1. What is Traction Alopecia?
There are many causes of hair loss, including medications, thyroid disease, iron deficiency and even pregnancy. Most of these 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 is a type of hair loss that can be prevented if caught early but is often permanent after it develops.
Traction alopecia develops when hair is pulled tightly for long periods of time. This occurs when women, and sometimes men, wear their hair in tight buns or in braids. The hair loss occurs 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.
2. What Causes Traction Alopecia?
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 hair puts significant tension on the follicle beneath the skin, damaging it. Eventually the damaged follicle can no longer make hair. Because the scalp cannot develop new follicles, as more and more follicles are damaged, more and more permanent hair loss results.
3. Who Gets Traction Alopecia?
Traction alopecia 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. A recent study in South Africa found that 17 percent of girls and 31 percent of women had traction alopecia in that country. It can occur in men, but is much more common in women who tend to wear their hair pulled tightly for months to years. The hair loss might also be made worse by using chemical straighteners, which can damage the follicle, or by adding extensions to the hair, which can worsen the tension on the hair follicles.
4. How Can You Treat Traction Alopecia?
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. It's important to know, however, that the drug is meant for male pattern alopeica, not for scarring hair loss, and may not have much effect.
5. How Can it Be Prevented?
The best option is to prevent traction alopecia from developing in the first place. This does not mean that you cannot braid your hair; many women and men braid their hair for years without any hair loss at all. Since each person's hair is different, it is important to have someone examine your scalp periodically to see if hair loss is developing. If so, then changing your hairstyle might be necessary to prevent further damage.
If you have hair loss, it is always a good idea to 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.
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