The hair grooming practices of women of African descent in London, United Kingdom: findings of a cross-sectional study.

BACKGROUND: There is a lack of published data pertaining to the hair grooming practices of women of African descent in Europe. However, these data are important in facilitating culturally appropriate discussions on hair loss prevention. OBJECTIVE: We sought to describe the hair grooming practices of adult women of African descent in London, UK. METHOD: Analysis of pooled data collected from a questionnaire-based study exploring correlates of hair loss in women of African descent in London. RESULTS: A maximum of 242 subjects were included in the final data analysis. Subjects had a mean age of 41.1 years (CI: 39.3-42.9) and exhibited a diverse range of scalp hair phenotypes, although the majority (76.3%) had type 6, 7 or 8 hair. A percentage of 64.9 had more than five different hairstyles since childhood, with natural hairstyles being the most frequent current hairstyle (52.6%). The mean frequency of hair washing was 17.9 days (CI: 15.8-20.0), increasing to 32.8 days (28.6-37.0) when hair was braided or in a weave. The mean frequency of hair braiding/weaving was 63 days (CI: 56.3-69.7), whereas that for application of chemical relaxers was 88.6 days (CI: 75.6-101.6). While 59.2% of subjects avoided concurrent use of hair colours and chemical relaxers, only 46.3% avoided braiding chemically relaxed hair. CONCLUSIONS: The hair-care practices of women of African descent should be borne in mind when treating hair and scalp disorders in this group. Although the current trend is towards natural hairstyles, some adverse hair-care practices still persist which should be addressed through culturally appropriate public health messages on hair loss prevention.

Clinical and anthropological perspectives on chemical relaxing of afro-textured hair.

The culturally engrained practice of 'relaxing' afro-textured hair has been linked with hair and scalp disorders. Herein, we discuss the evolution of human hair types, focusing in particular on afro-textured hair. We explore the biological features of this hair type, and discuss the different methods employed to straighten afro-textured hair, focusing in particular on chemical straightening. We also examine clinical, anthropological, and psychological issues associated with this latter practice. Examples of common scalp pathologies associated with chronic hair relaxing, such as alopecia, hair breakage, caustic burns and irritant contact dermatitis, are also highlighted. The data presented herein should enable clinicians to engage in culturally appropriate discussions with their patients about issues of appearance and conformity.

Multisystemic diseases and ethnicity: a focus on lupus erythematosus, systemic sclerosis, sarcoidosis and Behçet disease.

We present an overview of the association between ethnicity and the clinical and epidemiological aspects of four multisystemic diseases: lupus erythematosus, systemic sclerosis, sarcoidosis and Behçet disease. In particular, we highlight observed ethnic differences in cutaneous manifestations of these diseases. This article should help guide clinical management, as well as serve to highlight future areas for research.

Hair and scalp disorders in women of African descent: an overview.

We present an overview of hair and scalp disorders in women of African descent, discussing the biological features of afro-textured hair, as well as hair-grooming practices in this cohort and their association with specific hair and scalp disorders. A practical approach to diagnosing and managing common hair and scalp disorders in this cohort is also presented.

Chemical peeling in ethnic skin: an update.

With the growth of cosmetic dermatology worldwide, treatments that are effective against skin diseases and augment beauty without prolonged recovery periods, or exposing patients to the risks of surgery, are increasing in popularity. Chemical peels are a commonly used, fast, safe and effective clinic room treatment that may be used for cosmetic purposes, such as for fine lines and photoageing, but also as primary or adjunct therapies for acne, pigmentary disorders and scarring. Clinicians are faced with specific challenges when using peels on ethnic skin (skin of colour). The higher risk of postinflammatory dyschromias and abnormal scarring makes peels potentially disfiguring. Clinicians should therefore have a sound knowledge of the various peels available and their safety in ethnic skin. This article aims to review the background, classification, various preparations, indications, patient assessment and complications of using chemical peels in ethnic skin.

Skin bleaching: highlighting the misuse of cutaneous depigmenting agents.

Hydroquinone and other cutaneous depigmenting agents are widely used by dermatologists to treat pigmentary disorders. On 29 August 2006, the US Food and Drug Administration (FDA) published a monograph in the US Federal Register proposing to ban all hydroquinone products that have not been approved via a New Drug Application process. Reports in the scientific literature on the occurrence of exogenous ochronosis, in relation to the use of hydroquinone, was one of the concerns expressed by the FDA in relation to this agent. However, a review of the English-language scientific literature reveals that most of the reported cases of hydroquinone-induced exogenous ochronosis occurs in Africa, where the cultural practice of skin bleaching is highly prevalent. Skin bleaching is the practice of applying hydroquinone and/or other depigmenting agents to specific or widespread areas of the body, the primary function being to lighten normally dark skin. This practice typically occurs in men and women with Fitzpatrick skin phototypes IV to VI. It is a dangerous practice associated with a diverse range of side-effects, including mercury poisoning. Thus, this current discussion within the dermatological community on the safety of hydroquinone provides a unique opportunity to raise awareness about skin bleaching.

RAS and RAF mutations in banal melanocytic aggregates contiguous with primary cutaneous melanoma: clues to melanomagenesis.

BACKGROUND: Distinguishing banal melanocytic aggregates contiguous with malignant melanoma can be a histological challenge but is essential because of the potential for a spurious Breslow measurement. OBJECTIVES: Our aim was to ascertain whether the histological distinction between the two relates to differences in the prevalence of mutations in genes significant in melanomagenesis. METHODS: Mutations in BRAF codon 600, NRAS1 codons 12/13, NRAS2 codons 60/61 and KRAS codons 12/13 were ascertained in 18 cases of primary cutaneous malignant melanoma contiguous with banal melanocytic aggregates using laser capture microdissection. RESULTS: Overall, 12 of 18 cases (67%) exhibited a mutation in at least one gene. BRAF V600E appeared to be the most commonly mutated gene in both the melanocytic aggregate (seven of 18, 39%) and the melanoma (four of 18, 22%). Both populations demonstrated a similar BRAF genomic profile in 11 of 18 cases (61%) (two BRAF V600E, nine BRAF-WT), a similar KRAS genomic profile in 14 of 18 cases (78%) (one KRAS G12V, 13 KRAS-WT) and a similar NRAS2 genomic profile in 14 of 18 cases (all WT). Of interest, we noted a relatively high prevalence of KRAS mutations (five of 18, 28%). The frequency of KRAS mutations in the melanocytic aggregate (five of 18, 28%) was second to BRAF V600E, while in melanoma, the frequency was also second to BRAF V600E but equalled that of NRAS2 (1 of 18, 6%). No NRAS1 mutations were observed. BRAF and RAS mutations appeared to be mutually exclusive with only three of 18 cases (17%) demonstrating a mutation in both genes (melanocytic aggregate only). CONCLUSIONS: Our findings hint towards the interpretation of banal melanocytic aggregates serving as precursor lesions.