World afro day and supporting clients with alopecia

Within traditional African history, hair is profoundly respected and imbued with rich spiritual, social and emotional meanings (Dabiri, 2020).

Recent research highlights that discrimination against natural coily-textured Black hair is a real concern in the UK. It’s most likely to happen in school and workplace environments, including at job interviews. A significant proportion of Black women report being subjected to the micro-aggression of uninvited hair touching.

This is an ongoing legacy of the transatlantic slave trade in which pseudoscience was used to justify a deeply discriminatory, violent, and oppressive hierarchy. This system prioritised Eurocentrism so that straight, long hair was prized as desirable, good, hair whilst African culture, including hair, was devalued and ‘othered’ (Johnson & Bankhead, 2014).

In September 2024, de Leon and her team made important news as they took their campaign to the House of Parliament, insisting it was now time to end Afro hair discrimination by formally including it in the 2010 Equality Act.

As I listened to the World Afro Day online event, I wondered how these experiences might also impact on people of African and Caribbean descent who are living with Alopecia. Studies highlight that substantial numbers of Black women experience alopecia (Dadzie & Salem, 2015). I am one of them.

It is increasingly recognised that hair loss can cause significant distress such as shame, depression, grief and social anxiety (Hunt & McHale, 2007). But when the experience of having hair includes playground taunts, perhaps even school exclusion, hurtful remarks sometimes from own family relatives, work colleagues’ offensive ‘banter’, repeated scalp burns from long term hair straightening (relaxer) in the quest to be accepted as ‘professional’ – the reality for many Black clients/patients – what else needs attention in the consultation room?

Last year I was awarded a Churchill Fellowship to travel to the USA and South Africa to find out how psychological and medical practitioners there provide culturally-attuned care to Black women living with alopecia. I met with a hair psychologist, dermatologists, haircare professionals, community group organisers and public health academic researchers.

Some recommended best practices from my Fellowship learning include:

1. Show compassionate awareness by acknowledging likely hair discrimination and trauma as part of Black clients’ lived experience,
2. Respectfully ask for permission before examining a client’s hair and scalp (even if this is obviously what they are there for),
3. Enquire about but ensure not to minimise the distress often stirred up by hair loss (for example, avoid saying, “it’s only hair”).

My Churchill Fellowship report, with full recommendations for improving the emotional wellbeing of Black patients with alopecia along their healthcare journey, will be available later this year.

References:

• Dabiri, E. (2020). Don’t Touch My Hair. ISBN: 9780141986289
• Dadzie, O.E. & Salam, A. (2015). Correlates of hair loss in adult women of African descent in London, UK: findings of a cross-sectional study. British Journal of Dermatology, 173 (5), 1301 – 1304.
• Hunt, N. & McHale, S. (2007). The psychological impact of alopecia. The Psychologist. 20:6, 362 – 364.
• Johnson, T. & Bankhead, T. (2014). Hair It Is: Examining the experiences of Black Women with Natural Hair. Open Journal of Social Sciences, 2, 1 (Jan), 86 -100.