By Linda Carroll

(Reuters Health) – Primary care providers often don’t realize that hair care can be a barrier to regular exercise for some black women, a new study suggests.

Hair care routines aren’t a barrier for every African American woman, said study leader Dr. Sophia Tolliver, “but they are for a significant enough number.”

Creating a hairstyle “could take several hours during the day,” Tolliver said. Women may fear that working out and perspiring potentially could ruin that hairstyle, she added.

In a survey of primary care providers, Tolliver and colleagues found an overwhelming majority talk to their female African American patients about the importance of exercise. But three-quarters said they don’t talk with these patients about hair care, which can be a barrier to vigorous workouts, the researchers reported in the Journal of the American Board of Family Medicine.

“A lot of doctors are not aware that it’s a barrier to exercise in this population, let alone having the lexicon or tools to carry on a conversation about it,” said Tolliver, of the department of family medicine at The Ohio State Wexner Medical Center in Columbus. “In their free comments some said they were scared to talk about it, others said they didn’t have the tools, and others said they were afraid of offending women with this conversation.”

Doctors should ask female African American patients about their hair care routines, Tolliver said. A physician might open the conversation with: “Tell me about your wash-day routine,” she added. Then, “tell me what your hair means to you. Is it a barrier to exercising?”

Two earlier surveys of non-exercising African American women showed why those conversations are important: many women said concerns about “sweating out my hairstyle” were a barrier to getting enough exercise.

For the new study, Tolliver and colleagues emailed a survey to doctors, nurse practitioners and physician assistants in the department of family medicine at Ohio State. Out of the 151 providers who were sent the email, 62 completed the survey.

While 95% of respondents said they often or sometimes discussed physical activity with their female African American patients, a full 76% said they never included hairstyling or maintenance assessment in the conversation.

Although 60% said they believed discussion hair maintenance strategies would be beneficial and could possibly help to increase physical activity in female African American patients, just 34% said they were comfortable or relatively comfortable discussing the topic.

The new study points up the need for “cross cultural medicine,” said Dr. Angela J. Lamb, an associate professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York. “Everybody needs to know about this topic.”

At her hospital, Lamb gives lectures to junior dermatologists “on this exact topic,” she said. “I tell them to ask an open ended question: ‘How often do you wash your hair.'”

Many women may not realize it’s not necessary to wash out the sweat generated during a workout, Lamb said, adding “my hair only gets washed once a week and I exercise daily.”

For those who feel their hair has gotten oily or dirty from exercising, “there are dry shampoos,” Lamb said.

For African American women who, like Lamb, straighten their hair, there are strategies for preventing hair from getting wet during a workout. “I wrap mine with a satin scarf,” she said. “It’s all about finding what is practical, what is presentable and what allows you to be physically active.”

SOURCE: Journal of the American Board of Family Medicine, online November 8, 2019.