In this issue of the Archives, Sperling and Sau explore the murky depths of the histopathology of alopecia.1 In this thoughtful article the authors essentially debunk the myth of hot comb alopecia by a combination of historic and histologic comparisons. They conclude that the use of hot combs for hair straightening, apparently widespread 20 years ago, is much less common today primarily because of the availability of newer chemical straightening agents.
After the authors eliminated hot comb use as a causative agent, they were left with a distinctive clinical pathologic pattern of alopecia that is common. This form of alopecia is typically found in young adult to middle-aged black women who present with hair loss primarily localized to the centrofrontal region of the scalp. The extent of the alopecia is variable ranging from minimal hair loss to near complete baldness. Black men and white women are less commonly affected.
Solomon AR. Alopecia by a Different NameA Matter of Splitting Hairs. Arch Dermatol. 1992;128(1):102-103. doi:10.1001/archderm.1992.01680110112018