Hair Loss Condition: Traction Alopecia

Traction Alopecia: A Common But Preventable Condition

Some hairstyles can be worn so tight that they cause a type of hair loss condition called "traction alopecia".

The good news is that hair loss due to traction alopecia can be reversible and typically temporary, according to the American Hair Loss Council, if caught early enough. "The bad news is that in the more advanced stages, hair follicles can be so damaged by the trauma, that most women opt to trim it all off and wait to see if hair will re-grow," says Diahna Husbands of Diahna Lynn Hair Studio, who also says she sees at least two clients a week at her hair replacement studio suffering from this type of hair loss.

Signs and symptoms of traction alopecia

Did you ever or do you have to take a pain reliever after getting your braids done?

• Does your scalp get sore where you wear your ponytail?
• Has your hairline receded considerably over the years or recently?
• Do you notice some thinning or hair breakage around your hairline?
• Do you notice little bumps and redness around your hairline?
• Have you been wearing cornrows or braids your whole life?
• Do you have dreadlocks that are long and thick?
• Do your hair extensions break off?
• Do you have a hair system that is attached with clips or links?
• Traction alopecia: How did I lose my hair?

Sometimes traction alopecia can go on for years, which results from wearing your hairstyle too tightly.

While most commonly seen in African American women who wear a full head of cornrows, the condition results from any hairstyle (like a simple daily ponytail) being worn so tightly that it actually pulls out the hairs from the roots and causes inflammation and trauma to the follicles, explains Dr. Valerie Callender, M.D., board-certified dermatologist, specialist in African American skin and hair disorders, and Director of the Callender Skin and Laser Center in Washington D.C. This trauma throws the follicles into a resting state prematurely and hair does not regrow as long as the area is being pulled too tightly. The condition is usually evident in a thinning and receding at the hairline, that's where hairs are pulled the hardest and sometimes infections, pustules, and papules will appear at the site of the damage as well. In addition, many hairs will also just break off from the tension on the hair shaft and you will notice signs of this condition in a thinning around your front hairline area or at the spot where you gather your ponytail.

Traction alopecia can also be caused in both men and women from a hair system attached with clips or links that are pulling too tightly, from hair extensions that are too heavy for the existing hair they are attached to, from a weave that's too tight or even from dreadlocks that have grown too heavy for the scalp and hair to support. "If you ever feel any tension or pain in your scalp, visit your hair stylist immediately to have your style loosened, readjusted, and evaluated," cautions Husbands.

Traction alopecia: Will my hair grow back?

In most cases hair grows back, but it can take about six months or more and an obvious change in hair style to achieve healthy re-growth. Husbands advises, "That means no more relaxing, no more straight irons, no more tight braiding ... you need to let the hair follicles get back to business without putting any additional stress on them. You may need to find a new hair stylist if you've been going to the same one for years all the while you've had this condition! And that doesn't mean braiding it tightly somewhere else on your head ... traction alopecia can occur anywhere on your head. If you still want to braid in another area, just braid much more gently. If you have to take Advil after you get your hair done, then it's too tight!"

For more stubborn cases involving infected follicles and prolonged traction, along with changing your style immediately, the most common course of action is oral and topical antibiotics followed by either cortisone injections and/or topical cortisone cream to reduce the inflammation that is damaging the follicles, explains Callender. "After that, we may prescribe Rogaine to stimulate quicker regrowth at 2 percent generally, or 5 percent depending on the amount and severity of the hair follicle trauma. And the great thing about Rogaine for traction alopecia is that once follicles regain their health and start growing, Rogaine will no longer be necessary. It's one time we can prescribe Rogaine for temporary results that last!"

The bottom line on traction alopecia

Early detection and making the appropriate style change as soon as possible is the key to overcoming traction alopecia. "I also advise most clients to see a dermatologist just to make sure of the reason for the hair loss. A proper diagnosis is also the key to success with any hair loss issue," advises Husbands.