Hair Loss 101: Traction Alopecia

I saw several women last week for hair loss (alopecia). Hair loss is a common condition; it can be especially traumatic for women, because hair is often an important part of their identity and of their beauty. Traction alopecia is a type of hair loss that can be prevented if caught early, but can be permanent after it develops.

There are many causes of hair loss including medications, thyroid disease, iron deficiency, even having a baby. Most of these causes result in temporary hair loss — the hair eventually grows back. Some types of hair loss, however, are permanent; this is called scarring or cicatrical alopecia. A common scarring hair loss in women is traction alopecia.

Traction alopecia occurs when hair is pulled too tightly for long periods of time. It occurs often in girls and women who braid their hair, but can also be seen in women who pull their hair back tightly in a pony-tail or a bun. Over months and years the hair loss becomes permanent, and cannot regrow. It can be seen in men, but is more common in women. It can also affect children as well as in adults.

In traction alopecia the worst hair loss is in areas where the hair is pulled the tightest, usually the forehead and temples. It can be subtle at first, but becomes apparent over years as the hair line recedes from ear to ear starting farther and farther back on the head.

The hair is lost because the tension from pulling damages the hair follicles beneath the skin. The hair follicle is like a little factory working constantly to make hair. Each follicle is in an active state for years before it takes a short rest, sheds the hair, then starts all over again. Over time, pulling the follicle damages it and eventually the damaged follicle can no longer make hair. Because you cannot develop new follicles, as more and more follicles are damaged, more and more permanent hair loss results.

Unfortunately, traction alopecia is a scarring alopecia, so lost hair will not grow back. The best treatment is to release the tension on your hair as much as possible as soon as possible. This is often difficult because it requires adopting a different hairstyle (which can be distressing in itself).

Sometimes hair can be surgically transplanted from areas on your scalp with good growth to the scarred areas. This procedure can be expensive however, and is not covered by health insurance.

Using minoxidil or Rogaine might help promote new hair growth. The drug is meant for male pattern alopeica, not for scarring hair loss however, and using it might not help much.

If you have hair loss, then see your dermatologist. He or she can examine your scalp and can often prescribe medications, perform hair transplant surgery, or make suggestions on changing your hairstyle that can save your hair.

Post written by Jeffrey Benabio, MD. You might also like:

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28 thoughts on “Hair Loss 101: Traction Alopecia

  1. I love your blog! I am a senior in college and just decided I wanted to be a dermatologist but it is too late :( your posts are really special and diff from the makeup blogs I am used to reading (as well as their skincare info)

    -megan

  2. Pingback: Traction Alopecia « Medliorate

  3. Hi,

    I am a 32 years old male of korea and have been worried with my hair loss. I have light skin and dark straight hair but when i listen about the IHT 9 herbal hair regrowth shampoo. and tried. After using it my hair starts growing.The IHT 9 herbal hair shampoo is really a surprise gift for me. thanks to IHT 9 herbal hair shampoo.

  4. Another vote in the love your blog ballot.

    I know a woman who braids and weaves her hair, leaves it in for a month or two, than takes it out and goes natural for another month.
    She says this “rest” period is what prevents the traction alopecia and she’s been doing it for years without losing hair.

    Is she just extremely fortunate or does her theory make sense.

  5. I have been facing hair loss too since I was 16. I tried to consult many doctors and used many medicines but none of them worked.Then I came across this herbal shampoo named as Zulvera Shampoo (herbalhairshampoo.com). Within a few weeks, I could see a positive effect by using that shampoo and that shampoo really worked for me and made my hair grow again and also made them smooth.

  6. I tried Zulvera and I am really satisfied with the results. It is a herbal shampoo and it is not that expensive. So you can try and see for yourself without taking high risks.

  7. I am 32 years old and recently have been diagnosed with Fibromyalgia.I was wandering if this has anything to do with my hair thinning, I also have sand like particles and itchy scalp..

  8. I firstly think that a good shampoo is very relevant for your issue, think about it, when you brush your teeth you do it with teeth whitening toothpaste? do why don’t you do your hair the same.

  9. Post was good but I have always been under the assumption that traction alopecia was more a condition usually due to psychological condition.

  10. I am male and have experienced a noticeable amount of hair loss in the past two years. I normally have coarse, thick hair but the hairs have become thinner and wispier, and fall out quite easily. I used to always have my hair in a ponytail, but I haven’t done that regularly since about a year ago. I was wondering if I am still experiencing the effects of traction alopecia. Maybe also the thinner hairs are “strangling” the thicker hairs, causing knots and when I groom my hair, the brush or comb gets stuck, stressing the hair. But I’m careful to avoid this. Can anyone help?

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  12. I’ve been wearing my hair in a loose ponytail for the last several years, and now I’m wondering if that’s what has contributed to my hair loss at my hairline and temples. Now that I am trying to disguise my hair loss, I only wear it in a ponytail, which makes me paranoid that I’m just making it worse:(

  13. This article is such an interesting article. It tackles a person’s hair problem where everyone’s may encounter. Thank you for this information. Hope you will post more about this for us to be aware.

  14. I had noticed my hair falling out by the bunches. I had severe alopecia about 3 years ago and my hair grew back within time. However, it is thinner than ever. I was worried the alopecia would come back again leaving me with tiny bald patches. I was willing to try anything that would ease my hair loss/thinning. I have been using Shielo’s Volume Shampoo and Conditioner for about a week now. I have to say I AM liking the results. Since starting it a week ago I have 75% less hair shedding. The smell is fresh and clean (the smell reminds me of it working itself) I have to say maybe a little therapeutic. I WOULD TRY THIS PRODUCT IF YOU ARE LOOKING FOR HELP! I since then have ordered the shampoo and still waiting for it to arrive. I hope this helps, loosing your hair is hard and no one understands unless they have had it happen to them.

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