- Side Effects
- Weight Gain
- Glucose Intolerance
- Increased Susceptibility to Infections
- Bone Thinning (Osteoporosis)
- Easy Bruising
- Mood Swings/Insomnia
- Avascular Necrosis of Bone
- Abdominal Striae
- Baldness (Alopecia)
- What causes baldness?
- What are the symptoms of baldness?
- How is baldness diagnosed?
- How is baldness treated?
- Hair Replacement Surgery
- What are the complications of baldness and hair transplantation procedures?
- Key Points about Baldness
- All hairstyles are not created equal: Scalp-pulling and hair loss
- What Black Women Need to Know About Hair Loss
- Help for those struggling with hair loss
- In New Johns Hopkins Study, Black Women’s Hair Can’t Win For Losing
Prednisone is a corticosteroid. In contrast to anabolic steroids (used by “bodybuilders”), corticosteroids are used in inflammatory conditions for their anti–inflammatory effects.
They have a rapid onset of action, and profoundly affect many parts of the immune system as well as most other body systems.
Corticosteroids are a cornerstone of treating most types of vasculitis, and are often used in combination with other immunosuppressive medications.
Many of the side–effects of steroids are predictable. All are related to: 1) the amount of steroid a patient takes in his/her daily dose, and 2) the length of time the patient remains on the medication. We emphasize that not all side–effects occur in all patients.
Despite the numerous potential side–effects of corticosteroids listed below, their introduction into patient care 50 years ago revolutionized the treatment of many diseases, including vasculitis. When used properly, these drugs save lives and avert threats to the function of important organs.
One of the numerous potential side–effects of prednisone and other forms of corticosteroid treatment is hirsutism — excessive growth of body hair. Patients vary in the degree to which this side–effect of steroids occurs.
Although some experience minimal hirsutism, the patient depicted here developed this side effect after taking 10 milligrams of prednisone for a few months.
Weight gain is usually the most dreaded side–effects of steroid use, incurred to some degree by nearly all patients who take them. The amount of weight gain varies from individual to individual.
In addition to causing weight gain, prednisone leads to a redistribution of body fat to places that are undesirable, particularly the face, back of the neck, and abdomen. Pictured below is a example of redistribution of body fat to the back of the neck.
Accumulation of fat in this area is sometimes referred to as a “buffalo hump”.
Another example of this “redistribution” is pictured below.
Supraclavical “fat pads” are collections of fat at the base of the neck, just above the collarbones, which are common in patients on steroids.
They sometimes cause concern among patients if mistaken for lymph nodes or other causes for worry, but will gradually subside as the prednisone dose is tapered to below 10 milligrams/day.
High blood sugar, or steroid–induced diabetes. This usually resolves when the steroids are decreased or discontinued.
High blood pressure. This usually improves as the corticosteroid dose is reduced.
Increased Susceptibility to Infections
Patients are at increased risk for many types of infections, from minor fungal infections in the mouth (“thrush”, caused by Candida) to life–threatening infections such as Pneumocystis carinii pneumonia.
The higher the steroid dose and the longer the duration of therapy, the greater the risk of infection. The risk is also increased when patients receive combinations of immunosuppressive medications, such as cyclophosphamide (cytoxan) and prednisone.
The risk of some infections can be greatly reduced by taking specific types of antibiotics prophylactically.
Pictured below is woman under treatment with prednisone and methotrexate for vasculitis and a concurrent neurologic condition (myasthenia gravis) developed painful vesicles in her mouth. The vesicles were confirmed by culture to be caused by re–activation of a Herpes simplex infection, and responded to treatment with acyclovir.
Bone Thinning (Osteoporosis)
Prednisone may cause thinning of the bones even in people who are not usually at high risk for osteoporosis (for example: males, young people).
In people susceptible to osteoporosis, prednisone may accelerate the process of bone loss. Fortunately, in the past few years, excellent treatments and preventive measures have become available for osteoporosis.
All patients on prednisone for prolonged periods are candidates for these medicines.
Prednisone also causes “thin skin”. Patients on moderate to high doses of prednisone often notice that they bruise easily, even with only slight trauma. Pictured below is a patient with giant cell arteritis who suffered a skin laceration after she struck her leg against a chair.
Many patients find it difficult to sleep when taking high doses of steroids. Many also find that they are more irritable than usual. Steroids sometimes even induce depression, which improves when the drug is decreased or discontinued.
Avascular Necrosis of Bone
For reasons that are not known, high dose prednisone (for example, greater than 20 milligrams a day) predisposes some patients to joint damage, most often of the hips.
In avascular necrosis (or osteonecrosis, meaning “bone death”) of the hip, the part of the leg bone that inserts into the pelvis dies, resulting in pain with weight–bearing and some loss of joint function.
Many patients with avascular necrosis require joint replacements.
Abdominal striae (“stripes”), as pictured below, frequently occur in patients who take high doses of steroids for long periods of time.
Long–term steroid use may lead to cataract development in the eyes, which frequently require surgical removal.
High dose prednisone predisposes some patients to acne, especially facial acne, as pictured below. The facial acne developed after several weeks of high steroid doses.
Linkedin Pinterest Skin and Hair Care Hair Problems Skin
Baldness is hair loss, or absence of hair. It’s also called alopecia. Baldness is usually most noticeable on the scalp, but can happen anywhere on the body where hair grows. The condition is more common in men than in women.
What causes baldness?
Hair loss is believed to be caused by a combination of the following:
- Change in hormones
- Illness leading to shedding of hair (called telogen effluvium)
- Family history of baldness
- Untreated ringworm of the scalp
- Iron or protein deficiency
- Excess vitamin A intake
- Rapid weight loss
- Certain medicines, such as cancer chemotherapy
- Certain medical conditions, such as lupus
However, hair loss is not caused by the following:
- Poor circulation to the scalp
- Wearing hats
Generally, the earlier hair loss begins, the more severe the baldness will become.
What are the symptoms of baldness?
Depending on the type, the symptoms of baldness will vary. There are several types of baldness including:
- Female-pattern baldness. Although less common, female-pattern baldness differs from that of male-pattern baldness in that the hair generally thins all over the head. The hairline is maintained. Female-pattern baldness rarely results in total hair loss.
- Male-pattern baldness. Male-pattern baldness is usually inherited. The condition may begin at any age. Hair loss often begins on the front, sides, or on the crown of the head. Some men may develop a bald spot or just a receding hairline. Others may lose all of their hair.
- Alopecia areata. This hair loss disorder is characterized by sudden loss of hair in one particular area. The hair grows back after several months. However, if all body hair is suddenly lost, regrowth may not happen. The exact cause of this type of hair loss is unknown. There is a genetic link as well as a link with autoimmune conditions and allergies. If hair loss is complete on the scalp, it is called alopecia totalis, and if all body hair is lost, it is called alopecia universalis.
- Toxic alopecia. Toxic alopecia may happen after a high fever or severe illness. Certain medicines, especially thallium, high doses of vitamin A, retinoids, and cancer medicines may also cause it. Medical conditions, such as thyroid disease, and giving birth may also trigger toxic alopecia. The condition is characterized by temporary hair loss.
- Scarring or cicatricial alopecia. Scarred areas may prevent the hair from growing back. Scarring may happen from burns, injury, or X-ray therapy. However, other types of scarring that may cause hair loss can be caused by diseases. These include lupus, bacterial or fungal skin infections, lichen planus, sarcoidosis, tuberculosis, or skin cancer.
- Trichotillomania (hair pulling).Hair pulling may cause hair loss. This condition is common in young children.
How is baldness diagnosed?
In addition to a medical history and physical exam, a punch biopsy of the skin may help to identify the type of baldness and/or its cause. A culture may be done if infection is suspected.
How is baldness treated?
Your healthcare provider will figure out the best treatment for you :
- How old you are
- Your overall health and past health
- How sick you are
- How well you can handle specific medicines, procedures, and therapies
- How long the condition is expected to last
- Your opinion or preference
Most forms of baldness have no cure. Some types of baldness will go away without treatment. Treatment may include:
- Certain medicines to promote hair growth (such as minoxidil and finasteride)
- Corticosteroid injections (when treating alopecia areata or other inflammatory diseases that lead to hair loss)
- Treating any underlying condition or disease
- Hair transplants
- Scalp reduction
- Skin lifts and grafts
Hair Replacement Surgery
The interest in hair replacement has gone up over the past several years. There are a number of hair replacement techniques available. But, hair replacement surgery can’t help those with total baldness.
Candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. The hair on the back and sides of the head will serve as hair donor areas where grafts and flaps will be taken.
There are 4 primary different types of hair replacement methods, including the following:
- Hair transplant. During a hair transplant, the surgeon removes small pieces of hair-bearing scalp from the back or sides of the head to be used as grafts. These grafts are then relocated to a bald or thinning area.
- Scalp expansion. In this procedure, a device called a tissue expander is placed underneath a hair-bearing area that is located next to a bald area. After several weeks, the tissue expander causes the skin to grow new skin cells. Another operation is then needed to place the newly expanded skin over the adjacent bald spot.
- Flap surgery. Flap surgery is ideal for covering large balding areas. During this procedure a portion of the bald area is removed and a flap of the hair-bearing skin is placed on to the bald area while still attached at one end to its original blood supply.
- Scalp reduction. Scalp reduction is done to cover the bald areas at the top and back of the head. It involves first removing the bald scalp. Then sections of the hair-bearing scalp are pulled together filling in the bald area. This can be done alone or with hair transplantation.
What are the complications of baldness and hair transplantation procedures?
Baldness may lower cause self-esteem. There are complications associated with hair transplantation procedures that include:
- Patchy hair growth. Sometimes, the growth of newly placed hair has a patchy look, especially if it is placed next to a thinning area. This can often be fixed with more surgery.
- Bleeding and/or wide scars. Tension on the scalp from some of the scalp reduction techniques can cause wide scars and/or bleeding.
- Grafts not taking. Occasionally, there is a chance that the graft may not “take.” If this is the case, surgery must be repeated.
- Infection. As with any surgical procedure, there is the risk of infection.
Key Points about Baldness
- Baldness, also known as alopecia, is hair loss, or absence of hair.
- Baldness is usually most noticeable on the scalp, but can happen anywhere on the body where hair grows.
- Treatment for baldness depends on the type of baldness and its underlying cause.
- Most forms of baldness have no cure. Some types of baldness will disappear on their own.
- It is important to talk with your healthcare provider about your baldness and how it can be treated.
All hairstyles are not created equal: Scalp-pulling and hair loss
In a review of 19 studies, researchers at Johns Hopkins say they can confirm a “strong association” between certain scalp-pulling hairstyles — many common among African-Americans — and the development of traction alopecia, gradual hair loss caused by damage to the hair follicle from prolonged or repeated tension on the hair root. An estimated one-third of African-American women suffer from traction alopecia, making it the most common form of hair loss among that group.
In a report on their analysis, published ahead of print in the Journal of the American Academy of Dermatology, the investigators urge dermatologists to better educate themselves about the damaging hairstyles — which include tight ponytails, braids, knots and buns — and advise patients of risks and alternatives.
“Hair is a cornerstone of self-esteem and identity for many people,” says Crystal Aguh, M.D.
, assistant professor of dermatology at the Johns Hopkins University School of Medicine, “but ironically, some hairstyles meant to improve our self-confidence actually lead to hair and scalp damage.
” Traction alopecia, she adds, is entirely preventable, and early intervention can stop or reverse it. “We have to do better as care providers to offer our patients proper guidance to keep them healthy from head to toe,” she says.
In their research review, Aguh and her colleagues categorize hair practices into low-, moderate- and high-risk styles the degree to which follicles are exposed to tension, weight, heat and hair-altering chemicals, such as straighteners.
Moderate-risk styles, the authors say, include some of the same styles noted to be high risk, but because they are performed on natural, unprocessed hair, they are less ly to result in hair loss.
Low-risk styles generally included low-tension styles, such as loose buns, and loose-hanging styles, such as wearing the hair down, as well as practices that decrease the amount of friction on the hair and scalp and avoid chemical relaxers.
Aguh and her colleagues say the highest-risk styles include braids, dreadlocks, weaves and extensions, especially when applied to chemically straightened hair.
These styles are popular among African-Americans, she says, because they are low maintenance and chemical-free, but the constant pulling of the hair in one direction, the tight-locking patterns and added weight can result in significant breakage and eventually traction alopecia.
Damage can also be done if extensions are affixed with adhesive glue put directly on the scalp, especially when the glued-on hair is removed. Chemical straightening weakens the hair shaft, causing breakage.
In the more moderate risk category are thermal straightening, permanent waving and use of wigs.
Temporary thermal or heat-related straightening of the hair, such as the use of flat irons and blow drying the hair — while not by itself significantly associated with traction alopecia — can weaken shafts, leading to “significant” hair loss when traction is applied, the researchers conclude.
Permanent waves made with ammonium thioglycolate to create or alter curl pattern, together with added tension from chemical treatment, do the same. And wigs attached with clips and adhesives to keep them in place can cause significant breakage.
Aguh also noted that cotton and nylon wig caps that rub the hairline may also weaken hair shafts, while satin ones are less ly to do so.
Observations among clinic patients reported in the reviewed studies, Aguh says, found that loose, low-hanging styles or even updos are low risk for traction alopecia.
So are natural styles that avoid chemicals and the use of frequent moisturization with conditioning agents.
Untreated and unprocessed hair, she says, can withstand greater traction, pulling and brushing, and overall decreases the risk of traction alopecia, regardless of styling.
In their review, the investigators also offered guidelines for dermatologists and other care providers to prevent and manage hair loss from traction alopecia.
The first line of therapy, they say, is to loosen braids and other high-tension styles, as well as weight on the follicle permanently or periodically.
Braided hairstyles should be in place no longer than two to three months, they say, and weaves and extensions should also be removed for a period of time after six to eight weeks.
The investigators also recommend people alternate styles, mainly reducing or avoiding updos, to allow follicles to recover from stress.
“Dermatologists need to be conscious of the fact that many high- and moderate-risk hairstyles greatly improve hair manageability, and simply telling patients to abandon them won't work for everyone,” says Aguh. “Instead, physicians can educate themselves to speak with patients about making the best hairstyling choices to minimize preventable hair loss.”
Materials provided by Johns Hopkins Medicine. Note: Content may be edited for style and length.
What Black Women Need to Know About Hair Loss
Continue reading the main story
When Jasmine Collins, a hairstylist in the Atlanta area, turns her clients around to face themselves in the mirror, it’s often the first time they have seen their own hair styled in years, maybe decades.
Ms. Collins is convinced that increased wig and weave wear since the early 2000s has caused widespread hair loss among black women. “Remember 20 years ago, when people were wearing their own hair with relaxers?” she said. “People had heads full of hair.”
“I am not anti-weave,” she said. “I’m just trying to spread the word about an issue.”
The topic is fraught for black women. Wigs and weaves give them styling versatility, and, when done well, can protect their own hair. But critics are quick to accuse extension wearers of submitting to the pressures of a Eurocentric society and its beauty standards.
Another assault has a misogynistic slant — namely that wearers are trying to deceive men with hair that is not their own. Last year, Whoopi Goldberg added puzzling commentary when she conflated black women wearing straight blond extensions with cultural appropriation.
Amid the cacophony, change is brewing. As women let go of wigs and weaves, stylists Ms. Collins have perfected hairstyles to hide hair loss, and doctors are helping women through the process of growing back their own hair.
“A lot of people think they’ll be in weaves for the rest of their life,” Ms. Collins said.
ImageThe “before” photo of the client showing hair loss along the edges.
Traction alopecia is caused by inflammation of the follicle when the hair is being pulled too tight for too long.
“It’s probably the most common form of hair loss we see in the black community,” said Crystal Aguh, an assistant professor of dermatology at Johns Hopkins University Hospital in Baltimore and an editor of the textbook “Fundamentals of Ethnic Hair: The Dermatologist’s Perspective.”
Hair that is naturally curly is also fragile. Because of bends in the hair, sebum from the scalp, a natural protectant, can’t travel down the length of the shaft. The bends themselves also make curly hair prone to breakage.
Hair loss happens in phases. Pain and little bumps around the follicle, called traction folliculitis, are the first signs that a style is too tight. Subsequent thinning, traction alopecia, can still be reversed. After that, when the follicle is put under repeated tension, it scars over and hair stops growing permanently. This is called scarring alopecia.
Braids, wigs and extensions can be worn safely and are not the direct cause of hair loss. But when they put too much tension on the hair or are worn constantly, the follicles inflame and hair breaks. Women may notice hair loss but feel trapped in a cycle of wearing extensions to cover it.
“Patients come into my office, and they don’t even want the nurses to see their hair,” said Michelle Henry, a dermatologist in Manhattan who specializes in hair-loss treatments. “These styles — braids, weaves — are so a part of our culture that people think their hair loss is hereditary.”
With the right haircut and color, Ms. Collins is able to conceal hair loss.Credit….
Ms. Collins started posting striking before-and-after photos on her Instagram account two years ago. When word got out, she was styling about 120 clients a week. (“I was running myself into the ground,” she said.) She has a lighter client load now that she has passed on her technique to the nine stylists at her salon, Razor Chic in Lithonia, Ga. Education is part of her broader mission.
“A lot of stylists don’t know how to camouflage someone’s hair,” Ms. Collins said. “That’s another reason I’m always teaching classes.” She teaches in-person and online styling seminars, streamed through her website, razorchic.com.
Ms. Collins attributes her work to an expertise in hairstyling fundamentals. Camouflaging hair loss comes down to giving each client the right haircut and color, then working with her face shape to conceal balding along the edges or at the crown (or both) with whatever hair is remaining.
Her chemical straightening strategy depends on hair texture and length. If someone has medium to long hair, she won’t put a full relaxer in it, “because I want the fullness and volume,” she said. “The only time I’ll do a bone-straight relaxer is if I have to go very short.” New clients spend around $500 for services and any maintenance products Ms. Collins recommends.
“I’m able to give a person a nice look so they can walk around confident enough to rock their own hair,” she said.
Dr. Henry balances empathy with an urgent message about the condition. “The conversation I have with my patients is you can stop wearing these styles now and save your hair, or you can continue and end up with permanent hair loss,” she said.
Because traction alopecia is caused by inflammation, Dr. Henry injects the scalp with steroids. “I also make a compound with minoxidil that helps growth, a steroid and a little bit of tretinoin to help it all penetrate,” she said. Platelet rich plasma therapy, in which growth factors from the patient’s own blood are injected into the scalp, can stimulate hair growth, too.
Dr. Aguh doesn’t ask her patients to go cold turkey on a hairstyle because such a regimen is too difficult to stick to. Instead, she requests smaller, consistent changes. Relaxed hair is more ly to break when it’s braided, so she asks patients who are wearing extensions and also use relaxers to space out chemical treatments, for at least 12 weeks, and eventually go natural.
“But if you’re really noticing a lot of thinning, you have to get a style that doesn’t include your broken hair at all,” she said.
Dr. Aguh also recommends essential oils including thyme, rosemary, cedar wood and peppermint to patients who aren’t pregnant, aren’t prone to seizures and don’t have heart conditions. “Essential oils are very strong so they must be diluted with inactive oils grape seed, coconut or olive oil,” she said.
Once hair loss is permanent (a dermatologist can diagnose which phase the scalp is in), transplants are the only reliable treatment.
“But most people have nonscarring hair loss,” Dr. Aguh said. “They have the potential to get that hair back if they make styling changes and get treatment.”
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Help for those struggling with hair loss
This article was originally published by Hopkins Medicine magazine in its Spring/Summer 2018 issue
Dermatologist Crystal Aguh studies lifestyle factors affecting hair loss in ethnic populations—an area where most dermatologists fear to tread. She speculates that's because dermatologists, the vast majority of whom were never exposed to the topic in medical school, are often “nervous on how to approach treatment.”
“Hair loss seriously impacts self-esteem and quality of life. I always make sure to bring in a box of tissues when I'm talking with my hair loss patients. It really affects their entire being.”
Assistant professor of dermatology
This failure to communicate is particularly devastating to African-American women, as nearly 50 percent of them suffer some kind of hair loss.
Studies suggest a significant portion of middle-aged African-American women feel their hair is “unhealthy”—perhaps due to experiences involving hair care and styling—and that these concerns lead many to avoid exercising, so as to protect their existing hair.
Few of these women discuss their hair and scalp issues with their doctors, says Aguh, and those who do are often dismayed at their physicians' lack of knowledge about common African-American hair issues. These include dryness, breakage, and fragility—the result of curly hair that is farther away from the scalp's natural oils than straight hair.
“Hair loss seriously impacts self-esteem and quality of life,” says Aguh, who became the Department of Dermatology's chief resident in 2014 and is now an assistant professor. “I always make sure to bring in a box of tissues when I'm talking with my hair loss patients. It really affects their entire being.”
One common type of hair loss that almost exclusively affects African-American women is central centrifugal cicatricial alopecia, or CCCA. It's a permanent, scarring type of balding involving chronic inflammation radiating outward from the crown of the scalp.
There's no cure or effective treatment yet for CCCA—though Aguh is studying the same kind of new, platelet-rich plasma injections that other researchers are investigating for their possible use in treating inflammatory issues, including tendon injuries and arthritis.
Still, Aguh can work with patients to keep a difficult situation from getting worse.
“With CCCA, the worst hair loss comes in the middle of the scalp, but tight braids will pull out hair in other places (notably the front and sides of the scalp),” she says.
“Because there are no great CCCA treatments, I want them to max out their hair everywhere else. People who want to camouflage their hair loss want to know how styling can come into play.
So every patient I see with hair loss gets this discussion.”
As one of fewer than a dozen dermatologists nationwide specializing in hair care, Aguh treats more than 200 women a year (and some men) concerned with their hair loss and damage.
Often, they come in frustrated: They may have a dermatological scalp condition for which their specialist has prescribed a shampoo with instructions to use it every day—not knowing that daily shampooing often destroys curly hair (another effect of the lack of natural oils).
“Basic styling isn't part of any medical school dermatology curriculum, though it should be,” Aguh says.
“If someone has permanent hair loss and dreadlocks, the average dermatologist would focus on giving them steroid injections or steroid creams.
But no one will ask them how often they see their loctician and [discuss] the kind of different, looser dreads they could switch to that won't cause hair loss.”
Aguh recently co-authored Fundamentals of Ethnic Hair: The Dermatologist's Perspective (Springer, 2017) with Johns Hopkins dermatologist Ginette Okoye. The textbook covers basic science, including a comparison of the chemical and physical properties of Asian, black, and Caucasian hair—and discusses hair styling and its cultural and religious roots.
“Our book was, in part, aimed at increasing dermatologists' awareness of routine, common styling practices among our patients,” Aguh says. “That's [been] a nonstarter existing curriculums.”
Posted in Health
In New Johns Hopkins Study, Black Women’s Hair Can’t Win For Losing
Last week, a research team from Johns Hopkins Medicine published a review of 19 studies titled “All Hairstyles Are Not Created Equal”, in which they analyzed the relationship between “scalp-pulling” hairstyles and hair loss among Black women.
The takeaway, according to Dr.
Crystal Aguh, is to offer both Black women patients and dermatologists tips for how to better prevent traction alopecia by avoiding high and moderate risk styles, weaves, locs, tight ponytails, chemical treatments and braids.
And while it is rather enlightening to see more research being conducted on issues particular to or Black women, this is not news for us. The vast majority of us have known since adolescence what those tight micro braids can do to your edges as well as the dangers of any type of chemical treatment. But even though relaxer sales are on the decline in the U.
S., you’d be hard pressed to scroll through your Instagram ‘Explore’ page without catching videos showcasing luxurious weaves, braids, and faux-locs. No matter the damage to our own hair, many (but not all) Black women still feel compelled to manipulate their hair in such harmful ways because eurocentric beauty standards still reign supreme in our society.
From employers reprimanding natural-haired Black employees for not having hair that “lays flat”, to tasteless thinkpieces from White women reveling in Beyoncé’s “Becky with the good hair” lyric, and even college athletes being referred to by a media professional as “nappy-headed hos”, there seems to be no hairstyle we can don that won’t provoke the ire of our ever-critical, misogynoir-filled society—hoteps (or rather, “noteps”) included.
Contrary to what those folks would believe, we are not lazy, self-hating women who aspire to rid ourselves of our blackness and one day morph into White women.
Many of us are just trying to get by while either navigating the idealization within our own communities of images of Black women with Type 1 or Type 2 curl patterns that, for some, simply cannot be attained without chemical processing, or being told by White America that our hair, no matter what state it’s in, is “unprofessional”—or both.
And so we press, braid, weave, dye, and relax on. All while spending thousands of dollars and placing ourselves at risk of medical disorders in the meantime.
To focus on the harmful styling of Black hair without first focusing on the very real and very harmful societal pressures that would cause a woman to pursue them is akin to trying to solve an algebra problem while disregarding the first half of the equation. It is also dangerous, in that it misplaces blame onto Black women by implying a false sense of choice. I, personally, would much rather spend my hair care budget on myriad other things, bills, tuition, and Formation tickets.
But until we get serious about rooting out misogynoir in the world around us, we’ll keep doing what we have to do to get by.
Image via open source image