While African-Americans also suffer from genetic male and female pattern hair loss, there are two major types of hair loss causes that are unique to African Americans.
1) Traction alopecia: Repeated pulling and tension on the hair follicle can result in permanent hair loss along the sideburns or frontal hairline. Grooming techniques such as tight braids, relaxers, and weaves can put stress on the hair follicles that can lead to hair loss. This type of hair loss is called traction alopecia and is difficult to treat so prevention is key. Avoiding these grooming techniques in children and teens is especially important.
2) Central Centrifugal Cicatricial Alopecia (CCCA): Hair loss in the crown (vertex) of the scalp can exist in African-American women along with tenderness, burning, or itching. It may start as a small round or oval area of hair loss and increase in size over time. It can lead to permanent destruction of hair follicles as it moves outward. This condition appears to run in families but can be worsened by grooming techniques listed above.
Both of these conditions are usually amenable to hair transplantation but must first be examined and treated medically by a dermatologist or hair loss specialist. The hair loss may first require topical or locally injected steroids to help treat the underlying inflammation associated with these conditions.