black girl with glitter on her face showing alopecia in natural hair
Curly Hair Care

Alopecia in Natural Hair: Here’s What You Should Know

Ever parted your hair to find a bald spot? Or have you noticed that your part is slowly widening over time?

You may be thinking you have alopecia which, contrary to popular belief, is more common than you think!

Hair loss in general is a painful realization to come to, especially as a black woman. Our hair is a part of not only our femininity, but our black identity.

Plus, natural hair can be a chore to maintain. We don’t want to see it disappear!

But not to fear: about 40% of women have experienced hair loss at some point in their life. And contrary to popular belief, hair thinning/loss starts anywhere between 25-35 years old.

If sounds like you, although this may seem heartbreaking and scary, there is hope in stopping the hair loss and re-growing your hair. And, if you’re above this age, we have some tips for you too.

Let’s get into the different types of alopecia and how we can take steps to reverse it.

what you need to know about alopecia in natural hair

What is Alopecia?

Alopecia is hair loss from the scalp which occurs diffusely (randomly) or in a pattern. The hair loss is triggered by either nutrient deficiencies, medication, stress, diet, traumatic hair care practices, and autoimmune disorders.

The natural hair growth cycle is interrupted depending on the type of alopecia you have. To understand how alopecia affects us, let's quickly discuss the normal hair growth cycle is as follows:

1

Anagen Phase

  • Otherwise known as the growth phase.
  • Usually lasts a few years.
  • Your hair is growing actively. 


2

Catagen Phase

  • The hair stops growing and it separates from its follicle.
  • The catagen phase lasts about 10 days

3

Telogen Phase

  • The follicle rests for two or three months, and then the hair falls out.
  • New hair grows in the same follicle, starting the cycle all over again.

Alopecia Areata

Alopecia areata is a rare autoimmune disorder that affects 2% of the population. This type of alopecia is characterized by unpredictable, patchy hair loss all around the head in no observable pattern, and is attributed to an autoimmune disorder that attacks the follicles.

Traction Alopecia

Traction alopecia occurs when our hair follicles have become irritated/inflamed due to being in a tight hairstyle.

With this type of alopecia, hair loss occurs around the perimeter of the head: the temples, frontal edges and nape of the neck.

You may also notice little bumps at these areas, indicating intense follicle irritation. This is called traction folliculitis, and is usually a pre-cursor of incoming alopecia (if this sounds like you, take down the style ASAP!).

Traction alopecia is temporary (so long as the follicles remain unscarred) and pretty easy to treat once the style is taken out. But to address this type of alopecia:

  • Do not install another protective style. Only do low-maintenance protective styles such as twists
  • Focus on reducing scalp irritation/tension by clarifying with shampoo weekly and using plant-based, hair stimulating scalp oils on the scalp only (this one contains the best scalp stimulators for all hair types). Do not put anything on the scalp aside from oils and shampoo.
  • Avoid putting hair serums or gels on these areas until the areas are not irritated (drop the edge control, sis!). Oils are preferred.
  • Do not style your hair in any buns, low or high. The best style would either be a wash and go or twist out.

Androgenic Aloepecia

Androgenic alopecia, otherwise known as male/female pattern baldness, is the next type of alopecia. You know you have occurs when there is a well-defined pattern starting in the middle of the scalp, as seen below (taken from Harvard Health Publishing):

There is an obvious baldness pattern, similar to a Christmas tree. Hair thins at the temples and crown and thins outwards.

In men, the whole head may become bald. In women, rarely does it lead to total baldness. 

From a clinical perspective, this type of alopecia is caused by increased and sustained follicle inflammation (we'll talk more about the importance of addressing inflammation in a few) or hormone imbalances. 

As a result of this inflammation, an androgen hormone called dihydrotestosterone (scalp-DHT) goes to your scalp and tells your follicles to stop producing hair.

What does this mean? Your hair will linger in the telogen phase longer, halting the anagen phase, resulting in less hair in that area with time.

Overtime, your follicles become inactive because no growth is occurring. As a result, the inactive follicles begin to scar and the skin there becomes thicker. 

This is called fibrosis. Fibrosis happens before the hair loss starts.

Once fibrosis occurs, the body stops sending blood (which carries oxygen) to this area, which "chokes" our follicles.

No oxygen = no hair!

In most cases, dermatologists would provide either topical treatments (usually minoxidil) to fix the problem, which stops the production of DHT at your scalp. 

Central Centrifugal Cicatricial Alopecia (CCCA)

CCCA is another type of alopecia, most commonly seen in the black community.

You know you have this type of alopecia when hair loss starts at the crown and extends outward in a loosely-circular pattern. The scalp is immediately shiny (i.e. collagen production has increased) and you may feel a burning, itchy or painful sensation on your scalp.

Although scientists have yet to determine the exact cause, it has been linked to the use of relaxers and hot combs in combination with genetics, a poor diet and possibly an autoimmune disease.

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How To Treat Alopecia

If any of the above sound like you, you're most likely anxious to get started on treating the hair loss.

You may have been told that alopecia is "irreversible" due to genetics.

However what doctors fail to mention is something called epi-genetics, which is the relationship between your environment and your genetics.

Essentially, your environment plays a large role in whether the alopecia gene will turn "on" or not. This is known as gene expression.

So while you may have alopecia in your genes, there are things that you can do to counter it and grow the hair back.

Let's get into the clinical ways to treat alopecia and holistic, more natural ways to treat it.

Clinical Ways to Treat Alopecia

Stop All "Traumatic" Hair Care Practices

We've put traumatic in quotations because the term is subjective - something that is perpetuating someone's alopecia may not be perpetuating yours.

But here's a non-exhaustive list that summarizes some common ones:

  • Relaxers
  • Hair dyes
  • Tight hairstyles that pull at the scalp
  • Hot combs
  • Hooded dryers/hot heads

As a general rule of thumb, anything that is directed at your scalp should be avoided in order to keep the area undisturbed (aside from oils).

Chemicals such as relaxers, dyes and lyes are harmful to your scalp during this time, and should be avoided indefinitely. 

We know hot heads, hair steamers and other heat providing tools are great for product penetration, especially for low porosity natural hair. But the heat application may not be the best for your hair.

Reduce your use of these to once a month while you are addressing your alopecia. To deep condition, use the baggy method for 30 mins-1 hour, and let your hair air dry once you've applied your products.

Get A Blood Test

This is extremely critical to determining if you even have alopecia or not. 

The most common deficiencies that pertain to hair loss is iron and Vitamin D. These minerals are some of the best vitamins for natural hair, and if you body doesn't have enough, your hair is the first to suffer.

In fact, it has been shown that iron deficiencies result in hair loss similar to androgenic alopecia!!

A blood test will also determine if you have other alopecia-inducing health concerns, such as hyperthyroidism and Poly Ovarian Cystic Syndrome (PCOS).

Speak with your doctor regarding getting a blood test so you can see if your hair loss is actually alopecia.

Medication

Aside from a blood test, medication is normally the path that most doctors recommend.

There are two common treatments taken for alopecia: minoxidil and finasteride. Minoxidil works to bring more blood into your scalp, while finasteride targets reducing DHT.

Some people do report the hair loss stopping after using these treatments, however they are some adverse side-effects such as scalp dermatitis, flakiness, and in some cases, erectile dysfunction and pre-mature ejaculation (for men).

And as we discussed before, for androgenic alopecia, the scalp fibrosis starts before the hair loss. We need to target THAT if we want to truly start seeing hair growth.

In addition, hair loss may stop but the hair growth remains stunted. Therefore, it may be wise to combine the above with holistic treatments!

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Holistic Ways to Treat Alopecia

Scalp Stimulating Massages (SSM)

Scientists have shown that daily scalp massages have resulted in hair growth, in as little as 6 months. Who would have known!

Remember when we said that once the follicle becomes inactive, blood stops flowing to the scalp? Well, scalp massages work by forcing the blood back into the follicles.

There's a particular way you have to massage the area though. According to the scientists, here's how you do it:

  • Massage your entire scalp in circular motions using the palm of your hand for 3 minutes (warm-up)
  • Gently pinch the affected area (1-2 inches apart, hold for 1-2 seconds before moving to adjacent area) for 6 minutes
  • Gently press into the affected area (1-2 inches apart, hold for 1-2 seconds before moving to adjacent area) for 6 minutes
  • Gently stretch the skin of the affected area (1-2 inches apart, hold for 1-2 seconds before moving to adjacent area) for 5 minutes

This has to be done nightly, for at least half an hour, in two chunks: 15 minutes, and for another 15 minutes 12 hours later.

Hair Growth Oils

Oils will be your scalp's best friend during this time. 

Before you reach for your JBCO, there are more effective oils you can use instead.

The best oils to use for hair loss are rosemary oil, nettle, pumpkin seed oil, peppermint oil, black seed oil and coconut oil.

The Mane Choice Multi Vitamin Scalp Nourishing Growth Oil and Mielle Rosemary Mint Scalp and Hair Strengthening Oil have the best ingredients for stimulating hair growth without irritating or inflaming the follicles.

These individual oils have been shown to block DHT, the hormone responsible for your hair loss. They are also anti-fungal, anti-inflammatory and promote healthy blood flow.

Rosemary and peppermint oil are essential oils, so be sure to use these with a carrier oil like coconut oil. 

If you prefer to buy an oil from the store, read the ingredients carefully. Do not use any products with mineral oils, parfum, petroleum, canola oil or other sensitizing ingredients. 

Tea Rinses

Yes, I said it. Rinsing your hair with tea during your wash day helps retain hair.

Tea rinses are normally associated with hair shedding rather than loss (i.e. alopecia). But it has shown to increase hair retention!

Green tea is a natural DHT inhibitor so for alopecia, is the most effective tea to use.

To do a green tea rinse, steep two decaf green tea bags in 8 oz of water. Let it cool for an hour. 

On clean hair (after your shampoo but before your conditioner), dump your tea on your scalp and lightly massage.

As tea rinses are quite drying, follow it up with a conditioner and deep-conditioner to bring back the moisture. Some naturals report less shedding immediately after use! Repeat this twice a month.

Reduce Inflammation: Diet and Lifestyle Change

As mentioned above, one of the common denominators of most types of alopecia is inflammation.

Your follicles cannot support your hair anymore because your scalp was chronically inflamed. 

In fact, your whole body could be inflamed, and you just don't know it.

So, one way to think about treating your alopecia is to reduce the inflammation in your scalp and in your body.

The most effective way to do this? Diet.

Nutrition and diet choices are one of the most important factors in addressing internal inflammation. In fact, some people have cured their alopecia areata with healthy, non-inflammatory foods!

As much as our natural hair is important to us, our body treats it as a secondary area of concern.

So if we’re not eating right, our bodies will ration the nutrients its getting and send it to our vital organs: our heart, lungs and liver.

And our skin, nails, and yes, our hair, is left in the dust.

There are many known inflammatory foods we eat everyday, like sugar, gluten, corn, wheat and dairy.

Do an inventory of what you eat: does any foods make you feel bloated? That bloated feeling is a sign that your internal system is inflamed, which can contribute to your scalp inflammation.

Take note of what foods are hurting you rather than helping you. It may sound extreme but your hair and body will thank you!

The Bottom Line

Alopecia is no fun. Seeing your precious hair fall in chunks is alarming, but treatable.

Make sure to consult your doctor to conduct a blood test. Take note of some of the hair care practices that are harming your scalp. Watch out for inflammatory foods in your diet, and try some of the growth oils above!

Have you dealt with alopecia before? What are your experiences treating it? Share some tips down below!