Traction alopecia: causes and treatments

Traction alopecia is a form of hair loss in which the hair follicle is mechanically damaged by repeated tension or traction. This type of hair loss is common in people with colored skin, particularly African-American women, although it can be seen in all ethnic groups and at all ages.

Ballerinas, gymnasts, military personnel and some professionals who have to wear their hair back can develop traction alopecia.

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What causes traction alopecia?

Traction alopecia can be caused by wearing the same hairstyle for long periods, especially those that pull on the hair (e.g. braids, weaves, cornrows, tight ponytails, heavy locks, hair rollers, etc.).

Tight hairstyles applied to relaxed hair can damage it even further. Constant traction on the hair causes it to detach from the follicle. Associated scalp symptoms may include bumps, redness and tenderness. Prolonged inflammation and repeated tension on the hair can lead to progressive hair loss and scarring of the hair follicles.

How do I know if I have traction alopecia?

At first, you may notice small flesh-colored or white bumps around the hair follicles, where the hair is most pulled. Shortly afterwards, symmetrical hair loss appears. Hair loss is generally most visible at the hairline. At first, traction alopecia is temporary, but if styling habits remain unchanged, hair loss can become permanent.

What treatments are available for traction alopecia?

Traction alopecia is reversible, but must be treated promptly. If you stop the tight hairstyle that caused it, your hair will grow back normally. But if you continue to style your hair in the same way, hair loss can be permanent.

In the early stages, the best treatment for traction alopecia is to limit or eliminate hairstyles that pull on the hair, and to wear the hair loose (especially at night). We recommend reducing the amount of chemicals and heat used during styling. The presence of scalp tenderness, bumps or inflammation can be treated with antibiotics or topical corticosteroids.

In cases of moderate to severe traction alopecia, more aggressive treatments such as oral antibiotics, injected corticosteroids or topical minoxidil may be required. Once the scarring is present, the hair transplant may be one of the few options available. The best treatment for traction alopecia is prevention.

Preventing traction alopecia

To prevent traction alopecia, leave your hair loose. If you need to pull them up into a ponytail or bun, keep them loose and low on your head.

Here are some tips on how to prevent this condition:

• Change your hairstyle every two weeks. For example, alternate braids and loose hair.
• When you pull your hair up into a ponytail, don’t use elastics to hold it in place. They may tear your hair out.
• Avoid chemically treating your hair if you use weaves or braids. Chemicals can damage your hair and make it more susceptible to breakage.
• If you have weaves or extensions, wear them only for a short time and take a break between uses.
• When braiding or dreadlocking your hair, use thick braids. Thinner braids pull harder.
• Do not use relaxer.
• Set your hair dryer and straightening iron to a low temperature.
• Don’t sleep with rollers. Instead, curl your hair.
• If you wear a wig, choose one with a satin cap. It won’t pull as hard on your scalp.