Black History Month. No doubt, it’s an apt time to remember the achievements of Madam C.J. Walker, a pioneer of the modern Black hair care and cosmetics industry. As I think about hair care this Black History Month, it is important that healthcare professionals, researchers, and policymakers who want to address racial disparities in health begin treating Black hair care as Black health care.
Hair care may generally be seen as a small, mundane task to some, but Black hair care is a necessary practice of Black health care. For example, Black people sometimes wear their hair in protective styles—styles meant to protect hair from breakage and damage since natural hair is prone to such issues. Protective styles can be braids, weaves, or wigs.
Some protective styles can take a long time to establish. For example, microbraids, which are tiny braids, can take hours to establish. It would take anywhere from 12 to 16 hours for a sole braider to braid my hair. Sometimes they did it in one day, sometimes it took two. Even my current loc style took 20 hours to establish: 12 hours one day, eight hours the other. My hair is retightened about every six to seven weeks, and a retightening session usually lasts about 5 hours.
When I was younger, I would get microbraids all the time. Now, because of years and years of sitting for long periods of time, I get cysts on my tailbone whenever I sit for too long. Research shows that Black women who use chemical relaxers, hair dyes, leave-in conditioners, and oils are more likely to develop uterine fibroids, breast cancer, and uterine cancer than Black women who don’t use these products or use them infrequently. Black women are also more likely than women from other racial groups to have their fibroids surgically removed. (According to my doctor, the only way to prevent the cysts from returning is to surgically remove the cyst wall.)
When I would get my hair braided, I would always go to a trusted friend instead of a braiding shop. The braiders in the shop were notorious for not always being careful or gentle with people’s hair. They would sometimes braid too tight. Braiding too tight can lead to health issues such as hair loss, shedding, breakage, and traction alopecia. When I got older, I switched my protective styles to wigs, and I started learning how to braid my own hair with extensions. However, constantly wearing weaves and wigs can also lead to traction alopecia.
The hair care process can also take a toll on the physical health of the stylist, barber, or braider. For example, carpal tunnel, tendonitis, and other types of repetitive strain injury from repetitive movement, or bladder cancer and infertility from exposure to chemicals, are just a few of the health issues that hair stylists, barbers, and braiders can develop over time. These health issues can lead to financial strain if they are unable to work.
Black people experience hair discrimination, which is negative stereotypes and attitudes toward textured hair (e.g., Black hair is “bad hair”). Discriminatory workplace policies can trigger health conditions that disproportionately affect people with textured hair. For example, some workplaces have“clean-shave policies” that require employees to be free of hair on the face, neck, and chin. This poses a health issue disproportionately for Black and Latinx men—research shows that Black and Latinx men are more likely than men from other racial and ethnic groups to develop a painful and persistent skin condition called Pseudofolliculitis barbae, or razor bumps.
Black hair care is also Black mental health care. Research shows that Black and Latinx people have higher odds of developing major depression compared to white people. Black people can internalize stereotypes about textured hair, affecting self-image, mental health, and well-being. Discrimination is linked to several mental health outcomes, including changes in self-esteem, self-identity, and anxiety.
Moreover, when someone cannot maintain their hair, it may be a sign that their mental health is affected. For example, in “Hair Story: Untangling the Roots of Black Hair in America,” Ayana D. Byrd and Lori L. Tharps refer to historical archives showing that if someone’s hair appeared uncombed, it was a plea for social support, because this person was expressing bereavement or depression.
Not all haircare professionals are skilled with textured hair, limiting the options for Black women and making the process of Black hair care stressful. For instance, in college to save time and money, I would go to a hair institute on campus where my stylist was a Black woman named Darlene. However, because this was an institute, Darlene eventually graduated. One day, I called the institute and asked if there was someone who was knowledgeable about Black hair. I was assured that there was.
When I went to the appointment, my stylist was not Black, but she said her cousins were Dominican and had hair like mine. However, when she started combing my hair, she started from the root, and you must comb textured hair starting from the ends; otherwise, you will pull out the hair. Luckily, a Black stylist saw the look of horror on my face and intervened.
Healthcare professionals, researchers, and policymakers who want to address racial disparities in health care must take Black hair care seriously. Healthcare professionals can do this by making conversations about hair care a routine part of health examinations. Researchers can do this by exploring the physical and mental health effects of hair care and haircare products, and policymakers can create policies such as The C.R.O.W.N. Act that reduce race-based hair discrimination.
Madam C.J. Walker understood the value of Black hair care as Black health care. She first created Madam Walker’s Wonderful Hair Grower, a scalp conditioning and healing formula, because she suffered from a scalp condition that caused her to lose most of her hair. This Black History Month, let’s honor her legacy by making Black hair care a serious part of Black health care.
So’Phelia Morrow is a Ph.D. candidate in the joint social work and sociology program at the University of Michigan and a Public Voices Fellow with the OpEd Project and Equality Now.
