Traction alopecia is hair loss caused by tightly pulled hairstyles. Caught early, it is fully reversible and the hair can regrow. Over time, however hair follicles can become irreversibly damaged so that the hair does not regrow.
Traction alopecia can happen to anyone who wears their hair pulled back tightly, whether in braids, dreadlocks or a ponytail. It can also occur when tight headwear is used in the same way every day.
Repeated strain on the hair follicles can pull out strands of hair and even damage the follicles. This causes redness, itching and even pus-producing ulcers or infections.

Signs of traction alopecia include:
- A receding hair line typically around the forehead, temples or nape
- Small pimples appear on the scalp or at the base of the braids
- Redness, itching and ulcers on the scalp
- The hair parting widens
- Patches of thin or broken hair in places where the hair has been under strain
- Patches of shiny, scarred skin in more advanced cases
Traction alopecia is not a medical concern, but it can have adverse psychological effects. This form of hair loss is different from others, such as alopecia areata, alopecia universalis, and make or female pattern baldness, which are caused by genetic or immune factors.
Traction alopecia is made more likely by certain hairstyles and professions.
Here is a list of possible causes of traction alopecia:
- Certain hairstyles: including dreadlocks, braids, cornrows and tight ponytails.
- Hair extensions or weaves: extensions are glued to tightly tied to the base of the hair, which may cause tension at the hair roots.
- Headwear: such as sports helmets or tight elastic headbands, may cause the hair to thin where the headwear makes contact with the hair.
- Hair accessories: including hair slides or grips that are worn in the same way.
- Hair relaxers: and other chemical treatments. These change the structure of the hair shaft in a way that makes hair loss more likely.
Children and adults are both affected, but it is more common in older people because hair follicles naturally weaken over time. Treatment can be as simple as changing hairstyle techniques.
Here are some steps to treat this condition:
- Avoid tight hairstyles if possible: if a person’s religion or profession require tight hairstyles, they should tie their hair as loosely as possible and wear their hair loose or down whenever possible.
- Avoid or limit chemicals, including relaxers: avoid putting relaxer onto already relaxed hair.
- Change hairstyles every few weeks: to prevent stain on one area of the scalp.
- Use anti-inflammatories: steroid creams can reduce swelling on the scalp caused by traction alopecia.
If the hair still does not regrow after a few months, the hair follicles may be damaged. If there is substantial scarring, the hair may not be able to grow back.
These tips will help prevent traction alopecia:
- Loosen or change any hairstyles that is painful
- Change hairstyles every few weeks
- Wear thick, loose braids instead of small, tight braids
- Choose fabric hair ties instead of elastics
- Keep the hair loose as often as possible
Traction alopecia is fully reversible in the early stages. In most cases, recognizing the problem and avoiding tight hairstyles will result in a full restoration of the hair. In the later stages, follicles may become damaged and the hair may not regrow.

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