What is Traction Alopecia?

Traction alopecia is a type of hair loss caused by constant tension or pulling on the hair. It is non-scarring, with the potential of regrowth if a reduction in tension on the hair and scalp stops.  It may also lead to irreversible scarring alopecia if treatment is not sought. This tension damages the hair follicles, leading to hair loss, especially around the hairline and temples. It’s often seen in individuals who frequently style their hair in tight hairstyles such as braids, ponytails, or buns.  

​

What Causes Traction Alopecia?

The primary cause of traction alopecia is prolonged and repeated tension on the hair. Common contributing factors include:

• Tight Hairstyles: Braids, ponytails, buns, cornrows, dreadlocks and other styles that pull on the hair.

• Hair Extensions and Weaves: The weight and attachment method can strain the hair.

• Headgear: Wearing tight hats, helmets, or headbands regularly.

• Chemical Treatments: Relaxers and other chemical treatments can weaken hair, making it more susceptible to breakage and loss from tension.

 

Who is affected by Traction Alopecia?

Traction alopecia primarily affects individuals who frequently wear hairstyles that pull tightly on their hair, such as braids, ponytails, buns, or extensions. This condition can impact people of all ages and genders, noting one-third of women of African decent are affected.  It has been also been attributed to cultural and religious practices that may cause tension on the hair and scalp.  

​

What are the Symptoms of Traction Alopecia?

Symptoms of traction alopecia can vary but typically include:

• Hair Thinning: Especially around the temples and hairline.

• Redness and Bumps: Irritation or small pimples on the scalp where hair is pulled.

• Bald Patches: Small bald spots or thinning areas.

• Broken Hairs: Short, broken hairs in the affected areas.

• Sensitivities: tenderness, itching, tingling and or headaches

​

How Does Traction Alopecia Progress?

Traction alopecia progresses gradually, with early signs being hair breakage and thinning along the temporal, frontal and or hairline. If the tension continues, the condition can worsen, leading to more extensive hair loss and potentially permanent damage to hair follicles if not addressed.

​

How is Traction Alopecia Diagnosed?

Diagnosis of traction alopecia typically involves:

• Medical History: Discussing hairstyle habits and hair care practices with a healthcare provider.

• Physical Examination: Observing the pattern and extent of hair loss.

​

What are the Treatment Options for Traction Alopecia?

Treating traction alopecia may involve the noted below:  

• Eliminate the Cause: Avoid tight hairstyles and reduce tension on the hair and if applicable remove the use of chemical treatments on hair as well.

• Gentle Hair Care: Use mild shampoos and conditioners, and avoid harsh chemical treatments.

• Topical Treatments: Minoxidil (Rogaine) may help stimulate hair growth, with continuous use to maintain results.

• Medications: In some cases, doctors may prescribe anti-inflammatory medications and/or oral minoxidil.

• Surgical Options: For severe cases, hair transplant surgery might be considered.

 

Traction alopecia like other forms of alopecia is different for everyone, thus seeking medical advice from a dermatologist, a physician specializing in skin, hair and nail health, is recommended.

​

How to Cope with Traction Alopecia?

• Seek Support: Joining support groups or talking to a therapist can be helpful.

• Consider Wigs and Hairpieces: These can provide a cosmetic solution and boost confidence.

• Educate Yourself: Understanding the condition can help in managing expectations and exploring treatment options.

• Stay Positive: Focus on aspects of life that are not affected by hair loss and practice self-care.

​

Conclusion

Traction alopecia is a preventable and treatable condition, especially when caught early.  By understanding its causes, recognizing the symptoms, and following appropriate treatment and hair care practices, you can manage and potentially reverse hair loss. If you suspect you have traction alopecia, consult with a healthcare provider for a tailored treatment plan. Remember, coping with any form of hair loss involves both physical and emotional care, so don't hesitate to seek support when needed.

References:  

Billero, V., & Miteva, M. (2018). Traction alopecia: the root of the problem. Clinical, Cosmetic and Investigational Dermatology, 11, 149–159. https://doi.org/10.2147/CCID.S137296

 

Alessandra Haskin, Crystal Aguh,

All hairstyles are not created equal: What the dermatologist needs to know about black hairstyling practices and the risk of traction alopecia (TA),

Journal of the American Academy of Dermatology,

Volume 75, Issue 3,

2016,

Pages 606-611,

ISSN 0190-9622,

https://doi.org/10.1016/j.jaad.2016.02.1162.

(https://www.sciencedirect.com/science/article/pii/S0190962216013980)

​

Disclaimer: The information provided in the Alopecia Frequently Asked Questions (FAQs) section is intended for general informational purposes only and should not be construed as medical advice. While we strive to offer accurate and up-to-date content, the FAQs are not a substitute for professional diagnosis, treatment, or advice from qualified healthcare providers. Individual experiences with alopecia may vary, and it is important to consult with a healthcare professional for personalized medical guidance. We do not endorse any specific treatments, products, or services mentioned in the FAQs. Reliance on any information provided in this section is solely at your own risk.