Hair Loss in African American Women

Hair loss in black women is incredibly common. In fact, in a 2016 study on 5,594 African American women, a staggering 47.6% reported hair loss on the crown or top of the scalp. Even though hair loss occurs in almost half of all black women, hair loss in African American women is a topic that is rarely discussed. A majority of black women with hair loss do not seek treatment.

Why is Hair Loss So Common in Black Women?

Why is Hair Loss So Common in Black Women?

African-American women may have a genetic predisposition to hair loss, but the situation is made worse by damaging styling practices. Many black women braid, weave, and use chemical relaxers to straighten hair on a frequent and long-term basis. While chemical relaxers are super effective at straightening hair, they can reduce its strength, leading to breakage and hair loss. The negative effects of chemical relaxers are compounded by flat irons and blow dryers. Several different types of conditions are associated with hair loss in black women. 

Central Centrifugal Cicatricial Alopecia (CCCA) 

The number one cause of hair loss in the 2016 study, CCCA is caused by inflammation which can lead to scarring alopecia if left untreated. Scar tissue can cause permanent loss of functioning hair follicles. Once known as Hot Comb Alopecia, the condition was thought to be linked to oils applied to the hair that were then heated with a hot comb. Later, it was shown that many people developed CCCA even though they didn’t use hot oil and combs. 

Now, it is thought that CCCA is probably caused by genetic and autoimmune facrors, as well as enviromental factors. CCCA can occur with other hair loss conditions such as traction alopecia.

A large-scale study analyzing four years of data on 487,000 adult black women revealed a connection between CCCA and uterine fibroids. Nearly 14% of women with CCCA also had fibroids. From this data, researchers established that black women with CCCA have a fivefold increased risk of developing fibroids. It’s a well-known fact that black women are more prone to conditions that cause scarring, which may explain the co-occurrence of both conditions, but the connection is still unclear. Based on these findings, the recommendation is that black women with abnormal hair loss should be screened for CCCA, especially if they are suffering from heavy bleeding and pelvic pain associated with fibroids.


Traction Alopecia 

Traction alopecia is caused by inflammation of the hair follicles. This occurs when hair is pulled too taut over a long duration, in styles such as tight braids and ponytails, cornrows, hair extensions, or weaves. Hair that is naturally curly is fragile, preventing the natural protectant sebum from traveling down the length of the hair shaft. Traction alopecia is self-inflicted, setting it apart from other hair loss conditions linked to genes, stress, illness, and unavoidable factors. It can be reversed if it is recognized and treated, however, repeated tension caused by hair styles will lead to scars and permanent hair loss. Signs include small white dots at the sides of the scalp or in areas surrounding the hairline. Traction alopecia typically causes gradual, but noticeable hair loss on the edges of the scalp, including the back and the front parts of the hairline, behind the ears, and the temples.

Traumatic Alopecia

Traumatic alopecia is basically a fancy term for hair breakage. This type of alopecia affects hair growth because the hair itself is damaged and unhealthy. Like traction alopecia, traumatic alopecia is a type of self-induced alopecia caused by hair care and styling practices; unlike traction alopecia, this type of alopecia focuses on damage to the hair shaft rather than the hair follicle. Afro-textured hair is naturally more fragile than other hair types, making it especially susceptible to hair breakage. Practices such as dying hair, chemically straightening hair, and using heated styling tools such as straightening irons can lead to traumatic alopecia. 


Folliculitis Induced Alopecia

This condition, also called traction folliculitis, occurs when bacteria finds its way into the scalp. This causes inflammation of the hair follicles, damaging them and making it difficult for hair to grow back. Weaves are notorious for causing traction of the hair and inflammation of the follicle root because they allow bacteria to enter the follicle. Scalp tenderness, pain, and little bumps around the follicle are signs of inflammation and possible infection. Folliculitis can typically be treated with loose hairstyles and antibiotics, but it can cause permanent hair loss if it is left untreated. 

The Appearance of Hair Loss

Hair density is lower in black women. This means that there are significantly less hair follicles on the head of an African American woman when compared to women of other ethnicities. For this reason, hair may appear more sparse after it is chemically straightened and its natural texture is removed, even though no hair loss is present. This can also mean that hair loss can have a more noticeable effect in black women. 

How to Prevent Hair Loss

1. Make your straightened hair last as long as possible

Hair Loss in Black Women - Chemical Relaxers

Chemical relaxers are damaging to the hair and scalp. If you wear your hair relaxed, it is important that you don't "overuse" these chemical straighteners. Wait at least the recommended 8 weeks before retouching, and if you can, stretch this time out longer. This will minimize the use of chemical straighteners, making your hair healthier and decreasing breakage. To extend your style, make sure to keep your hair well moisturized with deep conditioning treatments and hair oils. If you feel your hair is not looking its best, try wearing wigs and headwraps to extend the time you can go between using relaxers. 

2. Allow your scalp to breathe between hairstyles

Weaves as well as other "tight" hairstyles put a lot of stress on the scalp. Constantly having this strain on your scalp is detrimental to your hair follicles, and will likely lead to hair loss. For this reason, it is important to give your scalp and hair follicles time to breathe and heal between weaves. If you wear weaves, it is recommended to wear your hair in a 1:1 ratio between tight hairstyles and loose hairstyles. For example, if you wear a weave for one month, give your scalp one month to rest before getting another weave or tight hairstyle; if you wear your weave for two months, wait two months before getting another weave, and so on.

3. Wear wigs properly

Wig Wearing Tips

Wigs are a good option because they allow you to have any hairstyle instantly, including long, straight, and colored hair without the use of tight weaves, chemicals, or hair dyes. A wig also has the added bonus of protecting your natural hair from the elements. However, it is important to wear your wig the “right way,” because wearing your wig improperly can cause hair breakage and affect hair growth.

  • It is especially important to wear the right size wig. Wearing a wig that is too small will cause the wig to rub against the hair, resulting in breakage. Measure your head to find out what size wig you need.
  • Additionally, try to minimize the use of glue that can block the pores . A velour wig gripper is an excellent, effective, and safe way to hold your wig in place.
  • Make sure to wash your wig regularly (about once every 7 wears) to prevent that build up of bacteria that can find its way into hair follicles.
  • We recommend choosing a wig that has an open cap, or monofilament cap to allow your scalp to breathe.
  • Do not wear wigs overnight.

4. Keep the Hair and Scalp Healthy

Use castor, Jamaican black castor, olive, or unrefined and pure coconut oil to massage your scalp to keep it moisturized. Additionally, keep hair moisturized by frequently applying masks and oils. When you use heated styling tools, always thoroughly apply a heat protector.

Healthy hair starts from the inside out. Help keep your hair healthy by eating foods rich in vitamins and healthy fats, such as salmon, avocados, seeds, nuts, and plenty of fruits and veggies.

5. Go Natural

Prevent Hair Loss

Of course, the best way to protect your hair from friction and chemicals is to wear your hair naturally–no weaves, no chemical straighteners, and no dyes.

More tips to Prevent Hair Loss:

  • Choose hairstyles that don’t put extreme tension and pressure on hair strands
  • Allow hair to be completely natural, which means no ties, slides, or clips
  • If you want to braid your hair, tie loose, larger braids
  • Use a wide hair band made of fabric to hold back your hair loosely
  • Wrap your hair in a silk scarf when sleeping to protect your hair and scalp. 
  • Brush hair with a wide tooth comb.
  • Try wearing a full wig or clip-in extensions instead of a weave to add length without pulling on your scalp for extended periods of time.
  • Be aware of how long you leave in tight hairstyles. If your scalp persistently feels uncomfortable, have the hairstyle removed.

Types of Treatment

Although hair loss is common among American-American women, many aren’t aware they should visit a healthcare professional for an evaluation. In fact, the 2016 study revealed 81.4% of participants never consulted a physician about hair loss.

When hair loss is detected and treated early before scarring has taken place, it may be possible to reverse some of the damage. Seeking medical help from a dermatologist, trichologist (hair and scalp specialist), or a physician is key to identifying scalp damage or illnesses that may cause hair loss. Consulting a dermatologist may help to reverse hair loss, and prevent further hair loss.

Common treatments include:

  • High-strength minoxidil formulations
  • Hair growth boosters
  • Medications applied directly to the scalp on a daily basis

Other treatments are also available depending on the cause of hair loss.

Related Pages:

Jada Pinkett Smith Talks Alopecia

What Is Alopecia?

Wigs for African American Women

Headwear for Hair Loss

Shop Head Scarves

Comments, Questions & Ratings

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Thank You! Review by Hair Loss in African American Women
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Thank you for addressing the common occurrence of hair loss in black women. I have a combination of self-caused and beyond-my-control alopecia. I cringe when I see young women with extremely tight braids and other stressful-to-hair styles, knowing what heartache may be in their futures. I will refer as many women as possible to this site. Many women (of all races) tend to take care of others before tending to themselves. I hope this information leads women to no longer view hair loss as natural. Following some simple advice may help them keep or regain their hair. If necessary, a visit to a healthcare professional may provide help. That is not the case for me. My hair is gone for good. Sometimes I just shave my head and roll with it. But, if I want to try a new look, you have a great selection of scarves and some cute wigs. Thank you. (Posted on 06/22/2019)

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