The role of hair care practices in the development of scarring alopecia has not been well-studied. In black women, there is a particular preponderance of hair loss with little consistent scientific data to support a mechanism for scarring alopecia. This retrospective cohort study examined the hair care practices of black women with and without scarring alopecia to determine behaviors that may be associated with this specific form of hair loss. Forty-four participants were surveyed: 21 with scarring hair loss on the frontal and vertex areas of the scalp that fit no other diagnosis, and 23 without scarring hair loss. All participants in the group without alopecia were currently using chemical-relaxing agents or had done so in the last 6 months. A 36-item questionnaire was administered to each participant and results were entered into a computer database. Questions included information on general health, history of autoimmune disease, family history of alopecia, medication use, and specific hair care practices (both current and past). Our results showed that family history of alopecia was statistically significant in participants reporting personal hair loss (P=.002) as well as current use of chemical relaxers (P=.042). Other statistically significant associations included prior history of hair dyeing (P=.049) and prior use of hair weaves (P=.015). Results showed that certain hair care practices were associated with scarring hair loss, and with larger clinical trials, it is likely that patterns in hair care rpactices will arise among these participants to help elucidate the mechanism of hair loss in scarring forms of alopecia.