Hair Care May Affect Exercise in Black Women

Jenni Laidman

December 17, 2012

Nearly 40% of 103 black women surveyed reported they avoided exercise to preserve their hairstyle, according to a study published online December 17 in the Archives of Dermatology.

Rebecca R. Hall, MD, formerly from the Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, and colleagues provided a questionnaire about physical activity (PA) to black women who were outside a waiting room for an academic dermatology department. The 40-item survey, which had not been validated, asked the women, aged 21 to 60 years, about exercise frequency and type and their reasons for exercising or avoiding exercise, as well as several questions about hair care and its association with exercise.

Thirty-nine of the participants (37.9%) reported they had avoided exercise at times because of their hair. All participants in that group said they were concerned that exercise would cause them to sweat out a style.

Although the authors write that the women who avoided activity because of hair concerns were 2.9 times (95% confidence interval [CI], 0.9 - 9.4 times) less likely to exercise adequately, the result failed to reach statistical significance (P = .08). Adequate exercise levels were based on the 2008 US Department of Health and Human Services guideline of more than 150 minutes per week of PA.

Kathleen Parker, PhD, health promotion and disease prevention program manager for the Oklahoma City Veterans Administration Medical Center, told Medscape Medical News that the study was "very superficial." She was not associated with the research.

Although the issue of hair maintenance as a barrier to exercise in black women does arise in some reports (eg, in focus group literature) and does not come up in other racial or ethnic groups, this is not the same as showing a direct connection between hair concerns and low PA rates among some black women — and this study fails to make the connection, Dr. Parker said.

"It glazes over some things and generalizes and says hair maintenance limits participation in physical activities. What it does not do is identify anything specific: What does it mean by hair maintenance? What does it mean by limit? It doesn't go on to say participation in what types of activities. We have premier athletes from this demographic. This doesn't really offer any science to say what's really going on here. On the surface, if you ask that question [about hair maintenance], if you do a superficial analysis, that's what you get. If you go a little deeper, it's not about the hair."

Dr. Parker noted that not only was the survey instrument not validated but the selection of survey participants near a dermatologic waiting room may increase the number of people in the survey group with scalp problems — an issue the authors acknowledge in their comments.

The authors also report that most women in the survey (62.1%) wore their hair chemically straightened and that 42.2% of the respondents said they spent more than 60 minutes each week maintaining their hair. Half said they had considered modifying their hairstyle for exercise.

More than half of those surveyed exercised less than 75 minutes per week, but 22.3% met minimum exercise guidelines, exercising more than 150 minutes per week. Just more than a quarter of the respondents (26.2%) reported no exercise.

"Effective strategies to promote PA in African American women, known to disproportionately have obesity and associated sedentary diseases, must include addressing dermatologic barriers to PA with strategies that address hairstyle maintenance," the authors write.

One coauthor is a consultant for the Cancer Registry of California. One coauthor reports receiving consulting fees, royalties, honoraria, and grants from Instant Recess, a program focused on incorporating PA into organizational practice, and is also on its speakers bureau. One coauthor reports receiving honoraria and acting as a consultant for Allergan, serving as a consultant for Johnson & Johnson, Galderma, KeraNetics, and Stiefel, and has received honoraria from Proctor & Gamble and Guthy Renker. Dr. Parker has disclosed no relevant financial relationships.

Arch Dermatol. Published online December 17, 2012. Abstract