Scalp Alopecias in Richly Pigmented Patients

The document from 2007 examines scalp alopecias in patients with richly pigmented skin, highlighting the impact of hair care practices like the use of hair relaxers, extensions, and tight braiding on the prevalence of these conditions among black American females. A study involving 39 African women showed that hair relaxers were used by 53%, extensions by 23%, and alternating between relaxers and braids by 20.5%, with 20 patients diagnosed with scarred alopecia due to long-term use of hair relaxers. Symptoms include a shiny scalp with few or no hair follicles, especially on the vertex and edges of the scalp. Treatments suggested are avoiding harsh hair styling practices, using intralesional steroids, and educating patients on the irreversible nature of scarring. The document stresses early identification and prevention, with less damaging hair care practices being crucial for hair retention. Diagnosis is based on clinical signs and patient history, with treatments like topical steroids, antibiotics, minoxidil, and triamcinolone injections, and progress tracking through baseline photographs and measurements.