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J Am Acad Dermatol. 2016 Sep;75(3):606-611. doi: 10.1016/j.jaad.2016.02.1162. Epub 2016 Apr 22.

All hairstyles are not created equal: What the dermatologist needs to know about black hairstyling practices and the risk of traction alopecia (TA).

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Howard University College of Medicine, Washington, DC.
Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD. Electronic address:


Prevalent among black women, traction alopecia (TA) is a type of hair loss that is often attributed to certain hairstyling practices. Although some of the hair care techniques common in the black community can promote ease of everyday hairstyling for black women, many of these practices have been implicated as risk factors for TA. Because of the limited literature on black hairstyling methods, hair loss in this patient population can present a diagnostic and therapeutic challenge for dermatologists. By increasing the knowledge and understanding of these practices and their risk of causing TA, clinicians can better manage this condition and stop the progression of hair loss before it becomes permanent. This information can be used to develop individualized recommendations for safer styling alternatives and improve patient education by identifying high-risk hairstyling habits. This review stratifies these hair care and styling practices into high-, moderate-, and low-risk categories, in addition to outlining a diagnostic approach for TA and detailed guidelines for conservative management.


alopecia; ethnic hair; ethnic skin; hair loss; nonscarring alopecia; traction alopecia

[Indexed for MEDLINE]

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