Certain types of
alopecia, such as
traction alopecia,
discoid lupus erythematosus, and central centrifugal cicatricial
alopecia, occur more commonly in African-American individuals than in those of other ethnicities. Both intrinsic hair qualities and hair care practices play a role. Lower baseline tensile strength, hair density, and growth rates, as well as the use of high-tension hairstyles and chemical relaxers may contribute to
alopecia in this group.
Alopecia can also occur as a result of
discoid lupus erythematosus, which involves chronic lymphocytic infiltration and eventual
scarring of the hair follicle.
Lichen planopilaris is a less common cause of
scarring alopecia that can appear clinically similar to other forms of cicatricial
alopecia. Lastly, although not classically associated with
hair loss, recent evidence indicates that
seborrheic dermatitis may play a role in shedding and
alopecia. Recognizing and differentiating these alopecic subtypes clinically and histopathologically is important for prompt diagnosis and treatment. This article is based on a chapter in Ethnic Skin and Hair, and intended as a supplemental article to "Current and Emerging Treatment Strategies for
Hair Loss in Women of Color."