Key Takeaways
Traction alopecia is a hair condition in which headwear or tight, binding hairstyles may be gradually pulling your hair out. This condition may cause gradual hair loss as prolonged or repetitive tension on the hair roots may cause permanent damage if not treated.
Traction alopecia may respond well to treatment if addressed early (1). In this article, we will outline exactly what traction alopecia is, what causes it, and how to treat it.
Note that this information is general in nature and does not constitute medical advice. Individual results may vary.
What is traction alopecia?
Traction alopecia is a form of hair loss that may be caused by gradual pulling and tension on the hair roots due to tight hairstyles, such as braids, ponytails, or buns (2). The condition may cause signs such as redness, thinning or itching, and may be reduced if it is caught early enough.
What causes traction alopecia?
Traction alopecia may be caused by a tight, binding hairstyle like a bun or ponytail, repeatedly pulling or putting tension on the hair follicles, which may eventually pull the hair out entirely (3). This damage may also be caused by constrictive headwear, and it may be permanent if damage to the follicles is not addressed in time.
Symptoms of traction alopecia:
Some key signs that your hairstyle or headwear is causing traction alopecia include:
- Receding hairline: Due to pulling and friction, you may notice your hairline receding at the temples, forehead, or nape of the neck.
- Scalp inflammation: Redness, red or white bumps and scaling are all signs that you may be affected by traction alopecia.
- Tender scalp: Due to the hair pulling, you may feel pain, soreness, itching or stinging in the affected areas.
- Broken hairs: The repeated damage may be causing multiple short, stubby and broken hairs, particularly near the forehead.
How to help reduce the risk of traction alopecia:
There are many methods you may use to reduce the risk of traction alopecia before it begins affecting your hair, including:
Hairstyling
One of the most immediate ways to reduce traction alopecia may be to reduce the pulling or tension certain hairstyles or hair accessories cause to your hair follicles. Generally speaking, if a hairstyle feels like it may hurt, it may be causing traction alopecia.
Consider wearing your hair looser, wearing looser headwear, switching hairstyles or limiting extensions.
Be mindful of your hair products
Certain hair care products may be causing your hair to loosen or become thinner, which may increase the likelihood of hair loss due to a tight hairstyle (3). Some products or hair styling features that could be encouraging traction alopecia include:
- Relaxers: Hair products with chemical relaxers may be causing the hair shaft to become weaker, which may increase the chances of hair being pulled out (2).
- Rubber bands: Standard rubber or elastic bands may be more likely to rip hair out when used. Try to use softer material bands instead, like soft fabric or silk.
- Extensions: Heavy extensions may be causing your hair to rip out due to the additional weight.
- Flat irons/blow-dryers: Keep flat irons and blow-dryers on low settings to avoid causing potential damage or breakage that may be exacerbated by tight hairstyles.
How to help reduce traction alopecia
Traction alopecia may be reduced by examining your hair care routine and determining if any hairstyles or headwear could be pulling your hair. Other methods for reducing traction alopecia include:
Products and Treatments
The following products may help with reducing or recovering from traction alopecia:
- Prescription medication: Some medications may help regrow hair that may have been pulled out by a tight hairstyle. Please be sure to consult a registered health practitioner to determine the best medication for you. (4)
- Scalp oils: Scalp massages may be able to improve circulation and add moisture that may assist hair growth and recovery.
- Sulphate-free hair care: Gentle hair cleansers may be able to help nourish the scalp, which may increase follicle recovery and hair growth.
- Procedural treatments: For more advanced conditions, an AHPRA-registered practitioner may recommend specific treatments or therapies. Individual results of these treatments may vary. A consultation is required to determine suitability.
‘The two main medications that we use are finasteride and minoxidil. One is primarily used to hold onto the hair that you have, and the other is used to help regrow hairs that become miniaturised."
Hair Transplant Doctor Dr David Ballantyne (AHPRA No. MED0001212633)
When to get professional help?
If you experience strong scalp pain, inflammation, or notice your hairline receding, it may be best to get in contact with a registered health practitioner. You may also want to book a free 15-minute discovery call with a hair growth advisor if your hair is still not growing back after six to eight weeks of wearing looser hairstyles.
Treatments at Gro Clinics
Gro Clinics offers hair restoration care in Auckland, New Zealand. A consultation is required to assess suitability.
Gro Clinics offers tailored treatment plans that follow a personalised assessment of each client. We create a plan suited to you based on your history, underlying health conditions and a discussion of your specific goals and treatment suitability.
Our services include:
- A free 15-minute discovery call with a hair growth advisor.
- An in-person conversation with our team and scalp evaluation.
- AHPRA-registered practitioners.
- Structured, in-clinic training and hands-on education before performing or assisting in procedures for all medical and clinical teams.
- Flexible payment options for eligible patients.
- Post-procedure support and annual check-ins.
Traction alopecia FAQs
Can you regrow hair from traction alopecia?
Yes, you may be able to regrow hair you have lost from traction alopecia. Depending on how early you act, you may reduce further damage to your hair follicles caused by a tight, pulling hairstyle and regrow pulled hair before the follicle is too damaged.
What hairstyles can lead to traction alopecia?
The following hairstyles may lead to traction alopecia and hair loss:
- Braids and locs: Tightly binding hairstyles like cornrows, box braids, dreadlocks and sisterlocks may cause pulling on the hair, which may increase the risk of traction alopecia.
- Tight up-dos: Sleek or tightly pulled ponytails, pigtails, top knots or similar styles may be damaging your hair follicles.
- Extensions and weaves: Heavy hair extensions, glued weaves or wigs that anchor heavily may be pulling hair out due to weight.
- Head coverings: If you frequently wear a tight hat, bandana, swim cap, turban or other headwear that rubs against the hairline, it may be causing repeated hair pulling.
When is it too late for traction alopecia?
If hair follicles have been destroyed, ripped out or replaced by scar tissue, it may be too late to reduce or resolve traction alopecia. If hair has not regrown within a year, it may also be too late to reduce the damage.
Does minoxidil help traction alopecia?
Yes, minoxidil may help with traction alopecia by stimulating the blood flow to the hair follicles, which may help promote growth (5). However, success may depend on the severity of the damage, and treatment may be more effective if it is used during the early stages of hair loss.
How bad can traction alopecia get?
If it is not treated, traction alopecia may lead to permanent, irreversible hair loss as the hair follicles may be damaged past recovery. This is because chronic pulling may destroy hair follicles, which may keep the hair from being able to grow back.
Where does traction alopecia start?
The first signs of traction alopecia typically start along the hairline, most notably at the temples, forehead or the area directly above the ears. These are typically the areas where a tight hairstyle may be pulling the hardest.