While not often documented or researched, wearing religious headwear has previously been associated with forms of alopecia, such as traction alopecia. Researchers Alhanshali et al sought to explore the associations between religious headwear and hair loss, shedding light on considerations for caring for patients in a recent review1 published in the International Journal of Women’s Dermatology.
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“Traction alopecia can result from how the headwear is secured and styled, or other practices that may lead to tension on the hair and scalp. Individuals with alopecia who observe religious head coverings may struggle to conform to practices regarding headwear styling,” review authors wrote.
- Wearing religious headwear, such as hijabs, turbans, kippahs, and others, can be associated with hair loss, particularly traction alopecia, due to the tension and styling practices involved.
- The study emphasizes the need for dermatology clinicians to consider culturally-sensitive best practices when caring for patients who wear religious head coverings, as certain treatments and practices may not be permissible or practical.
Researchers reviewed several different types of religious headwear, noting that approximately 84% of the world’s population identifies with religious groups. In doing so, they established a list of culturally-sensitive best practices for dermatology clinicians and advice for mitigating risk of alopecia in this patient population.
For example, Jewish patients may not be able to use lasers and other electronic therapies for treatment during Sabbath observance, authors wrote. Regarding some forms of religious headwear, such as peyot, turban (dastar), patka, dreadlocks, and headwraps, it is not permissible for patients to cut their hair.
“Traction is a likely contributor to hijab-related alopecia, owing to the consistent and tight wrapping of the hijab around the head and hair, which can lead to continuous pull on the hair roots,” Alhanshali et al wrote. “This is a particularly important consideration for certain subgroups, such as women with afro-textured hair who have fewer elastic fibers attaching hair follicles to the dermis compared to Caucasians.”
Recommendations for the best course of alopecia risk prevention and treatment, according to authors, may include:
- Dreadlocks and headwraps: Advise gentle handling and twisting of hair
- Hijab: Fabric recommendations, such as jersey or cotton, that are less likely to slip; caps that allow for size adjustment or that can be tied back; occasionally vary the location of a ponytail or knot
- Kippah: Recommend varying the location of clips, when worn
- Sheitel: Discuss techniques for wig attachment and types of wigs; recommend varying the location of clips, when worn
- Turban (daster) or patka: Advise patients to only wear when mandatory; recommend the use of a low hairstyle such as a ponytail or braid to counteract scalp tension with long hair, when turban or patka is not worn
Authors advised that it is important to discuss with patients the lasting impacts of traction alopecia, which may become irreversible in nature. Furthermore, it is important for providers to increase alopecia awareness and knowledge among patients, they wrote.
- Alhanshali L, Buontempo MG, Bawany F, Adotama P, Shapiro J, Lo Sicco K. Religious headwear and alopecia: considerations for dermatologists. Int J Womens Dermatol. 2023;9(3). doi:10.1097/jw9.0000000000000107