and Cutaneous Biology, Thomas Jefferson University School of Medicine in Philadelphia,

“There is no medical treatment available today to reverse late-stage traction alopecia. Patients then may have to consider surgical hair transplantation procedures. The scarring, which traction alopecia causes, makes hair transplantation more difficult. One should only utilize a skilled ‘expert’ hair transplantation surgeon when attempting to ‘cure’ their hair loss. The results can be quite dramatic, however it is always better to prevent the problem than to require a hair transplant.”

Bio: Joshua L. Fox, M.D. is a leading authority in the field of dermatology with an expertise in skin cancer, cosmetic surgery, and laser procedures.

As an official spokesperson for the American Academy of Dermatology and the American Society of Dermatologic Surgery, Dr. Fox has been an expert resource on dermatologic topics for numerous television networks including ABC, CBS, CNN, NBC, including local broadcasting television spotlights, Telemundo, talk shows, radio stations, newspapers and magazines.

Dr. Fox has served on the board of the National Rosacea Foundation and has done clinical trials in both medical and laser therapy in Rosacea.

He has received multiple research and clinical awards including recognition from Top Doctors, Who's Who, Journal of Dermatologic Surgery and Oncology, Community Service Award from the American Society of Dermatologic Surgery, the prestigious Husic Award as well as certificates of recognition for service from multiple hospitals, civic, educational and community organizations. Dr. Fox has authored and presented papers of his research on lasers, cosmetic procedures, stretch marks, scars, skin cancer, bug bites, photosensitivity and various rashes.

As founder and director of Advanced Dermatology and The Center for Laser and Cosmetic Surgery, Dr. Fox and his associates have expanded the practice into one of the largest in dermatology, laser & cosmetic surgery with more lasers than any hospital or university center on the eastern coast.

Dr. Fox is a graduate of the New York University Medical Center -Skin and Cancer and has been on the advisory board of the Psoriasis Foundation and National Rosacea Foundation among others. He has also been a fellow of many societies including the International Academy of Cosmetic Surgery, International Academy of Cosmetic Dermatology, and the Society for Investigative Dermatology.

Dr. Fox is the founder of the AAD Melanoma/Skin Cancer Prevention Program in Queens, New York since 1987. Dr. Fox has been Chief of Dermatology of several major teaching hospitals including Mt. Sinai Hospital of Queens and Jamaica Medical Center and is currently on the staff of ten NY area hospitals.

Dr. Fox and Advanced Dermatology the Center for Laser & Cosmetic Surgery have been used as a resource center educating dermatologists, laser surgeons, & cosmetic surgeons and others about lasers, cancer and cosmetic surgery and has one of the few Laser & Cosmetic Surgery Fellowship programs in the country. Dr. Fox is also the founder of the non-profit New Age Skin Research Foundation which participates and provides many research activities on unique issues of the skin and their causes or cures.

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