Weekly washing with appropriate products regulates the scalp microenvironment and reduces product buildup in Afro-textured hair, according to a recent review.
Afro-textured hair is characterized by an elliptical hair shaft and retro-curved follicle, which can contribute to uneven sebum distribution, increased tangling and knotting, and a greater susceptibility to breakage. In the review, investigators noted that conventional tensile strength testing may not fully capture the viscous “toe-region” response observed in curly fibers. With respect to hereditary conditions, partially penetrant autosomal dominant mutations in the PADI3 gene have been implicated in central centrifugal cicatricial alopecia (CCCA). Associations between CCCA and fibroproliferative disorders were also described, supporting examinations into shared fibrotic pathways.
The investigators further summarized evidence linking mechanical tension, protective styling practices, thermal styling, and chemical straightening to CCA, traction alopecia, and acquired trichorrhexis nodosa. Weekly gentle cleansing with appropriate products was supported in recent studies to regulate the scalp microenvironment and reduce product buildup. In diagnostic evaluation, a normal hair-pull test result range of fewer than two hairs was reported to predict low hair loss risk across all hair textures, and dermoscopy may be used to diagnose various conditions in patients with Afro-textured hair
The investigators conducted a narrative review of the PubMed, Scopus, and Web of Science databases from 2010 to 2024 using search terms such as “Afro-textured hair,” “curly hair care,” and “ethnic dermatology.” They included English-language, peer-reviewed studies applicable to dermatologic practice and formulated clinical recommendations based on consistently identified themes in the literature. The six domains identified were patient-physician relationships, classification and terminology, hereditary and acquired conditions, biochemical structure and behavior, diagnostic approaches, and hair products and styling practices.
The investigators acknowledged that the review lacked a systematic search strategy and formal quality appraisal, introducing potential selection bias. The recommendations have not yet been validated. The investigators stated that subsequent research may focus on evaluating how each domain can be applied in clinical practice.
“[T]hese recommendations help optimize patient and provider education and aid in diagnosing, preventing, and treating hair and scalp conditions,” noted lead study author Ja’Neil G. Humphrey, MA, of the School of Medicine at Loma Linda University, and colleagues.
The study authors reported no conflicts of interest.