Jamaican-born cosmetologist Susan Peterkin raises awareness about hair loss in Caribbean women

Jamaican-born cosmetologist Susan Peterkin is encouraging Caribbean women to pay closer attention to changes in their hair and scalp—and to recognize when it may be time to seek medical care.

For Caribbean women, conversations about hair have traditionally centered on how to care for it, style it and maintain it. Hair is deeply connected to culture and identity, and the versatility of Black hair has allowed generations of women to move between natural styles, braids, locs, extensions, wigs, pressed styles and other forms of expression.

Less frequently discussed is what happens when the hair begins to change in ways that cannot be explained simply by styling or normal shedding.

Hair loss affects women for many reasons, and for Black women, some forms of hair loss are associated with conditions that require medical evaluation. Jamaican-born cosmetologist and hair educator Susan L. Peterkin has spent more than four decades working with Black women's hair and has increasingly focused her work on helping women and beauty professionals recognize when changes in the hair or scalp may signal a larger concern.

"When a woman starts experiencing unexplained thinning, excessive shedding, changes in her scalp, pain, itching, burning or other persistent changes, our first response shouldn't automatically be, 'What product should we put on it?'" Peterkin says. "We should be asking, 'Why is this happening?'"

Peterkin's interest in the subject is personal as well as professional. She experienced hair loss herself and was diagnosed with central centrifugal cicatricial alopecia, or CCCA, as well as female pattern hair loss. Her experience led her to work more closely with dermatologist Dr. Chesahna Kindred and eventually to co-found PeterKINdred Hair & Scalp Wellness Center and S.T.R.A.N.D., an initiative that trains cosmetologists to recognize hair and scalp changes and work more effectively with dermatologists.

Why the cause matters

Peterkin emphasizes that hair loss is not a single condition. CCCA, traction alopecia and androgenetic alopecia, commonly known as female pattern hair loss, can affect Black women, but they have different causes and require different approaches.

CCCA is particularly important because it is a scarring form of hair loss. It often begins around the center or crown of the scalp and may be accompanied by symptoms such as itching, burning or tenderness. When inflammation damages the hair follicle, the resulting loss can become permanent.

Traction alopecia, meanwhile, is associated with repeated tension on the hair. Certain hairstyles, particularly when they are worn tightly or repeatedly, can place stress on the follicles. Women may notice tenderness, bumps or broken hairs around the hairline before more obvious hair loss develops.

Female pattern hair loss has a different cause and can sometimes be difficult to distinguish from other forms of thinning without a medical examination. This is one reason Peterkin believes women should resist the temptation to assume that every change in their hair is the result of a hairstyle or a particular product.

"I don't have to determine which one it is," she says. "As a cosmetologist, I need to recognize that something has changed and make sure my client gets to the professional who can."

That approach is particularly relevant in communities where women may have long-standing relationships with their hairstylists. A stylist who has cared for a woman's hair for years may notice a widening part, changes in density or thinning around the hairline before the woman herself recognizes that something is different.

Peterkin believes that observation can be valuable when it leads to an appropriate referral rather than an attempted diagnosis.

Culture, styling and the fear of losing hair

For Caribbean women, the emotional experience of hair loss can be complicated by the cultural significance of hair.

Peterkin grew up in Jamaica and remembers a very different hair landscape from the one many women encounter today. She eventually wore locs herself for 12 years and appreciated the length she achieved, but the weight eventually became uncomfortable around the center of her scalp. She later learned that she had CCCA.

Her experience has made her reluctant to frame hair-loss education as a criticism of the hairstyles Black women choose.

"There is beauty in that tradition, and I never want conversations about hair loss to become an attack on our culture," she says.

The issue, she believes, is awareness. Women should be able to wear braids, wigs, extensions or locs while also understanding the condition of the hair and scalp beneath them.

"I don't believe we have to reject wigs, braids or extensions to love our natural hair," Peterkin says. "But I do believe every woman should have an opportunity to know, understand and appreciate the hair that grows from her own scalp."

She also has a simple rule for styling: "A hairstyle should not hurt." Persistent pain or tenderness should not be dismissed as an unavoidable part of having one's hair done.

The emotional consequences of hair loss can also make women reluctant to seek help. A wig, weave, braid or other style may allow a woman to feel more comfortable while she adjusts to changes in her appearance, and Peterkin does not believe there is anything wrong with that.

"I don't have a problem with camouflage," she says. "My concern is when camouflage replaces observation."

For women who are covering thinning or hair loss, she recommends continuing to pay attention to what is happening underneath the style and seeking an explanation rather than relying solely on products or cosmetic solutions.

Knowing when something has changed

Peterkin encourages women to become familiar with their own hair so that changes are easier to identify. That includes noticing whether a part appears wider, whether more scalp is visible, whether the ponytail has become smaller, whether the hairline has changed or whether there is persistent breakage in a particular area.

She developed CHECK YOUR CENTER PART™ as a simple way for women to establish a baseline. By photographing the center part periodically, a woman can compare the images over time and identify changes that may otherwise be gradual enough to overlook.

"You don't have to become obsessed with your hair," Peterkin says. "You simply need to know what normal looks like for you."

Persistent itching, burning, pain or tenderness should also be taken seriously, particularly when accompanied by visible changes in the hair. When unexplained changes continue, Peterkin recommends seeking an evaluation from a dermatologist with experience in hair and scalp disorders.

The important point is that women do not have to wait until substantial hair loss has occurred before seeking answers.

Bringing the salon and medical office together

Peterkin's work with S.T.R.A.N.D.—Stylists Training, Researching, and Networking with Dermatologists—is based on the idea that cosmetologists and dermatologists can complement one another's expertise.

"Hair professionals are already on the front line," she says. "They see hair loss every day in the salon."

Through its educational programs, S.T.R.A.N.D. trains cosmetologists to recognize changes in the hair and scalp, understand what falls within their professional role and make appropriate referrals. The program has trained and certified more than 100 cosmetologists and worked with more than 20 dermatologists, according to its current materials.

Peterkin believes this collaboration is particularly valuable because the stylist may have years of history with a client, while the dermatologist has the medical training to determine what a change means and how it should be treated.

Dr. Kindred once described the relationship to Peterkin in a phrase that has stayed with her: "Cosmetologists and dermatologists are natural partners. We just weren't communicating."

For Caribbean women, creating that communication can make hair loss easier to recognize and less difficult to navigate. It also offers a way to move the conversation beyond the assumption that thinning hair is simply a cosmetic problem to be hidden or corrected.

Hair remains an important part of Caribbean culture and identity, and there is no reason for concern about hair loss to diminish that relationship. Peterkin's message is that greater knowledge can give women more choices, not fewer: the freedom to style their hair as they wish while also understanding their own hair and scalp well enough to recognize when something has changed.

"Love your hair, celebrate your hair, style your hair—but learn your hair too because there is help, and something can be done," Peterkin says.