Daree Allen Nieves, a Chesapeake, Virginia, native, has suffered from an itchy, irritated scalp for many years. Her hair became irritated when she began to straighten her tightly curled hair. She explains that she started taking relaxers at the age of 13.

In her late twenties, she started seeing a dermatologist every other month — first a black doctor and then a white one. Each doctor prescribed several treatments for skin irritation and dermatitis. Even after giving her hair a “big chop,” she still had problems with her scalp.

She says, “I have never been given a solution or cause for my problems.”

Allen Nieves’ experience with hair is common. Tightly coiled black hair can be very fragile and require lots of care. However, sometimes products and treatments can cause more harm than good. Many people may experience flaky scalps, slow growth, or progressive hair loss. However, they don’t know what to do.

Although a person may think that a stylist will help their hair grow, or they might buy a supplement to aid in growth, the truth is that a dermatologist can be of great assistance, especially if they have experience with Black scalp problems.

Candice Heating, MD, is a Black dermatology professor at Temple University. Most dermatologists don’t have the experience or training to recognize issues specific to Black patients.

Dermatologists may not be qualified to treat Black patients with tight-coiled hair.

Dr. Heath answered the question “Often too late” when she was asked about her encounter with a Black patient suffering from scalp problems.

What is Traction Alopecia?

Traction alopecia refers to hair loss caused by repeated trauma to the scalp due to styling. This is a problem that affects Black women, as well as anyone who wears their hair in tension-producing styles, such as military personnel or ballerinas. Traction alopecia can occur at any age, even in children.

Heath explained that people often talk about losing their edges on social media. However, they are talking about traction alopecia (hair loss from tension) which is most common around the scalp’s front edges. This alopecia is more common in people with tight braids or ponytails.

Many people react to traction alopecia by trying to cover thinning hair by using braids or extensions. This can make the situation worse and lead to hair loss.

Traction Alopecia Treatment

Heath says that traction alopecia can be reversed very quickly. Heath states that if tight hairstyles can be changed to allow for looser hairstyles, it may be possible to restore your hair. It depends on the extent of damage to your hair and how quickly it grows.

It is also possible to reduce chemicals and heat during styling.

According to the Skin of Color Society, a dermatologic non-profit group, dermatologists may recommend topical steroids or antibiotics to reduce inflammation. More advanced cases of traction alopecia may require oral antibiotics or steroid injections to stimulate hair growth.

What is Trichorrhexis Nodosa?

Trichorrhexis Nodosa refers to hair breakage that is frequent due to tight styling, excessive heat, overuse, dyeing, hair washing, or not washing hair enough. It can appear that the hair isn’t growing, but it’s just growing faster than it’s growing.

Crystal Aguh, MD, is the director of the Ethnic Skin Program at Johns Hopkins School of Medicine, Baltimore. She says that although many dermatologists might not be able to treat this condition, she still sees at most one case per week.

Trichorrhexis Nodosa Treatment

According to Aguh’s home remedies for trichorrhea xis, these include shampooing and conditioning your hair more often, applying a protein treatment, and adding oil after using a leave-in conditioner. These are all things that could have been overlooked by someone who wore a wig. A sulfate-free, gentle-sulfate shampoo would be recommended. After a few months, new growth may appear.

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