Teaching Kids to Love Their Hair: Comprehensive Strategies for Curly and Coily Hair Care

"We’ve got to teach people how to start to learn to love their hair, to live with their hair, to work with their hair,” Brandi Kenner-Bell, MD, FAAD, said in her session at the 2026 Society for Pediatric Dermatology Annual Meeting.

Kenner-Bell, pediatric dermatologist at the Ann & Robert H. Lurie Children's Hospital of Chicago, delivered a practical overview of hair care for patients with curly and coily hair, emphasizing that effective counseling requires both scientific knowledge and cultural competence. She opened by discussing the social context surrounding textured hair, including longstanding beauty standards, implicit bias related to hair type and ethnicity, inconsistent terminology, and the lack of universally accepted recommendations. These factors, she noted, can complicate conversations between clinicians and patients, making it essential for dermatologists to understand both the biology of textured hair and the lived experiences of the patients they treat.

Structural Differences and Chemical Vulnerabilities

Kenner-Bell, who is also an associate professor of dermatology and pediatrics at the Northwestern University Feinberg School of Medicine, then reviewed the structural differences that distinguish curly and coily hair from straight hair. Curl pattern is determined not only by the curved shape of the follicle but also by the distribution of cortical cells within the hair shaft. The irregular arrangement of disulfide bonds creates natural curl patterns, whereas chemical relaxers permanently alter these bonds to straighten the hair, often increasing hair shaft damage. Hydrogen bonds, in contrast, are temporarily disrupted by heat styling and reform with moisture, explaining why humidity can restore natural curl patterns after straightening. Ionic bonds are influenced by pH, making chemical coloring and bleaching additional sources of hair damage.

“This is really important to emphasize with your patients: you can not change the hair that God gave,” Kenner-Bell said. "You can modify it with things that probably damage it, but you can't use a product and change the nature of your hair...it’s genetically predetermined.”

These structural characteristics contribute to the unique vulnerabilities of curly and coily hair. Because sebum coats only the proximal portion of the hair shaft, textured hair tends to be drier and more susceptible to breakage than straighter hair types. While hair growth rates are generally comparable across populations, increased fragility often creates the perception that curly hair "does not grow." Kenner-Bell emphasized that all hair grows, but retention—not growth—is the primary challenge.

She also reviewed the widely used Andre Walker hair classification system, which categorizes hair from type 1 (straight) through type 4 (coily). Although patients frequently describe their hair using these classifications, she cautioned that the system does not account for hair shaft diameter, density, or porosity, all of which significantly influence hair care needs. Furthermore, multiple curl patterns may exist on the same scalp, requiring individualized care based on the most fragile areas.

Preserving Hair Health Through Cleansing and Hydration

Her presentation focused heavily on preserving hair health through proper cleansing and moisturization. Contrary to common belief, patients with tightly coiled hair often benefit from washing more frequently than expected to improve hydration. Clarifying shampoos containing anionic surfactants effectively remove buildup but can be drying, whereas nonionic surfactants found in co-washes provide gentler cleansing. However, prolonged reliance on co-washing alone may lead to product buildup, making periodic clarification important.

Conditioning represents the cornerstone of healthy textured hair care. Kenner-Bell recommended regular deep conditioning, often with heat to improve cuticle penetration, as well as frequent use of leave-in conditioners throughout the week. She stressed that oils should be viewed as sealants rather than moisturizers; applying oils to dry hair does not increase hydration and may instead impede moisture absorption. Popular layering techniques, including the LOC (liquid-oil-cream) and LCO (liquid-cream-oil) methods, can help maintain moisture depending on hair porosity and texture. Additional supportive practices include:

• Protein treatments for damaged hair
• Pre-shampoo conditioning with coconut oil to reduce hygral fatigue
• Detangling only on wet, conditioned hair
• Sleeping on satin pillowcases
• Obtaining regular trims to prevent progressive splitting of the hair shaft

Navigating Protective Styles and Preventing Mechanical Stress

The latter portion of the talk addressed hairstyling practices and their implications for pediatric patients. Kenner-Bell reviewed numerous protective styles—including box braids, twists, cornrows, crochet braids, locs, Bantu knots, twist-outs, and roller sets—highlighting terminology that dermatologists are increasingly likely to encounter in clinical practice. Although protective styles can reduce daily manipulation, many introduce significant mechanical stress through excessive tension, added extension weight, prolonged wear, and infrequent cleansing. She noted that braided styles commonly remain in place for several months because of their substantial cost, making realistic recommendations essential.

To minimize complications such as traction alopecia, Kenner-Bell advised using larger-diameter braids or locs, minimizing hair extensions, loosening braided styles, avoiding frequent tight updos, removing extensions at least monthly, and allowing 4 to 6 weeks of recovery between extended protective styles. She also encouraged patients to continue routine scalp cleansing while wearing braids by using diluted shampoo, focusing on the scalp, conditioning primarily the hair lengths, blot drying rather than rubbing, and ensuring the hair dries completely.

Conclusion: A Tailored Approach to Patient Care

Kenner-Bell concluded by reminding attendees that no single routine works for every pediatric patient with curly or coily hair. Successful management requires individualized recommendations, patience, and ongoing trial and error. Most importantly, she encouraged dermatologists to engage patients with culturally informed, practical guidance that respects personal preferences and builds trust while promoting long-term hair and scalp health. 

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