Scarring alopecia: clinical and pathologic study of 54 African-American women

Int J Dermatol. 2009 Aug;48(8):840-5. doi: 10.1111/j.1365-4632.2009.04129.x.


Background: Cicatricial or scarring alopecia results in the destruction of hair follicles and is a significant cosmetic concern in African-American women.

Objective: To correlate the clinical examination and histologic findings in African-American women with scarring alopecia with a history of hairstyling practices.

Methods: We reviewed retrospectively the medical records and scalp biopsy specimens of 54 women with scarring alopecia. Patients were selected from two dermatologic practices in the Detroit Metropolitan area.

Results: Alopecia commonly presents in patients who use a variety of traumatic haircare techniques, including chemical and physical straighteners, traction, braiding, hair extensions, hair gluing, and chemical curls. Histologic findings are centered around the follicular infundibulum with a lymphocytic infiltrate and perifollicular fibrosis.

Conclusion: Traumatic hairstyling techniques are common in African-American women, and all result in a similar picture of a peri-infundibular lymphocytic infiltrate and fibrosis, leading to alopecia.

MeSH terms

  • Adult
  • African Americans*
  • Aged
  • Alopecia / chemically induced*
  • Alopecia / ethnology*
  • Alopecia / pathology
  • Biopsy
  • Cicatrix / chemically induced*
  • Cicatrix / ethnology*
  • Cicatrix / pathology
  • Female
  • Hair Follicle / pathology
  • Hair Preparations / adverse effects*
  • Hot Temperature / adverse effects
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Scalp / injuries
  • Young Adult


  • Hair Preparations