Traumatic Alopecia – Causes, Symptoms, And Treatment

by Arshiya Syeda

We all have that one signature hairstyle that we love to sport all the time. It could be a messy bun or a high ponytail. But, did you know that continually wearing your hair in the same hairstyles – such as tight ponytails, buns, or braids – can be harmful to your hair follicles and lead to a condition called traumatic alopecia?

This article will tell you all about traumatic or traction alopecia, including its causes, symptoms, prevention tips, and treatments available to fix it.

What Is Traumatic Alopecia?

Alopecia, in general, is the medical term for loss of hair. But, it can occur in different forms. Traumatic or traction alopecia is a specific form of acquired hair loss that results mainly from extended or repetitive tension on the scalp.

The chances of developing traumatic hair loss are more if there is a forceful extraction of hair or the breaking of hair shafts by pressure, traction, friction, or any other physical trauma (1).

It is essential to know the causes of this condition to effectively deal with traumatic hair loss. Its causes are discussed in the next section.

What Is The Cause Of Traumatic Alopecia?

Traumatic alopecia is primarily caused by wearing the same hairstyle for extended periods, especially ones that tug on the hair, such as tight ponytails, braids, buns, cornrows, and heavy locks that cause hair trauma.

Other causes of traumatic alopecia include:

  • Excessive and repeated use of hair tools such as rollers or hot combs.
  • Putting constant force on the hair or scalp surface and pulling that can cause loosening of the hair from the follicles.

Heavy use of hair relaxers or chemicals used to straighten hair.

  • Repeated use of heavy hair extensions.
  • Using extremely tight head covers such as caps or turbans that pull on your hair.
  • Fluctuating hormone levels.

There is a wide variation in the pattern of symptoms, clinical presentation, and types of alopecia. Read the next section to find out more about it.

Symptoms Of Traumatic Alopecia

The early symptoms of traumatic alopecia include little bumps on the scalp that resemble pimples. However, as it progresses, the main symptom in most cases is hair fall or broken hair, especially on the front and sides of your scalp (2).

Apart from hair loss, other symptoms of traumatic or traction alopecia due to possible damage to hair follicles include (2):

  • Soreness or stinging sensation on the scalp
  • Itching and redness of the scalp
  • Thinning of hair
  • Receding hairline
  • Broken hair or hair injury
  • Folliculitis or inflammation of the hair follicles
  • Extreme scaling of scalp skin
  • Frequent headaches
  • Blisters on the scalp
  • Growth of vellus hair (peach fuzz) on affected areas
  • Widening of hair parting
  • Damaged and scarred hair follicles that are unable to produce new hair
  • Can lead to telogen effluvium and diffuse hair loss

Now that you know the symptoms of traumatic alopecia, you must be wondering who is most likely to get affected by this condition. Read on to know more about it.

Who Gets Most Affected By Traumatic Alopecia?

In general, traumatic alopecia can impact people of all ages, both females and males. However, there are specific populations who are more affected by the condition due to differences in hair structure, hairstyles, and lifestyle factors.

For instance, hair loss after trauma (due to traction) is most common in adult women (2). It is common among women with long hair who tie it up in tight hairstyles. Also, people who frequently wear wigs, tight hats, helmets, and people in specific professions that require them to pull their hair back, such as military personnel, ballerinas, gymnasts, and surgeons, are affected by this condition. People of African descent often suffer from this condition because their hair is generally curly, fragile, and tied tightly in protective hairstyles, which leads to breakage.

Wondering if you can prevent traumatic alopecia altogether or if there are any treatment options? Find out below.

Prevention Tips And Treatments For Traumatic Alopecia

Unlike other genetic forms of hair loss, traumatic alopecia can be treated. If identified and treated at an early stage, it is entirely reversible, and the hair can regrow. However, if left untreated, the hair follicles can soon become irreversibly damaged, leading to obstructed hair growth.

The treatment and the preventive measures after diagnosis both have a lot in common, so it is best to view them as a whole. Given below are preventative tips as well as treatment options for traumatic alopecia:

1. Avoid Tight Hairstyles

Since pulling of hair due to very tight hairstyles – such as ponytails, braids, buns, and dreadlocks – is the leading cause of traumatic alopecia, it is best to avoid such hairstyles. If you need to absolutely tie your hair up, make sure you keep it as loose as possible.

2. Limit The Use Of Heat-Styling Tools

Heat-based styling tools such as rollers, straightening irons, and curlers should be used only when absolutely necessary as they can cause irreversible damage to the hair follicles, leading to traumatic alopecia.

3. Try Different Hairstyles

Sporting just one hairstyle – such as a parting down the middle of the same side – for years can also lead to traumatic alopecia. To avoid putting too much pressure on specific parts of your scalp, make sure to change your hairstyle every few weeks.

4. Avoid Excessive Use Of Styling Products

Chemicals or other hair relaxers used for styles like perms or permanent straightening should be kept to a minimum as these styling gels or sprays can harden the hair, leading to increased hair tension and a higher risk of traumatic alopecia.

One of the best treatments for traumatic alopecia is to minimize the use of harsh chemicals on damaged strands of hair, as they can only worsen the condition. Opt for plant-based cosmetics or remedies instead to protect your hair from harmful chemicals.

5. Keep The Use Of Hair Accessories To  A Minimum

Hair extensions and accessories can pull on your natural hair and increase tension on your scalp. It is, therefore, recommended to wear hair accessories only when necessary or try to use them in different styles. Allow your hair to rest, and try to avoid the use of clips, bands, and clutches on a frequent basis. Also, explore different hairstyles every few days to prevent unnecessary strain on any area of your scalp.

6. Choose The Right Wigs

If you are using hair wigs, make sure to pick one that has a base made of a material that causes less friction with the scalp to minimize the chances of traumatic alopecia.

7. Use Hair Growth Products

High-quality hair growth products such as minoxidil can help you treat traumatic alopecia and facilitate regrowth of hair (3). However, it is best to use it after due consultation with your doctor.

8. Use Anti-Inflammatory Creams

Among other symptoms, traumatic alopecia also causes swelling on your scalp, which can be really painful. Using an anti-inflammatory cream can be useful in reducing pain and swelling.

9. Seek Medical Help

If there is no visible improvement and regrowth of hair after taking these measures for a few months, it is recommended to seek medical attention as it might be a case of severe hair damage.

Final Words

Traumatic alopecia is a relatively common condition, but it is entirely avoidable. The condition is typically caused by the hair being pulled repeatedly for an extended period, usually by wearing tight ponytails, pigtails, buns, or anything that continually tugs on the hair.

Fortunately, treatment of traumatic alopecia is entirely possible if it is spotted early. Make sure to wear your hair in loose hairstyles to avoid putting a strain on the same area of the scalp repeatedly. While it can take some time for the hair to grow back, there should be no lasting damage if you treat the condition gently and consistently.

Expert’s Answers for Readers Questions

Is it necessary to go to a doctor for traumatic alopecia?

It goes without saying that it is best to follow a hair care regimen for traumatic alopecia under a doctor’s guidance. They will know exactly what is needed to improve your condition, and there will be minimal risk of anything going wrong (which can happen if you start treatment on your own).

Is it best to avoid sulfate shampoos with traumatic alopecia?

Yes. Sulfate shampoos are harmful for people without traumatic alopecia. So, it is best to avoid them.

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Arshiya Syeda

Arshiya Syeda is an editor and certified counselor. Ever the lover of the written word, she served on the editorial boards of her school and college newsletters. Writing articles on hairstyles, hair care, and nutrition helped her combine her love for reading, writing, and research. As an editor, she helps her team members deliver polished and meticulously researched content. Arshiya is fluent in English, Urdu, and Hindi and aims to become a multilinguist by learning German and teaching herself American Sign Language (ASL).
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