Traction Alopecia: Causes, Symptoms, Treatment, & Prevention

Reviewed by Dr. Shruti Chavan, MBBS
Written by Annie Jangam

Traction alopecia is gradual hair loss caused due to the frequent wearing of certain tight hairstyles. You might look pretty in a ponytail, braids, or tight buns. But repeatedly pulling on your hair leads to hair loss. Chemical relaxers, hair extensions, headgear, and hair accessories also cause traction alopecia.

However, you can reverse this condition with proper care and attention. This article explores the causes, symptoms, possible treatment options, and preventive measures for traction alopecia. Keep reading.

What Is Traction Alopecia?

Hair that is pulled back tightly strains the hair follicles. Such constant strain can damage the follicles over time and cause itchiness and redness, eventually leading to hair fall. This condition is called traction alopecia.

An average individual loses 50 to 100 hair strands every day (1). This loss is not a matter of concern as it is replaced by new hair growth. Opting for tight hairstyles once a while does not necessarily cause traction alopecia. However, donning such hairstyles regularly can increase the risk.

Traction alopecia, in some people, starts as hair loss on the crown. The scalp starts scarring and the hair fall spreads outwards. This form of traction alopecia is called centrifugal cicatricial alopecia (CCCA) and is common in women.

Unlike most other hair fall conditions, traction alopecia is not genetic. Findings have established that reversing traction alopecia is possible with proper care and attention. We will explore these findings in the following section.

What Are The Histological Findings In Traction Alopecia?

Dermatologists have conducted numerous skin biopsies on areas of traction alopecia to further understand this condition. The onset of traction alopecia is characterized by a general thinning of hair, also known as tracheomalacia. This is followed by a sudden increase in the catagen and telogen or bulb hair (2). Experts have noted the preservation of the sebaceous glands and the telogen follicles.

Several other signs of permanent traction alopecia are observed as the condition progresses. These include the gradual replacement of the terminal hair follicles by the fibrotic fibrous scars. The sebaceous gland secretion also reduces. This condition causes negligible inflammation

Causes Of Traction Alopecia

  • Hairstyles

As discussed, tight ponytails, cornrows, dreadlocks, and braids are a common cause of traction alopecia. This condition is common among ballet dancers who wear tight buns for a longer duration.

  • Hair Relaxers

Chemical hair treatments weaken hair by altering the natural structure of the hair shaft. This makes the hair more prone to traction alopecia. Over 31.7% of African women with permed hair were found to have the condition (3).

  • Hair Weaves

Hair extensions involve the use of glue for attaching them to the base of the hair. This tight tying causes tension at the hair roots and may lead to traction alopecia.

  • Hair Accessories

Wearing hair clips or sliders in the same manner for days at a stretch can cause this condition too. Such accessories strain the hair follicles and eventually cause hair loss.

  • Headgear

Tight elastic headbands and helmets can also cause traction alopecia. Such headgear makes hair progressively thinner at the point of contact.

Symptoms Of Traction Alopecia

Most people associate traction alopecia with hair fall. While this is true, you must note that only the hair subjected to regular pull is affected. This is contrary to other forms of alopecia where multiple patches of hair fall are observed all over the head.

Other symptoms of traction alopecia include soreness and stinging of the scalp, and tiny scalp bumps resulting from the inflammation of hair follicles. A general redness of the scalp and scaling are the other common signs.

One may even observe pus-filled blisters on the scalp in extreme cases. This happens when the hair follicles are so damaged that they cannot produce new hair. Most of these symptoms appear gradually over months.

The good news is that most cases of traction alopecia have treatment options available. What are they?

Treating Traction Alopecia

The basic treatment for traction alopecia requires you to change your hairstyle to avoid a tight bun or braid. You may also go for antifungal shampoos, minoxidil, and biotin supplements after consulting a hair care specialist.

An extreme case of traction alopecia may warrant topical steroids to tackle the scalp swelling. Any infections in the open sores may need the use of prescribed antibiotics. You may also seek a hair transplant if you have lost a lot of hair due to this medical condition.

But we suggest you first consider certain home remedies that can help tackle traction alopecia (in the initial stages).

Home Remedies For Traction Alopecia

  • Consume Adequate Protein and Iron: Increasing intake of dietary protein and iron may facilitate natural hair growth.
  • Massage Your Scalp: Regular scalp massage helps regulate the blood flow to the hair follicles. Massaging the scalp in a circular motion for as little as 4 minutes in a day may result in thicker hair in half a year (4).
  • Consume Pumpkin Seed Oil: Consuming 400 mg of pumpkin seed oil every day may increase your hair count by 40% in about 6 months (5).

These home remedies may help tackle traction alopecia in its initial stages. But what if you can actually prevent the condition in the first place?

Prevention Of Traction Alopecia

An effective way of preventing traction alopecia is avoiding high-risk hairstyles. Ideally, you should not stick to one hairstyle. Keep experimenting with different styles. Use artificial hair minimally (with a sufficient break between two subsequent uses).

Choose thick dreadlocks and braids over thin ones whenever possible. Ensure your cornrows and weaves are not too tight and there is no pressure on the hairline.

These proactive measures will keep you comfortable and also reduce the risk of traction alopecia. However, can this condition be cured?

Can Traction Alopecia Be Cured?

Traction alopecia can be cured if it is detected early and the right measures are taken on time. Over the years, the hair completely regrows. However, identifying it too late can cause irreversible damage to the hair follicles.

When To See A Doctor

An unusual reddish patch on the scalp, soreness, and itchiness are the usual first symptoms of traction alopecia. Visit a dermatologist or a trichologist if you also observe unusual hair fall around the area where a headgear meets the hair. Proactive measures on your part will allow you to seek timely treatment before it is too late.

Key Takeaways

  • Traction alopecia refers to hair loss caused by tight hairstyles.
  • In addition to discomfort and stinging, traction alopecia may cause tiny bumps to form on the scalp.
  • Avoiding tight buns and braids, consuming pumpkin seed oil, and using antifungal shampoos may help you recover.

Tight hairstyles tend to tug on your hair follicles, leading to traction alopecia. Some chemical treatments and overusing hair extensions may also cause this type of hair loss. The most common type of traction alopecia is hair loss at the crown because of hairstyles like tight buns or ponytails. The good news is that with the right hair care, you can treat and reverse this type of hair loss. You can opt for treatments with minoxidil or biotin supplements. Or, you could try home remedies, such as a scalp massage and adding certain essential nutrients to your diet. Avoid tying your hair up too often in tight hairstyles, and follow a good hair care regimen to make your hair strong and healthy.

Frequently Asked Questions

Is there any age group that is more prone to traction alopecia?

Cases of traction alopecia are more prevalent among the older generation. Hair follicles naturally weaken over time and they become more prone to damage under pressure (6).

How to tackle traction alopecia in pets?

Traction alopecia occurs in pets when one leaves hair clips/rubber bands on their fur for a longer duration (7). Keeping the fur from forming deadlocks can help prevent this.


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Dr. Shruti Chavan

Dr. Shruti Chavan is a consulting dermatologist at Dr.Sheth's Skin and Hair Clinic since 6 years. She is a co-committee... more