Our commitment to culturally inclusive hair care services
Stephanie-Cara Durbano, OT/s, Boston University Doctor of Occupational Therapy Student
AOTA is committed to building an equitable and inclusive profession by having practitioners implement cultural humility and provide culturally inclusive services in practice. Our resources introduce specific hair care practices of different cultures, religions, and traditions and the importance of implementing cultural humility into occupational therapy.
Importance of providing culturally inclusive services
Haircare is an important ADL that also supports participation in other occupations such as social and community participation. By focusing on occupational therapy’s role in the importance of the intersection between hair care and occupational identity, we can address the lack of diversity and knowledge that negatively impacts clients' health and well-being. Bias and systemic racism play a significant role in affecting the way one interacts with diverse individuals and can lead to occupational therapy practitioners furthering health inequities.
There are four different curl patterns that are further categorized into subcategories based on tightness and looseness of the curl pattern. The following lists the different types of curl patterns in each “type” of hair. Do not use products with alcohols, silicones, sulfates, or parabens.
Washing hair may occur once a week to avoid losing moisture in curls. Using a wide tooth comb for combing and detangling prevents hair from breaking or snapping.
Products & Tools: Chosen products should be designed to care for textured hair
Products: Detangling products, curl creams, leave-in conditioner, moisturizing products, Jamaican black castor oil, raw shea butter, and raw coconut oil
Tools: Wide tooth comb, detangling flexi brush, and silk cap/wrap for sleep, drying with microfiber cloth or t-shirt to avoid breakage
Type 4 Hair Care:
Products & Tools - Chosen products should be designed to care for textured hair
Products: Detangling products, co-wash, deep conditioner, moisturizing products, hair masks, Jamaican black castor oil, raw shea butter, and raw coconut oil
Tools: Wide tooth comb, detangling flexi brush, and silk cap/wrap for sleep
Hair care in different religions, cultures, and traditions
For many cultures and religions, hair is considered a part of one's identity. The following are a list of a few cultures, religions, and traditions occupational therapy practitioners are likely to encounter when working with clients.
Although each nationality listed in this section has different ethnic backgrounds, they can have similar hair textures and hair care practices. African hairstyles continue to play a role in today's society. Hair expression is a powerful way for Black Americans to honor the story of the Black experience across the world.
Black Americans have shown their resilience, resistance, pride, joy, and courage by preserving, evolving, and reclaiming historical hairstyles. Throughout history, hair traditions aimed to create a sense of beauty signified by marital status, age, religion, wealth, and rank (Know Your Hairitage, 2022).
Some older women go to the salon weekly to get their hair done as part of their routine. Weekly salon visits for elderly women are important to their self-esteem, dignity, and overall mood.
It also helps with preventing depression and isolation and provides an opportunity for socialization (Haircuts on Wheels, 2021). An elderly woman's weekly hair salon appointments are equally as important as their ADLs such as bathing, eating, and dressing.
Shaving with razors can often irritate men with sensitive skin, especially for Black men who are generally prone to developing pseudofolliculitis barbae (PFB), which is the irritation of the skin due to hairs that penetrate the skin before leaving the hair follicle or leave the hair follicle and curl back into the skin (Levinbook, 2022).
Some men use depilatory creams as a way to chemically remove hair to prevent irritation (Oresajo et al., 2009; Gray et al., 2016). It is important to pay attention to specific shaving irritation such as burning, itching, and stinging in men with curly, wavy, coarse hair or exceptionally curly hair phenotype.
In Islamic teachings, Allah asks women to wear hijab in order to achieve modesty and redirect the focus of both women and men from the materialistic world towards a more spiritual world of Allah. This is a way for women to show their submission to Allah’s command and in doing so they feel closer to Allah and spiritually more satisfied.
By wearing hijab, women are able to construct their own identity and decide how others will interpret their identity (Hwaij, n.d.). When interacting with a male health care practitioner, women are not allowed to be alone or remove their hijab, to maintain their dignity and modesty.
In Native American culture, hair is a physical manifestation of a person's thoughts and an extension of themselves. Many Holy men and Holy women are recognized by the length of their hair. The cutting of hair represents the submission and defeat of their people, through humiliation by oppressors.
The way that individuals style their hair portrays and announces participation in various events and feelings expressed. Cutting hair symbolizes cutting off the flow of thought and usually only occurs when individuals choose to make a major change in their lives. Braids symbolize oneness and unity; by connecting strands of hair together, it physically demonstrates the strength of oneness, “one heart, one mind, one soul” (Johnstone, 2019).
In Orthodox Jewish culture, women cover their hair after marriage, upholding tradition and embracing their new status as a wife and eventually, mother (Milligan, 2014). Women may use hats, wigs, or scarfs to cover their hair when outside of their home. A woman’s head covering is essential to her dignity and modesty. In everyday life not all orthodox women will cover their hair but when attending service, they will do so.
Not all orthodox Jewish women practice covering their hair however, all Hasidic Jewish women cover their hair. Hasidic Jewish women are not allowed to be in a room alone with a male health care practitioner without their husband present to maintain their dignity and modesty, and to follow Jewish law.
References
Gray, J. & McMichael, J. (2016). Pseudofolliculitis barbae: understanding the condition and the role of facial grooming. International Journal of Cosmetic Science, 38(1), 24–27. https://doi.org/10.1111/ics.12331
Milligan, A. K. (2014). Hair, headwear, and orthodox Jewish women: Kallah’s choice. Lexington Books.
Oresajo, C., Recherché, L., Kindred, C., Yatskayer, M., & Halder, R. (2009). Comparative evaluation of men’s depilatory products versus razor. Journal of the American Academy of Dermatology, 60(3), AB99. https://doi.org/10.1016/j.jaad.2008.11.443
