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Traction alopecia: A type of hair loss

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What is traction alopecia?

It is hair loss caused by repeated pulling on your hair when styling or doing hair care, such as:

  • Braids
  • Cornrows
  • Weaves
  • Tight ponytails and buns
  • Repeated use of rollers to set hair

Tight hairstyles pull the hair strand that is connected to the hair follicle. Over time, it damages the scalp. This causes thin, short, broken hairs and bald spots. It is common near the temples and can happen anywhere along the hairline.

The condition is common in patients of African descent due to certain hair styling practices and hair texture. It can occur in other ethnic groups.

How do I know if I am at risk for traction alopecia?

You may have:

  • Small bumps on your scalp
  • A pulling sensation
  • Tenderness
  • Crusting
  • Stinging on your scalp

How do you treat traction alopecia?

  • Avoid wearing tight hairstyles.
  • Your hair will regrow within months if hair loss is caught early.

It is hard to treat if you have had hair loss for a long time. It can cause scarring and permanent loss of hair.

What can I do to prevent traction alopecia?

  • Wear low to moderate risk hairstyles.
    • Low risk hairstyles:
      • Loose ponytails and buns. Wear them low on your head instead of high.
      • Wear wigs with satin wig caps.
      • Do not use relaxers. Cut your hair to a healthy length and wear it natural.
    • Moderate risk hairstyles:
      • Loose braids, cornrows, and dreadlocks
      • Place weaves and braid natural hair, instead of chemically processed hair.
      • Wear wigs with nylon or cotton wig caps.
  • Change your hairstyle more often.
  • Take breaks between artificial hair use.
  • Make sure braids, cornrows, or weaves are not too tight. If it hurts while your hair is being styled, ask the stylist to stop and redo it. Pain equals damage.
  • Wear loose braids around the hairline especially.
  • Get thick braids or dreadlocks rather than thin ones.
  • Only leave braids in for 2 to 3 weeks.
  • Change the pattern of braided and twisted hairstyles.
  • Use hair extensions only for a short amount of time.
  • Take out hair extensions right away if they are causing pain or irritation.
  • Try loosely sewn-in weaves instead of bonding glues.
  • Do not use relaxers often.
  • Do not use heat often, especially within 1 to 2 weeks of using a relaxer.
  • Use low heat settings on flat irons and blow dryers.
  • Do not use rubber bands and elastic ponytail holders.
  • Do not sleep in rollers. Wrap or pin curl your hair at night.
  • Wear a satin bonnet or use a satin pillowcase at bedtime.