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Jada Pinkett Smith recently revealed she was having trouble with unexpected hair loss, the cause of which has not been determined. Many Black women are challenged by thinning and bare edges and sometimes balding and permanent hair loss. Leading dermatologist Dr. Karen Heidleberg-Barnwell says there are some measures you can take to combat hair loss.

 WHAT ARE THE MAIN TYPES OF HAIR LOSS?

There are 2 main types of hair loss; scarring (cicatricial) and non-scarring  (non cicatricial). Scarring hair loss causes damage to the follicular epithelium, causing permanent hair loss.  Non-scarring hair loss is not permanent. There are also abnormalities that can occur with the hair shaft which can be congenital or acquired. These abnormalities can cause hair breakage.

 WHAT ARE SOME OF THE COMMON CAUSES OF HAIR LOSS?

 Male-pattern hair loss is the most common form of hair loss in men, and female-pattern hair loss is the most common form of hair loss in women. There is an epidemic of avoidable hair loss that we are seeing in young African\-American women based primarily on styling practices.

DOES YOUR HEALTH AND/OR DIET AFFECT HAIR LOSS?

Yes, your physical health and diet can affect hair loss. Calorie and protein malnutrition is associated with hair loss. In addition, hair loss is often associated with chronic diseases, post-surgery, and with medications.

IS ALOPECIA HEREDITY?

Yes, there are studies that demonstrate that the predisposition to male balding is predominantly due to genetic factors. Women with androgenic alopecia often have a family history of pattern alopecia in both male and female family members.

DOES STRESS AFFECT HAIR LOSS?

Yes, stress can affect the hair. Telogen effluvium has been associated with severe prolonged psychological stress. Although Alopecia Areata (AA) is an immune mediated form of hair loss, a link between stress and the development of AA has been described.

CAN CERTAIN MEDICATIONS CAUSE HAIR LOSS?

Yes, medications can cause hair loss.  There are numerous medications where hair loss is a side effect.

 WHAT’S THE DIFFERENCE BETWEEN HAIR LOSS AND YOUR HAIR SHEDDING?

We have normal  hair shedding where we  lose about 100-200 hairs per day. The amount of hair we shed each day varies between individuals and there are seasonal variations.  This hair shedding does not lead to thinning.

WHAT TYPE OF DOCTOR SHOULD WE BE GOING TO CONCERNING HAIR LOSS?

The specialty of dermatology addresses all medical issues concerning the skin, hair and nails. Therefore, you should seek an evaluation from a dermatologist.

WHAT IS TRACTION ALOPECIA?

Traction alopecia is hair loss caused by too much tension being placed on the hair with styling. It is most often seen around the hairline.  Some of the common hairstyles which cause this type of hair loss include  braids, pony tails, and hair weaves.

HOW CAN HAIR LOSS BE PREVENTED?

The most important  way to avoid hair loss is to understand the causes. Understand the preventable causes of hair loss and avoid those practices.  We know that chronic tension on hair can cause permanent hair loss, so it is best to avoid those styles.  It is also important to seek treatment as early as possible if you are losing hair. The sooner the problem is identified and treated, the better the response you will have .

IS THERE A CERTAIN TYPE OF SHAMPOO AND CONDITIONER I SHOULD USE TO HELP STRENGTHEN AND GROW MY HAIR?

 It is important to determine the cause of your hair loss and address that issue specifically. A good shampoo and conditioner may not solve your problem. In general, I recommend a good moisturizing shampoo and conditioner in addition to any medications needed.

DO YOU RECOMMEND ANY SPECIFIC VITAMINS OR SUPPLEMENTS?

My recommendations for supplements depend on the needs of the individual patient.  In general, topical minoxidil is helpful for hair loss and I often incorporate that into my treatment. 

WHAT WOULD YOU NEED TO SEE ON MY SCALP THAT WOULD PROMPT A SCALP BIOPSY?

A  scalp biopsy is often used in the evaluation of a patient with hair loss.  If you have hair loss, don’t be surprised if your doctor recommends a biopsy, which is very helpful in the overall evaluation.

DO I NEED TO TAKE A BLOOD TEST TO DETERMINE THE CAUSE?

There are some types of hair loss where blood work is necessary, but it is not always required.

Dr. Heidleberg-Barnwell answers your ‘Text Tom’ questions on the next page.  

Can anything be done about thinning hair from dialysis? Been on it 4 years and hair has thinned.

Hair loss associated with dialysis is a common problem and can be treated. I would suggest that you see a board-certified dermatologist in your area.

 My hair has not come back from chemo 7 years ago. Any hope that I can regrow hair?

In general, hair loss associated with chemotherapy is usually non – scarring and doesn’t cause permanent hair loss. However, more recently there has been permanent hair loss associated with some chemotherapeutic medications. I would suggest that you see a board certified dermatologist for an evaluation and discuss your previous treatments.

What can be done for women with alopecia? My daughter in law is looking for option.

There are many treatment options for hair loss.  Your daughter in law needs to be evaluated by a board certified dermatologist to identify the cause of her hair loss and based on that, she can receive appropriate treatment.

Is wearing natural hair healthier or better for us, even if we are just braiding it and wearing wigs, weave, etc.?

Wearing tension-causing hair styles, which include braids and hair weaves, can cause permanent hair loss.

How does hair dye effect hair, especially bleaching?

Permanent hair dye penetrates the hair shaft.  As a result, sometimes the hair becomes dry, brittle and breaks more easily.

I have shallow roots. When my hair comes out it, comes out at the roots. Is there anything I can do to stimulate root growth?

It is normal to have hair shedding.  We may lose 100-200 hairs per day, but this varies between individuals.Your hair loss  should  be evaluated by a board certified dermatologist to determine if your hair loss is normal or requires treatment.

How do I find a good dermatologist in South Florida? I have been to dermatologist that were not that good. My son has growth on the tip of his finger under the finger nail. The dermatologist froze it, then burned it but it has come back.

I recommend contacting the American Academy of Dermatology.  It is the largest, most influential and representative dermatology group in the U.S. You can find a listing of dermatologists in your area.

 Does being diabetic cause hair loss?

Hair loss is sometimes seen with chronic diseases. You should have your hair loss evaluated by a board-certified dermatologist to receive appropriate treatment.

My wife loses hair whenever she combs it. She told me that it’s normal. What do you think is happening here?

Your wife is probably correct.  It is normal to lose hair daily with hair combing.  Some people can lose 100-200 hairs daily!  However, if there is a concern, she should be evaluated by a board-certified dermatologist to see if her hair loss is normal.

I have a 2-year old granddaughter and her hair has patches. What can we do now to restore her hair?

There are many causes of patchy  hair loss in children. I suggest you take her to a board-certified dermatologist for evaluation.  Most causes of hair loss in children can be treated.

 I have had universal alopecia for over ten years. I’m still hoping for a cure.

Alopecia universalis is a difficult type of hair loss to treat. The good news is that there are new medications that are being tested. Keep in contact with your dermatologist regarding JAK inhibitors.

I am 31 years old. Within the last 2 years, my hair has thinned out a lot & will not grow anymore. My hairdresser has even commented on the thickness and my length. Is there anything I can do to increase the thickness and get my hair to start growing again? I don’t wear braids or hair extensions.

Sometimes we can damage our hair with heat and styling practices. These practices can make our hair break and become shorter and thinner and it seems that the hair isn’t growing.  Of course, there are other things that can make your hair thinner.

I would suggest that you see a board-certified dermatologist to evaluate your hair.  The dermatologist can help to identify the cause of the hair loss and make appropriate recommendations.  It doesn’t sound like permanent hair loss which is great!

 Dr. Karen, how do I find a qualified Black dermatologist in my area?

The National Medical Association (NMA) is the leading organization of African0-American physicians. The NMA is the largest and oldest national organization representing African-American physicians and their patients in the United States.

Is a visit for hair lost diagnosis and treatment covered by insurance or is it considered cosmetic and you have to pay out of pocket? And if that is the case, about how much would this cost run you?

The coverage for a  hair loss evaluation by a dermatologist depends on your insurance.  Check with your policy and they can estimate your out of pocket expenses.

I’m a 70 years. young woman  with thinning around my hairline. I prefer wearing my hair away from my face. I have thick head of hair, thank God, however does thinning hairline come with age?

Thank God for thick hair! What a blessing!  Make sure that your hair styles are not putting tension on your hairline because this styling practice can cause thinning.

I’m 48 and have what I think is the typical male-pattern baldness…I call a sunroof….is there any treatment for someone my age?

As I mentioned in my interview, male-pattern hair loss is the most common form of hair loss in men. You should be evaluated for your hair loss. Depending on the extent of your hair loss, you may respond to therapy.  Therapy my include topical medications, oral medications, injections, laser, or a combination of these treatments. If all else fails, there is always hair transplants!

What can I use for eczema and flakes on my 9-year-old daughter’s scalp? Is there any oil that is safe to use on the scalp for adults or children?

The treatment of a flaky scalp often requires medical treatment if it doesn’t respond to over the counter remedies such as tar shampoos.

 

Dr. Karen Heidleberg-Barnwell, best known as  “Dr. Karen” is a board-certified dermatologist, with a successful practice in Detroit, Michigan.  She received her medical degree from the Howard University College of Medicine and completed her internship in internal medicine at George Washington University Hospital. She did her dermatology residency at the Mayo Clinic. At Heidelberg Dermatology, Dr. Karen is the managing partner and chief physician. 

PHOTO: Courtesy

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