Written by the AfroHairClinicTurkey editorial team, drawing on the clinical experience of our medical team · Last updated August 9, 2026 · How we write and check this
On this page 7 sections
A public record of claims we narrowed, removed, or left unpublished after checking the evidence underneath them.
Every entry below describes a change we made to this site. None of them describes a study being wrong. What is being corrected in each case is our own wording — the gap between what we had written and what a source actually supports.
Why this record exists
Clinic websites do not usually change their minds in public. When a claim turns out to be unsupported it is quietly edited, and the reader has no way of knowing it was ever there. That makes every claim on every clinic site look equally solid, which is the problem: a carefully sourced statement and a carelessly copied one are indistinguishable once they are both just sentences on a page.
So we publish the edits. If we tell you that we withhold claims we cannot support, this is where you check whether we actually do.
How we decide to change a claim
Behind this site is a register. Every factual statement is an entry in it, carrying what is claimed, which source it rests on, and how strong that source is. When we read a paper we record what that reading concluded about a specific claim, and there are only four possible conclusions: the evidence supports it, contradicts it, is insufficient, or the question is unanswered in the literature. There is no fifth option, and no “probably”.
A claim changes when a reading lands anywhere other than supported. It also changes when a source is retired, when two sources appear to conflict, or when the wording on the page claims more than the passage under it does.
What counts as sufficient evidence
Enough to support the sentence as written — not the topic in general. A study can be excellent and still not support a claim, if the claim is broader than what the study measured, or is about a population the study did not include. Several entries below are exactly that: good papers, used for the wrong sentence.
Where a statement contains a number, we expect to be able to follow that number back to the study that measured it. A figure repeated by reviews that cite each other is not a measurement, and one entry below is a number that turned out to have no traceable origin.
Why some claims stay unpublished
Because we could not establish them. Not because they are false — most of them may well be true, and some are widely believed. But “we could not find evidence” and “there is no evidence” are different statements, and only the first one is ours to make.
You will notice that several entries below removed claims that were useful to us: that textured hair needs fewer grafts, that our way of working is technically superior. Those are the ones where the evidence rule earns its keep, because they are the ones we had a reason to want to keep.
The records
6 records: 1 figure could not be traced · 2 claim removed · 1 wording narrowed · 1 source did not support this claim · 1 evidence found later
A traction alopecia figure we could not trace to a study
- What we had said
- We published that traction alopecia affects up to 32% of women and 22% of high-school girls with Afro-textured hair. Both figures came from a review article.
- What we checked
- We went looking for the studies the review was drawing on, and read two population studies from Cape Town — one of 874 adults, one combining adult and schoolgirl cohorts.
- What the evidence supported
- The adult figure held up: 31.7% of the women examined. The schoolgirl figure did not match. The primary study reports 17.1% in girls aged 6 to 21, while 22.6% is the overall adult prevalence in the separate study. We could not establish where a 22% schoolgirl figure comes from.
- What we changed
- We split the statement in two. The adult figure is now published with the study population named, so a reader can see it describes 874 adults in Cape Town rather than Afro-textured hair everywhere. The schoolgirl figure was removed from the site and remains unpublished.
Sources read
- Mirmirani P, Khumalo NP. Traction alopecia: how to translate study data for public education—closing the KAP gap? Dermatol Clin. 2014;32(2):153-61. open source →
- Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Hairdressing and the prevalence of scalp disease in African adults. The British journal of dermatology. 2007;157(5):981-8. open source →
- Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Determinants of marginal traction alopecia in African girls and women. Journal of the American Academy of Dermatology. 2008;59(3):432-8. open source →
First reviewed 9 August 2026 · AfroHairClinicTurkey editorial team
Suggested citation AfroHairClinicTurkey. Evidence Decision Record: A traction alopecia figure we could not trace to a study. Reviewed 2026-08-09. https://afrohairclinicturkey.com/research/evidence-decisions/
We removed the claim that coiled hair needs fewer grafts
- What we had said
- Our homepage stated that because each curl coils and overlaps, coiled hair covers more scalp per follicle — and that fewer grafts can therefore produce a fuller-looking result than the same graft count on straight hair.
- What we checked
- We searched for any study measuring coverage per follicle, or comparing graft requirements between coiled and straight hair. Three separate searches returned nothing.
- What the evidence supported
- The first half of the claim does have a source: scalp biopsies comparing African American and white patients found total hair density significantly lower in the African American group. Nothing we found measures whether curl compensates for that.
- What we changed
- The density finding stays, attributed to the study and its sample size. The compensation claim was removed. It was the half that told a patient they might need fewer grafts, which makes it the half that most needed evidence, and it had none.
Sources read
- Sperling LC. Hair density in African Americans. Archives of dermatology. 1999;135(6):656-8. open source →
First reviewed 9 August 2026 · AfroHairClinicTurkey editorial team
Suggested citation AfroHairClinicTurkey. Evidence Decision Record: We removed the claim that coiled hair needs fewer grafts. Reviewed 2026-08-09. https://afrohairclinicturkey.com/research/evidence-decisions/
We could not support what we said about robotic extraction
- What we had said
- Our homepage stated that robotic FUE systems use optical recognition calibrated around straight hair, that a camera-guided arm cannot reliably read a follicle that bends beneath the skin, and that this drives transection risk up.
- What we checked
- We searched for published comparisons of robotic and manual extraction in Afro-textured or curly hair, and for device-specific performance data. The closest source is a review describing how robotic systems work and noting they have advantages and disadvantages.
- What the evidence supported
- That review contains no data on performance in tightly curled hair. We found no study measuring it either way.
- What we changed
- The section was rewritten to say we could not find the data. It now states that anyone claiming robots definitively cannot handle textured hair is asserting something the published record does not currently establish — including us, previously. Our preference for working by hand is presented as a clinical preference informed by other evidence, not a proven superiority.
Sources read
- Rose PT, Nusbaum B. Robotic hair restoration. Dermatologic clinics. 2014;32(1):97-107. open source →
First reviewed 9 August 2026 · AfroHairClinicTurkey editorial team
Suggested citation AfroHairClinicTurkey. Evidence Decision Record: We could not support what we said about robotic extraction. Reviewed 2026-08-09. https://afrohairclinicturkey.com/research/evidence-decisions/
We stopped implying we knew why keloids form more often
- What we had said
- We wrote that melanin-rich skin carries a higher documented risk of keloid and hypertrophic scarring. That phrasing points at melanin as the reason.
- What we checked
- We read the dermatology review our statement rested on.
- What the evidence supported
- It records that keloids form more often in Black patients than in white patients, and states plainly that the reason for the difference is not known. It attributes nothing to melanin.
- What we changed
- The wording now reports the difference without offering a mechanism, and says the cause is unestablished. The word "documented" was removed from the risk itself: the difference is documented, the explanation is not, and the original sentence blurred the two.
The page now says “Keloid scarring occurs more often in Black patients than in white patients; the reason for the difference is not established.”
Sources read
- Kelly AP. Keloids. Dermatol Clin. 1988;6(3):413-24. open source →
First reviewed 9 August 2026 · AfroHairClinicTurkey editorial team
Suggested citation AfroHairClinicTurkey. Evidence Decision Record: We stopped implying we knew why keloids form more often. Reviewed 2026-08-09. https://afrohairclinicturkey.com/research/evidence-decisions/
A paper we wanted to cite did not support the point we wanted it for
- What we had said
- We intended to publish a transection rate for coiled hair, and to present curl as the reason transection risk rises.
- What we checked
- We read four studies. One reported rates of 2.2 to 4.3 percent — but only six of its 152 patients had coiled hair, and its own conclusion was that scalp thickness and firmness affected the rate more than curliness did. We recorded that as contradicting our claim.
- What the evidence supported
- Reading further resolved the apparent conflict rather than deepening it. A separate series of 64 patients of African descent reached the same conclusion: skin thickness and firmness mattered more than curl. The two studies were not in conflict; the first simply had a mostly straight-haired population, so it said little about Afro hair either way.
- What we changed
- No transection percentage for coiled hair is published anywhere on this site, because none of the studies measures one. What we publish instead is what they do support: that conventional rotary punches performed badly in one small series of tightly curled hair, that scalp thickness and firmness outweigh curl, and that a general FUE population showed transection in 6.3 to 7.4 percent of grafts — which makes transection a feature of the technique rather than a penalty for having textured hair.
Sources read
- Umar S, Khanna R, Gonzalez A, et al. No-shave long hair follicular unit excision using an all-purpose skin-responsive device. Clin Cosmet Investig Dermatol. 2023;16:3681-91. open source →
- Umar S, Khanna R, Lohlun B, Maldonado JC, Zollinger M, Osei-Tutu A, et al. Follicular Unit Excision in Patients of African Descent: A Skin-Responsive Technique. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]. 2023;49(10):949-955. open source →
- Umar S. Comparative Study of a Novel Tool for Follicular Unit Extraction for Individuals with Afro-textured Hair. Plastic and reconstructive surgery. Global open. 2016;4(9):e1069. open source →
- Park JH, You SH. Various Types of Minor Trauma to Hair Follicles During Follicular Unit Extraction for Hair Transplantation. Plastic and reconstructive surgery. Global open. 2017;5(3):e1260. open source →
First reviewed 9 August 2026 · last updated 10 August 2026 · AfroHairClinicTurkey editorial team
Suggested citation AfroHairClinicTurkey. Evidence Decision Record: A paper we wanted to cite did not support the point we wanted it for. Reviewed 2026-08-10. https://afrohairclinicturkey.com/research/evidence-decisions/
A question we had recorded as unanswerable, later answered
- What we had said
- We had no position on whether hair transplantation is appropriate in central centrifugal cicatricial alopecia, and recorded it as something we had searched for and not found.
- What we checked
- The first search returned only a general review whose abstract describes curly hair as needing special consideration, with no candidacy criteria and no outcome data. A later search found a case report.
- What the evidence supported
- Two African American women with end-stage disease and no inflammation on scalp biopsy underwent transplantation, and hair growth was observed at the recipient sites with no post-operative scarring reported.
- What we changed
- We now publish that transplantation has been reported as safe and effective in this condition — carrying the conditions with it, because they are the whole finding: two published cases, end-stage disease only, and a biopsy showing no remaining inflammation. It is not evidence for operating on active disease.
The page now says “Hair transplantation has been reported as safe and effective in CCCA, but only in two published cases, and only where the disease was end-stage and a scalp biopsy showed no remaining inflammation.”
Sources read
- Rogers NE, Callender VD. Advances and challenges in hair restoration of curly Afrocentric hair. Dermatologic clinics. 2014;32(2):163-71. open source →
- Callender VD, Lawson CN, Onwudiwe OC. Hair transplantation in the surgical treatment of central centrifugal cicatricial alopecia. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]. 2014;40(10):1125-31. open source →
First reviewed 9 August 2026 · last updated 10 August 2026 · AfroHairClinicTurkey editorial team
Suggested citation AfroHairClinicTurkey. Evidence Decision Record: A question we had recorded as unanswerable, later answered. Reviewed 2026-08-10. https://afrohairclinicturkey.com/research/evidence-decisions/
What this record does not contain
It is not every decision. Some entries in the register involve information about named clinicians that is not ours to publish while it is still being confirmed, and publishing a decision about someone’s credentials before that process finishes would be unfair to them. Those stay internal until the documentation resolves them one way or the other.
It is also not a claim to have got everything right first time. The opposite: each entry is a thing we published and then had to change. The reason for showing them is not that the changes are impressive, but that they are checkable.
Our verification record shows the current status of every claim on the site, and the measurement protocol covers how we intend to handle data we generate ourselves.
If you think one of these is wrong
Tell us. A decision recorded here is a decision we are prepared to defend or revise, and someone outside this clinic pointing out that we read a paper badly is more useful than anything we could publish about how careful we are. Get in touch.