A decade of hair prosthetic injuries: A review of U.S. emergency department cases (2013-2022)

Summary: Abstract Body: Emergency departments (EDs) are often the first point of care for many patients. With rising hair prosthetic injuries, EDs face a growing role in managing these cases and coordinating with dermatology. Given the diverse cultural practices surrounding hair prosthetic use, examining demographics, clinical presentations, and outcomes of these injuries may help promote health equity in the ED. The National Electronic Injury Surveillance System (NEISS) database, representing ~100 EDs, was queried using a keyword search of “wig”, “hairpiece”, “toupe”, “toupee”, including plural forms. T-tests evaluated gender and age differences (P<0.05). Among 88 hair prosthetic-related injury cases (mean age 34, range 2–84), 53.4% were Black, 10.2% White, and 94.1% female. Cases increased by 56.3% from 2013 to 2022, rising from 7 to 16. The most common diagnoses included dermatitis, lacerations, and contusions. Race documentation was significantly less frequent in patients aged 35+ compared to younger patients (46.3% vs. 25.5%, P=0.04). Common diagnoses included dermatitis, lacerations, and contusions. The most frequently injured areas were the head, eyes, and ears, with women experiencing significantly more ear injuries, lacerations, and pain than men (7.2% vs. 0.0%, P=0.01; 16.9% vs. 0.0%, P<0.001; 6.0% vs. 0.0%, P=0.02). Ultimately, hair prosthetic injuries are rising in the US, with Black women representing 53.4% of cases. Expanding culturally competent education on safe prosthetic use is crucial, given the cultural significance and symbolism of hair for women of color. Discrimination and inadequate training may worsen outcomes for this group. Advocacy areas include wig testing, allergy prevention, safe removal practices, and scalp protection measures. Surya Khatri¹, Aakash Arora¹, Esther Henebeng², Daniella Reimann², Elie Saliba^{2, 3} 1. Brown University Warren Alpert Medical School, Providence, RI, United States. 2. Department of Dermatology, Brown University Warren Alpert Medical School, Providence, RI, United States. 3. Department of Dermatology, Lebanese American University School of Medicine, Beirut 13-5043, Mount Lebanon Governorate, Lebanon. Minoritized Populations and Health Disparities Research