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Board-certified dermatologist discusses common types of hair loss seen in women with darker skin tones
NEW ORLEANS (March 17, 2023) — Hair loss in women can be emotionally devastating and may negatively impact quality of life, and new research suggests that it can also be associated with having other common medical conditions. A board-certified dermatologist at the American Academy of Dermatology’s Annual Meeting in New Orleans will discuss the types of hair loss seen in women with darker skin tones, common types of medical conditions associated with hair loss, and hair loss treatment options.
“Research shows that women who experience hair loss can also have other medical conditions like diabetes, acne, and breast cancer,” said board-certified dermatologist Valerie D. Callender, MD, FAAD, professor of dermatology at Howard University College of Medicine. “By recognizing the signs of hair loss and seeing your dermatologist as soon as possible, you may be able to limit the progression, hold on to the hair you have, and discover any other underlying medical conditions you may have.”
Central centrifugal cicatricial alopecia (CCCA), which causes hair loss in the center, or crown, of the scalp, is the most common type of hair loss seen in women with darker skin tones. It is estimated to affect nearly 15% of Black women1, says Dr. Callender.
Early detection is important to preserve and protect your hair because CCCA can cause scarring by destroying hair follicles—the tiny openings from which your hair grows. While it’s possible to regrow some hair, once the hair follicle scars completely, regrowing hair becomes difficult and hair loss can be permanent.
A board-certified dermatologist can diagnose the type of hair loss you have and work with you to determine the best course of treatment for CCCA, which can include antibiotics, topical steroid medication, or corticosteroid injections. These medications may give patients relief from the pain, tenderness, and itching they’re feeling in an affected area, as well as prevent scarring from getting worse.
Conditions such as breast cancer, high cholesterol, diabetes, and high blood pressure2-3 are common among Black women with CCCA, says Dr. Callender. If you have CCCA, your dermatologist may be able to tell you if the other symptoms you’re experiencing are caused by a dermatologic condition, or if they are a symptom of another disease.
Another common type of hair loss is female pattern hair loss, which affects millions of women of all skin tones. In female pattern hair loss, the hair thins mainly on the top of the scalp, and it usually starts with a widening of the center hair part. This type of hair loss is hereditary, and many women who have female pattern hair loss also have acne4 due to an increase in hormones, says Dr. Callender. While acne is more common in the early stages of female pattern hair loss, menopause and high blood pressure are common as female pattern hair loss progresses.
Minoxidil is a common treatment option for female pattern hair loss because it has been shown to reduce hair loss, stimulate hair growth, and strengthen existing strands of hair. Although minoxidil can be found in products at the drugstore, it’s important to consult with a board-certified dermatologist as your hair loss may need to be treated with a higher dosage that is only available with a prescription. Your dermatologist can also advise you on how to apply the treatment to your scalp.
While braids, a ponytail, or an updo can look great, Dr. Callender says hairstyles that tightly pull the hair can cause traction alopecia, which is a common type of hair loss in women with darker skin tones due to hair styling.
“One of the first things I ask my patients who have a history of braids is if it hurts when their hair is braided,” said Dr. Callender. “Getting your hair done shouldn’t hurt, so if they have pain, it’s an indicator that they could be developing traction alopecia.”
Fortunately, there are options that allow a person to keep their sense of style without losing their hair. Loosening up the hairstyle, avoiding frequently wearing hairstyles that pull on your hair, and changing hairstyles can all help prevent traction alopecia.
It is especially important for women with any type of hair loss to consider the ingredients in their products. Women with darker skin tones, particularly those of African descent, have hair that tends to be coarse, dry, and fragile, says Dr. Callender. Some of the shampoos for dandruff and other scalp disorders can further dry out hair, leading to breakage. Patients with darker skin tones should use shampoos and hair products with ingredients that moisturize their hair such as vitamins A and E, jojoba oil, and shea butter.
“When treatments are not effective to prevent hair loss, a permanent solution is to consider a hair transplant, which creates natural-looking results,” said Dr. Callender. “Hair transplants are most effective in patients with traction alopecia and female pattern hair loss. While patients with CCCA aren’t always ideal candidates for a hair transplant due to scarring, it is possible for them to have success. A board-certified dermatologist can determine if a hair transplant is the right option.”
Board-certified dermatologists are the experts in the diagnosis and treatment of hair loss. To find a board-certified dermatologist in your area, visit aad.org/findaderm.
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Hair loss resource center
Central centrifugal cicatricial alopecia
Female pattern hair loss
Headquartered in Rosemont, Ill., the American Academy of Dermatology, founded in 1938, is the largest, most influential and most representative of all dermatologic associations. With a membership of more than 20,800 physicians worldwide, the AAD is committed to advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair, and nails; advocating high standards in clinical practice, education and research in dermatology; and supporting and enhancing patient care because skin, hair, and nail conditions can have a serious impact on your health and well-being. For more information, contact the AAD at (888) 462-DERM (3376) or aad.org. Follow @AADskin on Facebook, Pinterest and YouTube and @AADskin1 on Instagram.
Aguh, Crystal and Amy McMichael. “Central Centrifugal Cicatricial Alopecia.” JAMA Dermatology, vol. 156, no. 9, 1 Sept. 2020, p. 1036, https://doi.org/10.1001/jamadermatol.2020.1859.
Comorbidities in patients with central centrifugal cicatricial alopecia: A retrospective chart review of 53 patients Leung, Bonnie et al. Journal of the American Academy of Dermatology, Volume 88, Issue 2, 461 – 463.
Association of breast and colorectal cancer in patients with central centrifugal cicatricial alopecia: A cross-sectional, pilot study Brown-Korsah, JessicaRoche, Fritzlaine C.Taylor, Susan C. et al. Journal of the American Academy of Dermatology, Volume 85, Issue 3, AB74.
The comparison of demographics and comorbidities of female pattern hair loss according to the clinical subtype and stage Özkoca, Defne et al. Journal of the American Academy of Dermatology, Volume 87, Issue 4, 779 - 783.