I kept my hair in two strand twist. Then I wore the twist outs. It didn't break off at the root, it's just short. I have no health problems. I did notice that once I did the twist and wear the twist out, once I went to wet and detangle my hair I had shedding. It happens every so many years in that one area. It may be a stress point in my head, but I figured it was something I could do to strengthen it. There is some stress and miss some sleep. Nothing out of the normal though.