Hair Frustrations

by Jen
(Baltimore, MD)

Hi Dr. Weaver,
I am a 27 year old African American female who has been experiencing hair issues all of my life. My hair grows in very kinky and is hard for me to manage. I have been to different stylists over the years, but no one has been able to truly help me style my hair properly. I have a long history of frustrations with my hair which I will try to summarize for you.

As a child, I would wear my hair natural, with braids, and with a relaxer. When I was a teenager (around 15 years old), I wore my hair in a press in curl because my hair would shed if I had a relaxer. At that time, my hair was full and thick. I wanted to relax my hair because I wanted to look like all of my friends. By the end of high school, I did away with the hot comb and relaxed my hair. The relaxed style was fine for a little while, but then I started noticing breakage at the crown of my head. The hair in this spot was shorter than the rest of my hair, but I did not notice any balding at that time so I continued to relax my hair until about 2 years ago.

Over the years when I had relaxed my hair, I probably did experience some over-processing. I would get my relaxer touch-ups about every 4-6 weeks because I could not manage the new growth without it shedding. I also did color my hair only twice in 2001 and then again in 2002. In 2002, about 2 weeks after I colored my hair, I got a relaxer touch-up, which was a big No No because the sides of hairline began thinning. I learned my lesson from that one and never colored my hair again. I cut off my hair to a short style and continued to relax my hair.

About 2 years ago, I noticed the spot on the top of my head was practically bald. I consulted a dermatologist who only spent about 2 minutes with me and prescribed Nizoral shampoo and Fluocinonide for seb. dermatitis. About 4-6 months after that, I had not seen much of a change. I tried to get cornrows, but the hairstylist noticed that the cornrows were pulling the hair from the roots at my hair line so she took them out. The next day, I chopped off all of my hair and went natural. I consulted another dermatologist who has been very helpful with my hair issues. He diagnosed me with seb. dermatitis and alopecia. He told me to continue using the Nizoral shampoo, but discontinue the Fluocinonide. He also prescribed Luxiq, Derma-Smoothe, and daily vitamins for me to treat my hair loss and dry scalp. I also receive injections in my scalp every few months. I had been faithful in my treatment regiment and began to see great improvements. I could not even notice the bald spot at the crown of my head anymore. I stopped taking the prescribed medications and thus, the bald spot has returned. I know that I fell off the wagon, so I began my treatment again about a 6 weeks ago.

With all of this said, I have become very frustrated with my hair and distrust going to hairstylist that feel that they know how to handle my hair. I have not been to a hairstylist in about a year and a half because I got tired of explaining to them why I lost my hair. I have been so embarrassed that someone may see my thin spot. My dilemma now is that I am getting married in November 2009 and would like for my hair to look beautiful for the wedding. I am hopeful that if I keep up my treatment regiment, the health of my hair will improve, but I'm just not confident that I will be able to find a hairstylist that will be able to style my hair without causing more damage to it. Currently, I wear my hair naturally in an afro. Sometimes I twist it but most times I try to just leave it alone because I don't feel like being bothered with it.

I guess my question is how do I find a stylist with the qualifications to manage my hair without causing more damage? I would like to be able to consult with the stylist to find the best hair styles that I should wear.

RESPONSE

Your frustrations are understandable.

You have received medical care that is appropriate for your concerns, however, there seems to be persistent dryness and difficulty with styling your hair that would be helped the most by using a type of hair strengthener or moisturizer.

In order to give you the best advice, it would be necessary to really examine your hair and scalp more closely.

You are in Baltimore, which is close to Mitchellsville, MD and Valerie Callendar, M.D. is an African American dermatologist who it might be worth your while to visit and see if she has some additional recommendations to make for either additional medical care or a hair professional in that area that she feels can help you.

The area that you describe in the middle of your scalp where the hair has been lost really looks like an area of neurodermatitis, which should be reversible with treatment that you have been using. However, it can reappear due to anxiety or stress related matters amongst other reasons.

Good luck!

S.M. Weaver, III, M.D.