Bad Hairstyling Practice
High Risk Hairstyling Practices for Traction Alopecia
Frequent use of tight buns or ponytails
Applications of weaves and/ or braids to relaxed hair
Hair extensions applied to relaxed hair
Tight braids, cornrows, locs (frequent and tight re-twisting/ “palm rolling”)
Tight scarves worn during the day or at night to bed
Any style causing any symptoms such as pain, inflamed red skin, stinging, crusting, tenting, or pimples
Moderate Risk Hairstyling Practices for Traction Alopecia
Loosening of braids/ cornrows/ locks
Weaves and braids applied to natural hair
Hair extensions applied to natural hair
Wigs worn with cotton or nylon wig caps
Good Hairstyling Practice
Low Risk Hairstyling Practices for Traction Alopecia
Loose, low hanging ponytails and buns
Wigs worn loosely with satin caps
Natural unprocessed hair
Very loose twists and braids
General Hairstyling Recommendations
Loose application of braids
Braids should be looser at the hair line, also consider leaving part of the hairline out around the scalp
Avoid braiding hair down to scalp
Try to start braiding hair leaving at least 1/2 cm of base hair
Opt for larger diameter braids
Avoid using an increased amount of heavy extension hair to braid a small amount of your own hair
Avoid braid styles that cause pain, pimples and hair breakage after as this may eventually cause permanent hair loss.
Avoid updos and pulling hair back while braid extensions are installed
Use extensions sparingly and for short periods of time and remove immediately if they cause pain or irritation
Don’t leave braids styles in for more than 4-6 weeks at a time
Give breaks between braid styles at least 8-12 weeks where your own hair is worn.
Make sure scalp is based with petrolatum product at lead 20 minutes prior to relaxer.
If the scalp starts to burn or tingle then ask for the chemical to be washed out as your scalp is signaling to you that there may be damage and inflammation deeper in the scalp that can lead to hair breakage and baldness.
Relax the hair no more than once every 2-3 months.
Make sure that ends of hair are protected with petrolatum based product and that ONLY "new growth" get the relaxer.
Get relaxers done by trained professionals.
Try to avoid daily heat styling
Try to minimize heat to once per week if hair must be straightened
Decrease use of thermal straightening on chemically relaxed hair
Avoid thermal straightening and styling at least 1-2 weeks after chemical relaxing
Use lower heat settings on flat irons and blow dryers
Use heat protectants when styling the hair
If hair is natural, try to air dry the hair
Avoid tight and repeated re-twisting
Allow “new growth” to remain
If re-twisting, leave at least 1cm of hair before twisting
Avoid tightly braiding hair under weaves
Opt for loosely sewn-in weaves instead of bonding glues
Bonding glues can cause skin allergies
Don’t leave weaves in for more than 4-6 weeks at a time
Give breaks between weave styles at least 8-12 weeks where your own hair is worn.
Should not create too much tension on the frontal scalp
Wear a silk or satin cap
Be careful of glues on the scalp
Avoid use of tight scarves or “hair/ head tie” during the day or while sleeping
Avoid tension hair styles with relaxers
Alternate hairstyles when possible
Avoid styling in “up-dos”
Get regular trims to remove split ends
Give hair a break from all styling practices by adopting a “natural hairstyle”
Recurrent pain and pimples and hair breakage after any hairstyle hair will eventually cause permanent hair loss. Prevention is better than cure
Keep children’s hair natural hair, and in loose styles otherwise, they may have traction alopecia by the time they are teenagers.
Try to avoid products heavy, greases on the hair (petrolatum, lanolin, mineral oil) and stubborn silicones that can weigh down the hair down and build up on the hair and eventually lead to breakage
Protect the hair, particularly the ends, from environmental damage.
Caution with many harsh materials on the hair (wool. cotton, etc)
Try to sleep with silk or satin scarf and or pillow.
Pay attention to and avoid any side effects from all hair grooming practices
Brochure by Dr. Ncoza Dlova MBshB FCDerm. PhD)
Aguh C, Okoye G, eds. Fundamentals of Ethnic Hair: The Dermatologist's Perspective. Cham: Springer, 2016
Ogunleye TA, McMichael A, Olsen EA. Central centrifugal cicatricial alopecia: what has been achieved, current clues for future research. Dermatol Clin 2014;32:173e81.