Table 4.
Practical recommendations to decrease risk of TA in adult and pediatric patients of African descent.
Adult hairstyles/practices that increase risk of TA | Modification/recommendation to patient |
---|---|
Weaves | Avoid using bonding glue, choose sew-in weave option (Haskin and Aguh, 2016) |
Tight/heavy/long braids | Leave edges out when getting hair braided (may use edge control balm to style edges); avoid up-dos when styling braids; if up-dos preferred, gently loosen proximal ends of frontal hairline braids to decrease tension after hair tie in place; ask stylist to loosen braid if pain or stinging is experienced at time of braid placement, decrease volume and length of weave added to hair to decrease tension on hair follicle, leave styles in place no longer than 2–3 months; consider twists instead of braids |
Chemically relaxed hair | Chemically relaxed hair combined with other hairstyles has highest prevalence of TA. Avoid weaves, braids, and extensions; if avoidance is not possible, decrease volume, length, and longevity of hairstyle; consider transitioning to natural hair and styling with temporary blow-out or thermal method when straight hair is desired |
Wigs that rub frontal hair line | Satin wig cap or velvet wig band should be used to protect the hair and hairline; avoid cotton and nylon because these can cause friction and absorb moisture (Haskin and Aguh, 2016) |
Ponytails, buns, and up-dos | Replace rubber bands with covered elastic ties or other types of hair ties without metal. If sleek appearance desired, instead of pulling hair tightly, use alcohol-free gels and hairstyling cream; use satin scarf to help set hair and control frizz |
Dreadlocks and sisterlocks | Avoid length because this can increase weight and damage to hair follicle; avoid combining locks along the frontal hairline; when styling locks, loosen locks at frontal hairline once styled |
Prolonged or repetitive styles | Give hair a break to recover between styles; consider wearing a wig with satin cap or other loose protective hairstyles |
Pediatric hairstyles/practices that increase risk of TA | Modification/recommendation to parent |
Tight cornrows | Avoid excessive pulling of hair during braiding of a cornrow; loosen tension of hair at the hairline before braiding loose end of cornrow; satin pillowcase or bonnet can help maintain style; consider flat twist instead of cornrows |
Hair bound with rubber bands | Use covered elastic bands/ties or other hair bands without metal to decrease pulling and breakage caused by traditional rubber bands |
Tight pigtails and ponytails | Frizz or unkempt appearance is a common reason for tight styles. Hairstyling balms, pomades, creams, and alcohol-free gels used with styling can help control frizz. Satin bonnets, satin scarves, or satin pillowcases can reduce frizz |
Braids styled in updo or pulled back | Allow braid in frontal hairline to hang freely or once hair tie is in place, gently pull proximal ends of frontal hairline braids to decrease tension; avoid pulling loose braided end of cornrow perpendicular to director of the style (particularly cornrows braided along the frontal hairline); consider twists instead of braids |
Prolonged braided or repeated braided styles | Prolonged tension from tight hairstyles can lead to TA; avoid leaving hairstyles in place longer than 2–4 weeks (up to 2 months for older children); moisturize hair along frontal hairline to decrease breakage; take breaks between braids/cornrows and avoid repetitive patterns of tension |
TA, traction alopecia.