Reducing the Use of Chemicals Can Prevent Scarring Alopecia




Styling and grooming practices can place all women at risk for hair loss, but African-American women are especially at risk for another form of “traumatic” hair loss from constant and irritating chemical processes such as hair relaxers. It’s called central centrifugal cicatricial alopecia (CCCA), where hair loss typically occurs at the crown area of the head. Although the exact cause of this type of hair loss is “idiopathic,” meaning “from no proven or known cause,” doctors are pretty confident of this diagnosis by noting if your scalp, and/or hair, has a certain reaction right after you undergo any coloring, relaxing or perming process, whether at home or in a salon.

This type of alopecia usually occurs from a salon service, such as a relaxer, that was overprocessed, explains Diahna Husbands, hair replacement specialist and owner of Diahna Lynn Hair Studios, located in the Washington, D.C., metropolitan area. This will also eventually cause the hairs to just break off midshaft. Dr. Valerie Callender, M.D., board-certified dermatologist, specialist in African-American skin and hair disorders and director of the Callender Skin and Laser Center, also in the Washington, D.C., area, adds that the inflammatory condition and permanent scarring of the scalp from these processes can damage hair follicles to the point of their death, in some women.

Sometimes called follicular degeneration syndrome, the condition often continues unnoticed because most women cannot see the very top or back of their head, called the crown, and it will remain so until they feel pain and soreness, see the hair loss or someone else, such as a friend or their hair stylist, alerts them to a problem. Some women may mistakenly think it’s female-pattern baldness and also not seek medical intervention. So, if you practice a lot of chemical or heated styling and grooming, you need to be on the alert for this condition — if caught early enough, it can be reversed.

Signs your chemical processes are harming your scalp and causing hair loss

  • Frizzy hair
  • Noticeable breakage
  • Hair fall-out
  • Sore, dry, flaky or itchy scalp directly after a process
  • Hair thinning on the top of your head
  • Repeated or excessive use of chemical processes

What’s the problem?

  • Semipermanent and permanent hair colors: These swell the cuticle to open up hair shafts and contain harsh chemicals that can irritate your scalp if processed on hair for too long, although these chemicals should never directly touch your scalp.
  • Bleach: Bleach removes the melanin in your hair to completely strip away its color and leaves hair in such a weakened state that it could break right off.
  • Permanent waves (perm): An extremely alkaline solution that can absorb into skin and irritate scalp; always perform a patch test before undergoing this process.
  • Relaxers: There are many different chemical choices, so allergic reactions are common; leaving relaxers on for too long and applying heat also are common mistakes.

Salon process dos and don’ts to prevent scarring alopecia

  • DO try demipermanent, instead of permanent or semipermanent, colors on damaged, weak hair because demipermanent coloring lies on the outside of the hair shaft, giving it a strong, clear coating.
  • DO ask your hairstylist to perform a patch test behind your ear 72 hours before you undergo any chemical process, especially if you have known sensitivities.
  • DO tell your hairstylist if you’ve ever had a bad reaction to any type of process in the past and, for future reference, do take note of any problems you have with a current process.
  • DON’T do these at home!
  • DON’T color and relax or perm your hair at the same time or day. Relax or perm first; then color two weeks later. Otherwise breakage, damage and extreme sensitivity can occur.
  • DON’T rake the scalp with a comb to apply a relaxer — alert your stylist if you feel the comb scraping your scalp.
  • DON’T ever mix bleach with any other process, because all your hair could break off midshaft during another process.
  • DON’T ever go outside with a perm solution on your head. It can react negatively and unexpectedly with heat, humidity and sunlight.

Scarring alopecia: The bottom line

If you notice any signs of oversensitivity (e.g., itchiness, redness, flaking) directly after a treatment at the salon, definitely call your stylist immediately, advises Husbands. “She may be able to neutralize or reverse the process. And she (and you) should definitely make a note of what did not work for your hair so she can try a different formula next time. Otherwise, you may need to find a more skilled stylist.