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Traction alopecia – hair loss from styling

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read

Traction alopecia is hair loss as a result of repetitive heat damage and pulling on the hair. If a particular area is traumatized over a prolonged period, this may cause permanent destruction of the hair follicles and make it impossible for hair to grow back.

What causes the damage?

Traction means tension or pulling, so consider how certain styling techniques affect the hair. Using heat styling products at the hair root causes damage – hot combing, is one culprit, or using straighteners from the roots. Even keeping your hair in a tight ponytail or bun day after day can cause damage from pulling. Anything that adds weight to the hair can pull it out, including braids, hair extensions, or weaves. Any chemicals to dye or relax the hair weaken it and add to the trauma of traction.

To avoid traction alopecia, minimize styling practices, and give your hair a break to allow recovery. Once you notice hair loss, cease these practices completely before permanent damage sets in.

What does it look like?

Bald patches appear where the forceful pulling has occurred. This is often around the front hairline, as we pay the closest attention to this when styling our hair. You might see a receding hairline, and any hairs look short and scanty. You might see bald patches between cornrows or dreadlocks. It may feel a bit itchy or uncomfortable, and it might look a bit red and flaky.

Hair can regrow in these patches if the hair styling or other causes of pulling stops. You might notice thin hair to start, but more will regrow after three months or so.

If constant traction continues over time, hair loss may be permanent if follicles are irreversibly damaged, and these patches will look smooth and completely hair-free.

Are there any treatments?

The most important thing to do is to stop whatever is causing the traction. Cutting long hair may help ease the weight, and avoiding anything irritating the area, such as tight caps or wigs, can help avoid any further trauma.

When you first notice hair loss, you can try applying minoxidil 2% or 5% solution, available to buy from a pharmacy. Applied to affected areas, this aims to keep the hair from shedding, allowing it a chance to recover. It's not a permanent solution, and won't work if traction continues or if hair follicles have been destroyed. It can be expensive, and won't work for everyone.

If the area is red, itchy, or flaky, your doctor may consider giving you a steroid cream for a limited period of time, to calm any inflammation.

Does anything put my hair at higher risk?

Not specifically, although many of these techniques are favored by certain communities. Experts have considered if some types of hair are more susceptible to breakage, but it's more likely to come down to hairstyling practices. Some men have had traction alopecia from tying their beards and hair up.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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