Hair-Loss Perceptions and Treatment Expectations in Young People of Color

July 2021 | Volume 20 | Issue 7 | Original Article | 746 | Copyright © July 2021


Published online June 15, 2021

doi:10.36849/JDD.5960

Abrahem Kazemi MD,a,b Abigail Cline MD PhD,a,b Tamar Aliya Gomolin MD,a,b Bijan Safai MDa,b

aDepartment of Dermatology, New York Medical College/Metropolitan Hospital Center, New York, NY
bNew York Medical College, Valhalla,

Abstract
Background: While much research has been dedicated to hair loss in older patients, little has addressed hair loss perception and treatment expectations among young people of color (POC). This study evaluates disease perceptions, willingness to utilize specific therapies, and treatment expectations in younger versus older POC with any form of hair loss.
Methods: An online survey was utilized to analyze 217 responses to 37 questions assessing perceptions of hair loss, hair care practices, and treatment expectations among others. These parameters were measured on a 1–5 Likert scale. Comparison between groups was be done using Chi-Square tests for proportions and Student t-tests.
Results: Included were 52 respondents between the ages of 18 and 29 (POC<30), and 36 respondents greater than 30 years of age (POC>30). The reported average hair loss in POC<30 was 67.0%, compared to POC>30 reporting 60.0% (P<0.05). Average embarrassment was 2.6 for POC<30 versus 3.4 for POC>30 (P<0.001). Average pain was 2.0 for POC<30 versus 1.8 for POC>30 (P<0.05). Average hair thinning was 3.0 for POC<30 versus 3.7 for POC>30 (P<0.001). Average willingness to use topical treatments including creams, solutions, ointments, and gels was 3.0 in POC<30 versus 3.8 in POC>30 (P<0.001). The average perceived effectiveness of topical treatments was 2.9 in POC<30 versus 3.6 in POC>30 (P<0.01).
Conclusion: Early identification and appropriate management of young POC with hair loss may facilitate follicular rescue. This, in turn, may help reduce the negative consequences of advanced hair loss, such as embarrassment, as seen in older POC.

J Drugs Dermatol. 2021;20(7):746-750. doi:10.36849/JDD.5960

INTRODUCTION

Dermatologic disease perception and treatment expectations vary greatly among ethnic and age groups. Gauging these subjective parameters are at the cornerstone of managing hair loss. Hair loss is a devastating dermatologic condition that corroborates a significantly adverse quality of life (QoL). This is particularly evident among people of color (POC), who have diverse cultural hair styling practices that contribute to a sense of self-identity but may also contribute to certain types of hair loss.1 Treatment options for hair loss disorders often have unsatisfactory results and cumbersome regimens that may overwhelm patients.

Hair loss in POC may present unique challenges to dermatologists partly due to incorrect disease perception or unrealistic treatment expectations by patients. Hair loss in POC can present a unique diagnostic challenge requiring extensive knowledge of historical symptoms, haircare practices, and previous treatments.2 While much research has been dedicated to hair loss in older POC, there is a paucity of research addressing hair loss perceptions and treatment expectations among young POC. This study evaluates disease perceptions, willingness to utilize specific therapies, and treatment expectations in younger versus older POC with any form of hair loss.

MATERIALS AND METHODS

After institutional review board approval, an online survey was distributed to individuals older than 18 years of age who reported having hair loss within the past year and had a working knowledge of English. Overall, 217 participants completed the survey via REDcap (Nashville, TN), after recruitment through Amazon's Mechanical Turk (Amazon, Seattle, WA), an online crowdsourcing platform extensively used by psychologists for participant recruitment.3 Subjects were asked about their perceptions of hair loss, hair care practices, and treatment expectations. These parameters were measured on a 1–5 Likert scale. Comparison between groups was be done using Chi-Square tests for proportions and Student t-tests.

RESULTS

A total of 88 POC respondents with any form of hair loss were included in the survey. There were 52 respondents between the