Traction Alopecia: Causes, Prevention & Treatment | Expert Trichology

Traction Alopecia – Causes, Symptoms, and Treatment

Traction alopecia is a type of hair loss caused by prolonged mechanical stress on the hair and scalp. It results from excessive tension on the hair follicles due to tight hairstyles or consistent pressure from headwear. Over time, this stress weakens hair growth, causing hair to become thinner, shorter, and more fragile. If the condition persists, it can lead to permanent follicle damage and scarring, making hair regrowth impossible.

This condition can affect both children and adults, regardless of gender.

What Causes Traction Alopecia?

The primary causes of traction alopecia fall into two categories:

1. Hair styling habits
2. Micro-injuries to the follicles caused by headwear

Hair Styling Habits

Consistently wearing tight hairstyles—such as ponytails, buns, braids, dreadlocks, and cornrows—places excessive strain on the hair, leading to gradual hair loss. Hair extensions, sleeping in hair rollers, or frequently using accessories that pull on the hair can also contribute to follicular damage.

Micro-Injuries from Headwear

Another potential cause of traction alopecia is prolonged pressure on the scalp from wearing tight or heavy headwear. This includes helmets (cycling, skiing, or construction helmets), turbans, or stiff caps that continuously rub against the hairline and scalp, weakening the follicles.

Signs and Symptoms of Traction Alopecia

The first noticeable sign of traction alopecia is increased hair shedding, particularly in areas exposed to the most tension, such as:

• The temples and behind the ears
• The frontal hairline
• The crown of the head, depending on the hairstyle or headwear habits

Other symptoms include:

• Redness, tenderness, and tightness of the scalp
• Localized itching and flaking of the skin
• Increased scalp sensitivity
• Hair becoming brittle and prone to breakage
• Small inflammatory bumps (folliculitis)

Unlike some other types of alopecia, traction alopecia typically does not present with widespread inflammation.

In early stages, a trichoscopic examination (a scalp analysis under magnification) often reveals an increased number of hairs in the catagen and telogen phases (the resting and shedding phases). As the condition progresses, a higher percentage of vellus hairs (thin, weak hairs) may be observed.

 

Advanced Traction Alopecia

If the underlying cause of traction alopecia is not addressed, the condition can worsen, leading to:

• Permanent thinning of hair in affected areas
• Significant hairline recession (particularly at the temples, frontal hairline, and crown)
• Chronic inflammation and scalp discomfort
• Changes in hair texture—hair may become brittle, dry, and more fragile

Can Traction Alopecia Be Reversed?

If traction alopecia is detected early, removing the underlying cause is often enough for hair to regrow naturally. However, early intervention is key—once scarring occurs, hair loss becomes permanent.

A professional diagnosis from a trichologist or dermatologist is recommended. The diagnostic process typically involves a trichoscopy (detailed scalp analysis) and a thorough consultation.

Treatment Options for Traction Alopecia

Depending on the severity, different treatments may help stimulate hair regrowth:

1. Eliminating the Cause

The first step is to stop wearing tight hairstyles and avoid accessories that pull on the hair. Letting the scalp "rest" can allow the follicles to recover. Sleeping with loose hair and gently detangling hair can also prevent further damage.

2. Trichological Treatments

• Scalp treatments and serums – Using specialized trichological treatments can help strengthen hair and improve follicular health.
• Scalp massages – Stimulating blood circulation can enhance nutrient delivery to the follicles.

3. In-Clinic Procedures

• Microneedling / Mesotherapy – Injecting vitamins, peptides, and hyaluronic acid directly into the scalp to nourish the follicles.
• Carboxytherapy – Carbon dioxide injections to improve blood flow and oxygenation of the scalp.
• Platelet-Rich Plasma (PRP) – A natural treatment that uses the patient’s own plasma to boost hair follicle activity.
• Low-Level Laser Therapy (LLLT) – Light therapy that helps reduce inflammation and stimulate hair growth.
• Radiofrequency Stimulation (INDIBA Therapy) – A technology that enhances follicle regeneration.
• Stem Cell Therapy – Using regenerative cells (usually from the patient’s adipose tissue) to promote hair regrowth.

4. Pharmacological Treatments

• Minoxidil – A commonly used topical or oral treatment to stimulate hair regrowth.
• Corticosteroids – Used in cases with underlying inflammation, either topically or as injections.

5. Hair Transplantation

In severe cases where hair loss is permanent, a hair transplant may be considered. However, this is only an option once the underlying cause has been completely eliminated and the scalp is free from inflammation.

How Long Does Recovery Take?

Patience is key—hair regrowth typically takes 4–6 months after removing the cause and beginning treatment. The earlier traction alopecia is addressed, the higher the chances of full recovery.

 

 

Please note: The information provided here is for informational purposes only and does not constitute medical advice. If you have any serious health issues, are taking medications, or have concerns about your health, please consult your GP or a medical advisor.