Why does my hairstyle give me a headache?

Q: I wear hairstyles like box braids, cornrows, and sleek ponytails, but sometimes they give me a headache. Why does this happen? Should I be worried?

How you wear your hair is often about more than just looking and feeling good. For some people, their hair is a form of self-expression that makes a little pain seem worthwhile.

For others, it’s a way to feel connected to their cultural heritage, said Dr. Victoria Barbosa, an assistant professor of dermatology at the University of Chicago. And sometimes, slicked-back buns or protective hairstyles like summer braids that are meant to protect hair from damage are just convenient, she said.

However, any hairstyle that involves tugging can cause what experts call external tension headaches; the constant tension can lead to hair loss.

“Nobody wants to spend their hard-earned money, often hundreds of dollars, on a style that they then have to remove prematurely,” Dr. Barbosa said. “But sometimes that happens.”

How Tight Hairstyles Cause Headaches

Tension headaches cause a numb ache or pressure, or a feeling of a tight band around the head. But external traction headaches — which experts previously called ponytail headaches — are felt primarily at the site of the hair being pulled, said Dr. Susan Broner, a neurologist at NewYork-Presbyterian Hospital.

For example, wearing a high ponytail can cause crown pain, and newly installed braids can cause scalp pain. This is because hairstyles can cause sensitivity nerve endings on the scalp, said Dr. Annie Shea, a neurologist at University of Michigan Health.

But these hairstyles won’t cause long-term nerve damage, she said. In most cases, it should be feel better within an hour of relaxing your hair.

To avoid these headaches altogether, Dr. Shea suggested opting for looser hairstyles. If you need to pull your hair out of your face, such as while working out or cooking, she recommended using hair clips and gentle headbands.

If you wear tight braids, it’s harder to pull your hair down. Box braids — which are created by dividing your hair into sections, or boxes, and braiding each one — put tension on your hair roots because they typically involve placing hair extensions right next to your scalp. Knotless braids, however, introduce the extensions into the braids in a way that creates less tension, Dr. Barbosa said.

In situations where a looser hairstyle isn’t possible, Dr. Shea suggests taking a painkiller like ibuprofen before your haircut or even after you start feeling pain.

Still, it’s significant to tell your hairstylist if you experience pain while getting your hair done, says Dr. Barbosa, “because once the hair is done, of course someone can take a painkiller, but that doesn’t change the fact that the hair is too tight.”

Long-Term Effects of Tight Hairstyles

Any hairstyle that adds friction or tension to the hair can cause it to break. Regularly using hair ties, for example, means the ties rub against the hair “like a little knife,” Dr. Barbosa said.

Traction alopeciaa type of hair loss caused by repeated pulling on the hair root, is another risk. At first, it may look like a receding hairline or patches of hair loss. It can also manifest as “acne pimples or flaking of the scalp,” said Dr. Jordan Talia, an assistant professor of dermatology at Mount Sinai.

If someone continues to wear hairstyles that pull on the hair, this condition can worsen, causing scar tissue to form, which can destroy hair follicles and cause the skin to become shiny and numb. permanently bald.

Traction alopecia can affect anyone, but it is most common among black womenespecially those who wear their hair in tight curls, Dr. Barbosa explained. Although it’s not clear why, the risk may also enhance in people with chemically straightened hair, experts said.

“It’s such a common problem that even though it’s not normal, it’s become the norm,” Dr. Barbosa said.

There are treatment options for traction alopecia: Beforehand, a dermatologist may prescribe a topical steroid or inject steroids into the patient’s scalp to reduce inflammation and prevent scarring, Dr. Talia said. They may also recommend minoxidil (Rogaine), an over-the-counter topical medication that stimulates hair growth. Oral minoxidil is also available by prescription, which dermatologists employ as an off-label treatment for the condition, Dr. Barbosa added. (The Food and Drug Administration has not approved any medications specifically for traction alopecia, but topical minoxidil is approved for androgenetic alopecia in women and men.)

For people with enduring hair loss, a hair transplant — which involves taking fit hair follicles from the scalp and transplanting them to the area where novel hair is desired — may be an option, Dr. Barbosa said, although the procedure can be exorbitant. thousands of dollars.

In general, Dr. Barbosa advised people to avoid tight hairstyles. When it comes to protective hairstyles, such as box braids or cornrows, she suggested wearing them only once or twice a year and for no more than six weeks at a time.

These styles can protect your hair “because you don’t have the breakage associated with repeated styling,” but they can damage your hair follicles, she said. “Protective styles aren’t always as protective.”