Begin with hair care, not tension.
For extension-based styles, the American Academy of Dermatology advises starting with clean natural hair that is free of product buildup. Its Black-hair care guidance also recommends conditioning whenever hair is washed, with attention to the more fragile ends.
If you already notice persistent scalp pain, crusting, new thinning, or hair loss, avoid adding a tight style over the area and consider having a board-certified dermatologist evaluate it.