Skip to main content
. 2021 Jan 29;7(2):174–179. doi: 10.1016/j.ijwd.2021.01.019

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.