Support for dermatological research in Sub-Saharan Africa: insights from African hair and skin research programs.

BACKGROUND: The structure and physiology of skin and hair in people of African ancestry are different from other ethnic categories and studies from other continents cannot necessarily be extrapolated to Sub-Saharan Africa (SSA) due to the differences in genetics, lifestyle, climate, cultures, and hair and skin care practices. The aim of this report is to highlight the recent advances in local skin and hair research in SSA from a grant program. METHODS: African Hair and Skin Research Grants from an industrial sponsor were awarded between 2013 and 2022 on five main topics: acne, hair and scalp, keloid scars, atopic dermatitis, and air pollution. A literature search in Scopus identified publications on these topics in African or black skin in SSA and worldwide to provide insight into the impact of the program. RESULTS: The number of publications from around the world on the skin and hair of people of African ancestry has increased significantly over the past 30 years on all five topics, especially as a result studies conducted in the United States. Fewer studies have been conducted in SSA but there has been an increasing number of publications over the past 10 years, especially from South Africa. CONCLUSIONS: Scientific and clinical partnerships between the industry, academia, and public healthcare sectors have contributed to a steady increase in hair and skin publications from SSA, which may be useful for the development of tailored products and public educational campaigns to raise awareness of the risks of using inappropriate products.

Weekly hair washing: The recommended solution for women with afro-textured hair to alleviate dandruff and scalp discomfort.

Dandruff and scalp discomfort are common concerns for women and men in Africa. Moreover, women with afro-textured hair are prone to scalp discomfort owing to irregular hair washing, frequent use of oil-based products on their scalp, and harsh chemical treatments. Current literature does not, however, provide data on the pathophysiological mechanisms of these conditions in this population. In this study, we investigated the mechanisms behind scalp discomfort and dandruff in women of African descent before and after hair washing. We conducted the in Durban, South Africa, over a 3-week period with 60 women of African descent aged 20-40 years. The respondents were equally divided into a "dandruff" and a "no dandruff" group, based on clinical grading of adherent dandruff by a dermatologist. Malassezia spp. and bacterial loads were quantified by quantitative polymerase chain reaction. Evaluations of scalp condition and sample collection were performed at five time points during the 3 weeks. Data on discomfort symptoms were collected via a self-assessment questionnaire. We observed that the dandruff severity peaked at the end of the first week after hair washing and plateaued from thereon in both groups. Dandruff was associated with higher Malassezia and bacterial load counts and there was a direct correlation between the Malassezia spp. load and dandruff score. Via self-assessment questionnaire responses submitted by participants, we observed that itching was the most pronounced scalp discomfort, compared with the sensation of tingling and burning at baseline, while an improvement of the scalp symptoms of dandruff and itch was observed in both groups after one hair wash. The study also showed that higher colonization with Malassezia spp. and bacteria is associated with dandruff independently of the time point, confirming a scalp microbiome contribution to the dandruff pathophysiology in the study population. The benefits of washing were, however, not sustained after 1 week and we thus recommend weekly hair washing for long-term management of dandruff and scalp itchiness in this population.

Quantifying the impact of braiding and combing on the integrity of natural African hair.

BACKGROUND: Afro hair breakage is most commonly attributed to grooming practices such as braiding, hair extensions and weaves, both for chemically treated hair and natural Afro hair. These grooming practices are also frequently associated with traction alopecia in clinical studies. However, there is little to no quantitative scientific data on the surface and internal hair fibre damage caused by grooming, including combing, on Afro hair. METHODS: Qualitative and quantitative techniques such as scanning electron microscopy, cuticle cohesion and tensile testing were used to determine the effects of frequent braiding on the integrity of female Afro hair in 15 frequent braiders and 15 occasional braiders (control group) in Johannesburg, South Africa. Frequent braiders were women who braided more than 8 times per year, while occasional braiders typically limit braiding to only twice 2 per year. The severity of traction alopecia was quantified in both groups using the standard Marginal Traction Alopecia Scoring system. Surface damage on naturally curly Afro hair, that was combed but not braided, was assessed as another hairstyle option. RESULTS: All measurements showed a relationship between surface and internal hair fibre damage and braiding frequency. Frequent braiders had thinner hair, with more cuticle damage as shown by SEM and cuticle cohesion assessments. Their hair fibres were also significantly weaker (p < 0.05), as shown by the tensile testing. In addition, they also had higher traction alopecia severity scores. In the combing impact assessment, a linear trend was observed between surface hair fibre damage and the number of combing strokes. Cuticle damage from 480 combing strokes was more severe than that from frequent braiding. CONCLUSION: Frequent braiding and combing damage natural Afro hair. Quantification of damage caused by different grooming practices identifies a need to develop products that could help mitigate specific hair damage associated with grooming practices. The degree of damage and subsequent hair loss could also be minimized by education on best braiding practices to protect the hair fibre and avoid hair follicle miniaturization caused by high traction hairstyles.

CONTEXTE: La casse des cheveux d'origine Africaine est le plus souvent associées à des pratiques cosmétiques telles que le tressage et les extensions de cheveux, à la fois pour les cheveux traités chimiquement et les cheveux naturels. Ces pratiques cosmétiques sont également fréquemment associées à une alopécie de traction, comme le relatent les études cliniques. Cependant, il existe peu ou pas de données scientifiques quantitatives sur l'impact de ce type de pratiques, y compris le peignage, sur les dommages internes et de surface des cheveux d'origine africaine. MÉTHODES: Des techniques qualitatives et quantitatives, comme la microscopie électronique à balayage (MEB), la cohésion cuticulaire et des tests de traction, ont été utilisés pour déterminer les effets du tressage sur l'intégrité des cheveux de deux groupes de 15 femmes Africaines (à Johannesburg, Afrique du Sud) : un premier groupe de femmes pratiquant un tressage fréquent et un autre groupe un tressage occasionnel. Le groupe des tresseurs fréquents correspond à des femmes qui pratiquent le tressage plus de 8 fois par an, tandis que les tresseurs occasionnels limitent généralement le tressage à seulement deux fois par an. La gravité de l'alopécie de traction a été également quantifiée dans les deux groupes à l'aide du système standard de notation de l'alopécie tractionnelle. Parallèlement, à titre de comparaison, les dommages de surface ont été également évalués sur des cheveux d'origine Africaine naturellement bouclés, non tressés, mais qui ont subi un peignage répété. RÉSULTATS: Toutes les mesures ont montré une relation entre les dommages de surface et internes de la fibre et la fréquence de tressage. Les tresseurs fréquents ont des cheveux plus fins, avec un endommagement plus important de la cuticule, comme le montrent les évaluations MEB et la cohésion cuticulaire. Les cheveux sont également significativement plus fragiles (p <0,05), comme le montrent les tests de traction. De plus, ces femmes ont également des scores d'alopécie de traction plus élevés. Dans le cas spécifique du peignage répété, une tendance linéaire a été observée entre les dommages en surface de la fibre capillaire et le nombre de coups de peigne. On peut également noter que l'endommagement de la cuticule causé par 480 coups de peigne est plus important que celui causé par des tressages fréquents. CONCLUSION: Les tressages et peignages fréquents endommagent les cheveux naturels d'origine Africaine. La quantification des dommages causés par différentes pratiques cosmétiques met en évidence le besoin de développer des produits qui pourraient aider à atténuer les dommages liés à des pratiques spécifiques. Le niveau de dommage et la perte de cheveux pourraient également être minimisés par un apprentissage de meilleures pratiques de tressage pour protéger la fibre et éviter la diminution des follicules pileux causée par des coiffures qui entrainent un forte traction sur la fibre.