Dr. Dina Strachan is a New York City based board-certified dermatologist who is highly sought after by media sources and has been cited in a variety of local and national outlets including The New York Times, The Washington Post, AM New York, Women’s Health, Ebony, Essence, Latina, Shop Smart, Rolling Stone, health.com, beautynewsnyc.com, mommymd.com, The Network Journal, HSN, as well as the local CBS and NBC news.
She is a graduate of Harvard College and Yale Medical School and completed her residency training at the University of California, San Francisco. She served on the faculty of UCLA and was Director of Resident Education at King/Drew Medical Center in Los Angeles prior to moving to New York City, where she founded Aglow Dermatology. Dr. Strachan joins us to discuss her contribution to the Lily discussing the cultural importance of hair, especially for African American girls and women.
myDoqter: Thank you for joining us again, Dr. Strachan - this time to discuss a topic near and dear to dermatologists – hair! First off, congratulations on being quoted in the Lily, where you were discussing “Hair Love”. The Lily describes "Hair Love" as a children's book that celebrates “Black Girlhood”, touching on the issue of African American hair. Before we get to your expertise in this area, can we just say how thrilled we are to be two degrees of separation away from Jay-Z, Beyonce, and their daughter Blue Ivy Carter through you?!
Back to the issue at hand, you made some important comments about young girls loving their hair and the sense of confidence that can be instilled in them around that. Can you elaborate more on your thoughts on this?
Dr. Strachan: Black girls often receive messages at a very young age that there is something wrong with their hair. It needs to be "fixed." It needs to be changed or covered. This may come from family. And when the family does support love of the natural texture of hair, society may respond with negative messages. There are many reports of black children being asked to leave school because they wore their hair in braids or dreadlocks, which are conventional hair styles for their texture of hair.
Even as an already successful doctor myself, I've had people suggest that I straighten my hair to be more "TV friendly" or look "professional." It didn't feel good as an adult! Just imagine how children feel when they are told by the world that there is something wrong with the way the hair grows out of their heads.
myDoqter: Yes, and we all have a responsibility to ensure that children feel supported and encouraged. Can you share with us some of your specialized expertise in African American hair. Specifically, what are some of the unique hair care needs, techniques, and practices of which we should be aware?
Dr. Strachan: African American hair, which tends to be more kinky or curly is more delicate than straighter hair and therefore, it must be managed differently. Kinky hair tends to be drier, so it shouldn't be shampooed daily. This is important to know when suggesting therapy for scalp conditions. Also, some of the popular grooming and styling practices, such as tight braids and weaves, can exacerbate certain conditions such as traction alopecia or central centrifugal cicatricial alopecia (CCCA). CCCA also has a genetic predisposition.
myDoqter: That’s a good point; both genetic factors and environmental factors are important to consider. Both are involved in CCCA, a hair loss condition characterized by scarring and loss of hair on the top of the scalp.
As we all know, hair thinning can be a huge concern for all of our patients who are experiencing hair loss. Do you have any other unique approaches to hair loss in African American hair and any special considerations that you might take into account?
Dr. Strachan: I approach all my hair loss patients in the standard way in terms of taking a history and doing a physical diagnosis. In African American patients, I am perhaps more vigilant for problems such as traction alopecia and CCCA as they can cause scarring and permanent loss.
myDoqter: As you say it is important to take a good history and evaluate all patients for possible medical conditions causes such as thyroid and other systemic diseases, medication side effects, and even psychological and physical stressors. Then examining the scalp for scarring is very important.
Besides hair loss, can you expound on some of the unique hair issues for which treatment might be sought and what treatment options are available?
Dr. Strachan: "Dry scalp", which is usually seborrheic dermatitis, is a condition that I often see and which is misunderstood in black patients. Many think that if there is no flaking in the hair, it isn't seborrheic dermatitis. This is because they just think of dandruff when they think of seborrheic dermatitis. It is true that scale along the frontal hair lines can be seen, but sometimes skin discoloration and lightening are some clues.
This can result from shampooing less than once a week to maintain a hair style. Seborrheic dermatitis causes scalp inflammation which may exacerbate some types of hair loss. Usually, a topical steroid treats this condition, which is often seasonal. Dandruff shampoo is also helpful, but it should be in a moisturizing formulation.
myDoqter: Thank you so much for sharing your thoughts. Our readers can link to your quotes in the Lily to read more about the cultural importance of hair. Indeed, hair holds great importance for men and women and all cultures around the world!
If you had to give us your top 7 tips to maintain strong and healthy hair, what would they be?
Dr. Strachan: My top tips:
1. Shampoo at least weekly.
2. Deep condition weekly.
3. Cut split ends.
4. Remember, anything that changes the color or texture of your hair damages it - even if just a little. So, see rule 2!
5. Hair styles should not cause pain.
6. Groom according to your hair texture (e.g., avoid brushing curly hair).
7. Daily, leave-in conditioner.
Bonus - love your hair!!!