Hair at the intersection of dermatology and anthropology: A conversation on race and relationships

Abstract

Said with a large smile that sentence led to this article. It was in a video teleconference (Zoom TM ), an early meeting in what became several academic and friendship conversations between the authors.Colleagues within the same academic medical center, Candrice is a Black female dermatologist and Nora is a White female anthropologist and bioethicist. Candrice shared how happy she was that her new 15-year-old bonus daughter had asked Candrice to wash her hair. An awkward pause followed because Nora was not grasping statement's significance; she lacked the shared experience of the historically deep importance of relationships build around hair among Black women.Letting the moment pass would have damaged the friend relationship. In a dermatologic encounter, doing so can have negative interpersonal and clinical consequences, from lower patient satisfaction to prolonged morbidity if the recommended treatment does not respond to the patient's social context. 1 The authors' friendship deepened because they did not let the moment pass. Candrice told her story, Nora listened, and together, they explored the meaning of hair through personal, dermatologic, and anthropologic lenses. We tell Candrice's story and the lessons it engendered here because approaching patients (and their hair) clinically and socially can lead to more humble and effective care. Tightly coiled hair from personal, clinical, and social lensesBeliefs, attitudes, and behaviors around Black hair have structural roots in the fact that tightly coiled hair is more prone to dryness and breakage, 2 requiring intentional hair-care actions to preserve the integrity of the hair. A typical hair-care routine for a child with tightly coiled hair may take hours. Washing the hair and scalp with shampoo twice, applying conditioner, and then the first detangling can take a while because tightly coiled hair is more prone to biologically form knots. 2 Conditioner is rinsed out, leave-in conditioner is applied, and the hair is detangled again, a process that can be painful if not done properly. Finally, the hair is styled while wet or dry.Styling time varies based on the intricacy of the style. This work is most often done by mothers or stylists, and we will use the term 'hair-caregivers' to refer to them both.