Ethnic hair update: past and present

Hair and scalp disorders in African American patients are challenging because of the lack of pathophysiologic explanations for many of the disorders that occur in this population. To understand the clinical appearance of these disorders and to design an effective treatment plan, the dermatologist must have a clear knowledge of the basic hair-care practices and concerns of this group of patients. Given that patients of African American heritage are not a homogeneous group, this overview describes many of the common hair-care practices of African Americans and how they affect patients' health. The common hair and scalp disorders are discussed, with a specific focus on inflammatory disorders that result in significant pigmentation alteration or scarring.