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Hair care practices and scalp/hair disease in African American girls

      To the Editor: The recent study by Rucker Wright et al
      • Rucker Wright D.
      • Gathers R.
      • Kapke A.
      • Johnson D.
      • Joseph C.L.
      Hair care practices and their association with scalp and hair disorders in African American girls.
      is to be commended for being the first to investigate grooming practices in a clinic population of African American girls. This knowledge is crucial if we are to make strides in understanding scalp disease in patients with Afro-textured hair. However, the study does warrant a few comments regarding its stated aims, methods, results and their interpretation.
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      References

        • Rucker Wright D.
        • Gathers R.
        • Kapke A.
        • Johnson D.
        • Joseph C.L.
        Hair care practices and their association with scalp and hair disorders in African American girls.
        J Am Acad Dermatol. 2011; 64 (Epub 2010 Aug 21): 253-262
        • Khumalo N.P.
        • Jessop S.
        • Gumedze F.
        • Ehrlich R.
        Hairdressing is associated with scalp disease in African schoolchildren.
        Br J Dermatol. 2007; 157: 106-110
        • Khumalo N.P.
        • Jessop S.
        • Gumedze F.
        • Ehrlich R.
        Hairdressing and the prevalence of scalp disease in African adults.
        Br J Dermatol. 2007; 157: 981-988
        • Khumalo N.P.
        • Jessop S.
        • Gumedze F.
        • Ehrlich R.
        Determinants of marginal traction alopecia in African girls and women.
        J Am Acad Dermatol. 2008; 59: 432-438
        • Khumalo N.P.
        • Jessop S.
        • Gumedze F.
        • Ehrlich R.
        Marginal traction alopecia severity score: development and test of reliability.
        J Cosmet Dermatol. 2007; 6: 262-269

      Linked Article

      • Hair care practices and their association with scalp and hair disorders in African American girls
        Journal of the American Academy of DermatologyVol. 64Issue 2
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          Few studies have extensively examined the prevalence of hair care practices and their association with scalp and hair conditions in African American girls.
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      • Reply
        Journal of the American Academy of DermatologyVol. 64Issue 6
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          To the Editor: I would like to thank Dr Khumalo for her comments on our original article, “Hair care practices and associations with scalp and hair dermatoses among African-American girls.”1 Dr Khumalo’s main concern is the use of self-report in our analyses. We did not have clinical examination as part of this exploratory and hypothesis-generating study. The authors acknowledge the limitation of self-report, which may lead to misclassification and biased results. However, there are other factors that can add credence to our observed associations in accordance with the Bradford-Hill criteria,2 such as the strength of the association, the biological plausibility of our study’s associations (which we detail in the Discussion section of our article), the consistency of the observed associations in different study samples, coherence with current theories on the pathogenesis of certain hair disorders, and the report of other associations between similar factors and diseases, such as braids and traction alopecia.
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