Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Coping
The rates of traction alopecia have not been well researched. This type of hair loss has been described in people of all races.However, it appears more common in females than males and frequently occurs in people of African descent.
This article discusses traction alopecia symptoms, causes, diagnosis, treatment, and how to cope.
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Traction Alopecia Symptoms
With traction alopecia, hair loss occurs most often along the edges of the hair. The areas where the hair is pulled tightest generally have the most significant hair loss.Tightly pulled hairstyles seem to be the main cause of traction alopecia.
A “fringe sign” may occur along the forehead or around the ears.Hair is generally lost along the outside edges, but a small amount of weak and broken hair is left behind. The fringe sign helps rule out other conditions that cause hair loss.
Areceding hairlineis the most common way traction alopecia occurs. When hair is divided into sections for braids or other hairstyles, hair loss can happen along the edges of the sections.
Early signs of traction alopecia involve discoloration (change in the natural skin tone) or redness around the hair follicles (perifollicularerythema). The hair follicles then become inflamed or infected (folliculitis), andpustulesandpapules(a red or discolored bumpy rash) may occur.
If left untreated, the areas of hair loss can progress to scarring. The hair follicles stop making new hairs, and permanent hair loss occurs.
High tension, tightly pulled back hairstyles can cause traction alopecia.Tenting, skin on the scalp pulling upward toward the braid or ponytail, is a risk factor for traction alopecia.Common hairstyles that may cause hair loss include:
Chemical relaxers or straighteners may increase the risk of developing traction alopecia. The chemical process may weaken the hair and make it more susceptible to the forces used to create hairstyles. Overall, relaxer use is a risk factor for traction alopecia.
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Trichoscopyallows your healthcare provider to look closely at your scalp and hair with a device called adermatoscope. This tool magnifies the skin’s surface on your head and allows your healthcare provider a close-up look at the hair growth patterns and any changes to your scalp.
Broken hair of varying lengths and empty hair follicles (where the hairs have been pulled out) may be seen. Because there are different kinds and causes of alopecia, a skilled healthcare provider must carefully inspect your hair loss.
Other changes can occur in areas where too much pulling has damaged the hairs and follicles. Hair may be thinner, or peach fuzz (vellushairs) may develop in the areas of hair loss from traction.
Prevention of hair lossis the best treatment. Choosing looser hairstyles, avoiding tight hairstyles after using relaxers and chemical treatments, and avoiding heat treatments can help to prevent damage to the hair and follicles.
Scalp discoloration (change in the natural skin tone), redness, and inflammation may benefit fromsteroidsandantibiotics.They may be taken orally or put directly on the affected skin areas (topically), depending on the prescription from your healthcare provider.
Rogaine (minoxidil) may have some benefits in helping hair regrow.Be sure to discuss any treatments with your healthcare provider before starting them.
If you notice changes related to your hairstyle, early intervention is important. Limiting damage to hair follicles can prevent scarring and permanent hair loss.Once scarring has occurred, the hair loss is no longer potentially reversible.However, hair transplants are sometimes helpful in returning hair growth to areas where the original follicles have scarred.
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Hairstyles can be part of social, cultural, and religious practices.Hair is an important part of identity and self-presentation for many people. Hair loss has been found to increase rates ofanxietyanddepression.
Children and adolescents may be at higher risk than adults for developing traction alopecia. Educating caregivers and hairdressers has been recommended as a tool for choosing styles that help preserve hair.
Hair loss can also affect personal emotions about appearance.Interestingly, an individual’s sense of hair loss and the effects of alopecia do not always match the degree of hair loss a healthcare provider may diagnose.Your sense of the severity of hair loss impacts your perception of your quality of life.
Prevention
Hair loss prevention is possible, especially if caught in the early stages. Treatments are available to help with damage and potentially re-grow hair.Wigs, hair pieces, and extensions should be avoided while allowing hair to heal.
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Summary
Tightly pulled hairstyles most often cause traction alopecia. Over time, chronic pulling damages the hair and the follicles. Skin pulling and pimples around the base of the hair can be early warning signs of damage. Loosening ponytails, braids, and buns may help prevent permanent damage. If you have already lost some hair, especially around the edges of your face, be sure to see a healthcare provider.
A Word From Verywell
Hair loss can be an emotionally challenging issue to face. Hair can be very important in your appearance and sense of self. Typically, traction alopecia is not due to a serious medical condition. There are ways to reverse traction alopecia, especially if it is found early. If you notice breakage or hair loss and have worn tightly pulled-back hairstyles, reach out to your healthcare provider as soon as possible to restore your hair growth.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology.Hairstyles that pull can lead to hair loss.Phillips TG, Slomiany WP, Allison R.Hair loss: common causes and treatment.AFP. 2017;96(6):371-378.Akingbola C, Vyas J.Traction alopecia: a neglected entity in 2017.Indian J Dermatol Venereol Leprol. 2017;83(6):644-649. doi:10.4103/ijdvl.IJDVL_553_16Billero V, Miteva M.Traction alopecia: the root of the problem.Clin Cosmet Investig Dermatol. 2018;11:149-159. doi:10.2147/CCID.S137296Sharquie KE, Schwartz RA, Aljanabi WK, Janniger CK.Traction alopecia: clinical and cultural patterns.Indian J Dermatol. 2021;66(4):445. doi:10.4103/ijd.IJD_648_20Samrao A, Price VH, Zedek D, Mirmirani P.The “fringe sign” - a useful clinical finding in traction alopecia of the marginal hair line.Dermatology Online Journal. 2011;17(11). doi:10.5070/D325m840mzRaffi J, Suresh R, Agbai O.Clinical recognition and management of alopecia in women of color.International Journal of Women’s Dermatology. 2019;5(5):314-319. doi:10.1016/j.ijwd.2019.08.005Khopkar U, Doshi B, Jain N.Trichoscopy in alopecias: diagnosis simplified.Int J Trichol. 2013;5(4):170. doi:10.4103/0974-7753.130385
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology.Hairstyles that pull can lead to hair loss.Phillips TG, Slomiany WP, Allison R.Hair loss: common causes and treatment.AFP. 2017;96(6):371-378.Akingbola C, Vyas J.Traction alopecia: a neglected entity in 2017.Indian J Dermatol Venereol Leprol. 2017;83(6):644-649. doi:10.4103/ijdvl.IJDVL_553_16Billero V, Miteva M.Traction alopecia: the root of the problem.Clin Cosmet Investig Dermatol. 2018;11:149-159. doi:10.2147/CCID.S137296Sharquie KE, Schwartz RA, Aljanabi WK, Janniger CK.Traction alopecia: clinical and cultural patterns.Indian J Dermatol. 2021;66(4):445. doi:10.4103/ijd.IJD_648_20Samrao A, Price VH, Zedek D, Mirmirani P.The “fringe sign” - a useful clinical finding in traction alopecia of the marginal hair line.Dermatology Online Journal. 2011;17(11). doi:10.5070/D325m840mzRaffi J, Suresh R, Agbai O.Clinical recognition and management of alopecia in women of color.International Journal of Women’s Dermatology. 2019;5(5):314-319. doi:10.1016/j.ijwd.2019.08.005Khopkar U, Doshi B, Jain N.Trichoscopy in alopecias: diagnosis simplified.Int J Trichol. 2013;5(4):170. doi:10.4103/0974-7753.130385
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Dermatology.Hairstyles that pull can lead to hair loss.Phillips TG, Slomiany WP, Allison R.Hair loss: common causes and treatment.AFP. 2017;96(6):371-378.Akingbola C, Vyas J.Traction alopecia: a neglected entity in 2017.Indian J Dermatol Venereol Leprol. 2017;83(6):644-649. doi:10.4103/ijdvl.IJDVL_553_16Billero V, Miteva M.Traction alopecia: the root of the problem.Clin Cosmet Investig Dermatol. 2018;11:149-159. doi:10.2147/CCID.S137296Sharquie KE, Schwartz RA, Aljanabi WK, Janniger CK.Traction alopecia: clinical and cultural patterns.Indian J Dermatol. 2021;66(4):445. doi:10.4103/ijd.IJD_648_20Samrao A, Price VH, Zedek D, Mirmirani P.The “fringe sign” - a useful clinical finding in traction alopecia of the marginal hair line.Dermatology Online Journal. 2011;17(11). doi:10.5070/D325m840mzRaffi J, Suresh R, Agbai O.Clinical recognition and management of alopecia in women of color.International Journal of Women’s Dermatology. 2019;5(5):314-319. doi:10.1016/j.ijwd.2019.08.005Khopkar U, Doshi B, Jain N.Trichoscopy in alopecias: diagnosis simplified.Int J Trichol. 2013;5(4):170. doi:10.4103/0974-7753.130385
American Academy of Dermatology.Hairstyles that pull can lead to hair loss.
Phillips TG, Slomiany WP, Allison R.Hair loss: common causes and treatment.AFP. 2017;96(6):371-378.
Akingbola C, Vyas J.Traction alopecia: a neglected entity in 2017.Indian J Dermatol Venereol Leprol. 2017;83(6):644-649. doi:10.4103/ijdvl.IJDVL_553_16
Billero V, Miteva M.Traction alopecia: the root of the problem.Clin Cosmet Investig Dermatol. 2018;11:149-159. doi:10.2147/CCID.S137296
Sharquie KE, Schwartz RA, Aljanabi WK, Janniger CK.Traction alopecia: clinical and cultural patterns.Indian J Dermatol. 2021;66(4):445. doi:10.4103/ijd.IJD_648_20
Samrao A, Price VH, Zedek D, Mirmirani P.The “fringe sign” - a useful clinical finding in traction alopecia of the marginal hair line.Dermatology Online Journal. 2011;17(11). doi:10.5070/D325m840mz
Raffi J, Suresh R, Agbai O.Clinical recognition and management of alopecia in women of color.International Journal of Women’s Dermatology. 2019;5(5):314-319. doi:10.1016/j.ijwd.2019.08.005
Khopkar U, Doshi B, Jain N.Trichoscopy in alopecias: diagnosis simplified.Int J Trichol. 2013;5(4):170. doi:10.4103/0974-7753.130385
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