It’s been said there’s a price to pay in order to stay fashionable, but some might question the cost if there’s a health consequence.

While the practice is in fact an ancient one dating back to the Egyptians, hair braiding and weaving has gained tremendous popularity in the past thirty years, especially among African Americans. Back in the early nineteen-seventies, many women sporting afro hairdos gave up the rounded frizzy look for chemical relaxers, straighter hair and then, hair extensions. Today, braids and weaves are not only worn by black women, but by people of all ethnicities, following in the fashion footsteps of models and movie stars.

But the pulling, traction and tension caused by attaching the added hair pieces to one’s own hair may just wreak havoc on the scalp, according to a new study published in the Archives of Dermatology. In particular, a balding condition known as centrifugal cicatricial alopecia [Sic-a-trick-ee-uhl Allo-peesha] was seen in many women wearing the extensions.

The researchers analyzed the hair-grooming methods of more than three hundred-and-twenty-five African American women, as well as their overall health status. Each woman was then evaluated by a dermatologist who specifically examined the scalp to determine hair loss. Findings showed that more than sixty percent of the women did in fact show signs of advanced central hair loss with scarring, characteristic of the condition. These women were also more likely to experience bacterial scalp infections.

The researchers noted that those who most often sport hair extensions also have a great deal of curve in their natural hair, which can easily hide the thinning areas. But beware… the hair loss is permanent, so early detection and a visit to the dermatologist are important.