Hair loss can affect up to 50% of women after menopause. This can be a disturbing experience as many individuals worry if their hair loss is a sign of an internal problem with their health. Additionally, hair loss in women is often not as culturally accepted and is often not routinely discussed compared to hair loss in men. Many find their hair to be part of their identity and a way to express themselves. Hair loss can make many feel less confident and have lower self esteem.
There are several reasons for hair loss in women, including hormonal imbalance and changes, nutritional deficiency, stress, genetic factors, hair care practices, certain medications, and certain medical conditions.
While hair loss is common in women especially after menopause, women of color may have a different experience with their hair loss compared to Caucasian women. This may be due to a number of factors including the types of hair loss (which can be due to things like genetic predisposition and hair care practices), hair texture, access to a specialist or doctor experienced in treating the individual’s type of hair, and the availability of treatments appropriate for the individual’s hair type. We at Root Hair Institute (RHI) are a truly comprehensive and inclusive hair restoration center. We specialize in and are experienced in treating hair loss in all hair types and ethnicities. We want to bring awareness to some of these differences to educate both those suffering from hair loss and other providers.
According to studies and statistics by the World Health Organization, women of color are more likely to suffer from hair problems like hair breakage, traction alopecia, and central centrifugal cicatricial alopecia (CCCA). Let’s take a deeper look at each one of these hair problems:
Hair problems that are more common in women of color:
Hair breakage can be caused by over-manipulation, heat damage, chemical treatments, and tight hairstyles that put strain on the hair shaft and roots. This type of hair damage is usually temporary and can be reversed with some changes to your hair care routine. It is important to address it as many of these same stressors on the hair if left unchecked can eventually lead to permanent hair loss.
Moreover, if you have fine or thinning hair, you may want to avoid tight hairstyles altogether and give your hair a chance to recover and grow back. Other things that can help minimize breakage include brushing gently starting at the ends, brushing when the hair is dry not wet, avoiding aggressively towel drying hair (such as by gently drying with a microfiber towel), and using a bonnet or silk pillowcase to minimize overnight damage. Another way to treat hair breakage is to use a protein or conditioning treatment to help strengthen the hair shaft. Please see our blog post on “6 Tips to Avoid Damaging Your Hair” for more tips.
Traction alopecia is caused by repetitive pulling or tension on the hair such as from tight hairstyles. This type of hair loss is often seen in individuals who wear their hair in tight ponytails, buns, or braids. It can also be caused by extensions and weaves that are glued or sewn into the hair.
If you are experiencing traction alopecia, it’s important to give your hair a break from any hairstyles that are pulling on your scalp. At the beginning of the process, traction alopecia can be reversible and hair can grow back. Later on with continued pulling on the hair, the follicles can eventually become permanently scarred down with permanent hair loss. It is important to see someone specializing in hair loss as there are treatments such as topical steroids, steroid injections into the scalp, and minoxidil based treatments that can help. In severe cases, surgery may be necessary to correct the problem.
Central centrifugal cicatricial alopecia
Central centrifugal cicatricial alopecia (CCCA) is a type of hair loss that is common in women of African descent. There is thought to be a genetic component, and there have been some studies identifying gene mutations associated with CCCA in some patients. This included a study finding mutations in PADI3 (which is usually important for proper hair shaft formation) in 5/16 patients (31%) in a recent study.  Additionally, hair in individuals with CCCA can be more prone to breakage and hair loss and more sensitive to damage from heat, chemical treatment, and pulling on the hair. Thus it is important to avoid heat treatments or styling of the hair, chemical treatments to the hair, and any hair styles that pull on the hair (see above) to avoid further damage.
The hair loss in CCCA typically starts with a small bald spot or area of thinning in the center or back of the scalp (the vertex scalp) and progresses outward. CCCA is caused by inflammation leading to scarring damage to the hair follicles. If biopsied, the initial stages are marked by inflammation and later by a larger degree of scarring on dermatopathology.
There is no cure for CCCA, but treatments are available to help slow down the progression of the condition and potentially regrow hair in areas where there are still existing follicles. This is why it is important to seek treatment with a hair loss specialist as early as possible to minimize the degree of scarring and maximize the number of intact follicles. Potential treatments for CCCA include oral medications, topical treatments, and injections.
What are the warning signs of hair loss?
There are different signs and symptoms of hair loss, which can vary depending on the type of hair loss you’re experiencing. Some common signs to look out for are:
– Thinning of the hair
– Gradual loss of hair density
– Excessive shedding
– Visible bald spots
– Receding hairline
– Difficulty growing your hair out
If you notice any of these signs, it’s important to see a dermatologist or other hair loss specialist to get a proper diagnosis. They will be able to determine the cause of your hair loss and recommend the best treatment options.
If you are a woman of color experiencing any of these types of hair loss, you may contact our professionals at Root Hair Institute to schedule a consultation. We have many years of experience helping women with all types of hair loss. We offer a variety of treatment options, including medications, surgery, red light based therapy, platelet-rich plasma (PRP) therapy, and other injections. Contact us today to schedule your consultation!
- Malki, L., Sarig, O., Tomano, M.T., et al. Variant PADI3 in Central Centrifugal Cicatricial Alopecia. New England Journal of Medicine. 2019;380(9):833-841