Highlighting Educational Gaps in Hairstyling Practices amongst Dermatologists and Trainees

Background Hairstyling practices are associated with the development and/or exacerbation of various forms of alopecia. Exposure to various hairstyling practices ranges but is often insufficient in current dermatologic textbooks and training curricula. We therefore conducted a survey to establish dermatologists understanding of hairstyling practices, particularly those that have been implicated in alopecia. Methods A 34-item anonymous, electronic survey was distributed by email to 291 board-certified dermatologists and dermatology residents across the US between August 2020 and February 2021. Responses were rated on a 10-point scale to identify physician confidence in various styling practices Results Black providers were more confident in both the knowledge and counseling of all hair practices (chemical straightening, heat styling, braiding, weaving, and wigs) compared to non-Black providers (p <0.001), with the exception of counseling patients on hair dyes for which no significant difference was found (p=0.337). Female providers were only more likely to indicate confidence in knowledge regarding different heat styling methods and hair dyes, and counseling of heat styling methods compared to male providers (OR 15.72, p<0.001; OR 2.47, p=0.022; OR 3.78, p=0.001 respectively) across all hair practices surveyed. Overall, 63.8% of providers reported that the majority of their knowledge on hair practices was from personal experience as opposed to formal training. Limitations This survey is limited by its response rate and the inability to characterize non-responders due to anonymity. Conclusion Our study highlights educational gaps in dermatologic training on hair practices, especially those more common among Black patients. Interestingly, the majority of provider knowledge came from personal experience rather than dermatologic training emphasizing the need for formalized curricula to enhance understanding among all dermatology providers. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the Johns Hopkins Institutional Review Board I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data will be produced upon reasonable request to the authors