Hairstyles and Traction Alopecia

By Sally Robertson, B.Sc.Reviewed by Susha Cheriyedath, M.Sc.

Traction alopecia refers to the hair loss that arises when the hair roots are gently but persistently pulled throughout the day, usually as a result of particular hairstyling habits such as wearing the hair in tight buns, knots or ponytails and the use of straighteners.

The persistent pulling that occurs with these hairstyles may go unnoticed until prolonged tension on the hair roots starts to damage the hair follicles and alopecia begins to develop. Nowadays, with increasing numbers of women opting for certain scalp-pulling hairstyles such as hair extensions, braids and clip-ins, dermatologists are starting to see increasing numbers of women develop traction alopecia.

The condition is particularly common among African-American women, a third of whom are affected by the problem. African hair is not only very curly and tight, but the individual hair fibers are much thinner than those found in European and Asian individuals, making them much more likely to break. Furthermore, hairstyle habits adopted in order to control the curls such as straightening or braiding, exert forces on the hair root that can cause it to detach from the follicle.

Various different hairstyles produce different stresses and effects on the hair. Regular wearing of a ponytail can lead to hair loss that involves the frontal and parietal scalp areas. Braiding can lead to hair loss in the marginal or central scalp regions, with widening of the partings between cornrows. Wearing the hair twisted in a bun on the top of the head can lead to a ring-shaped alopecia in the central area of the scalp. Tightly applied rollers may cause irregular bald patches and too much brushing can produce wide-spread hair loss.

Many women are often reluctant to change how they style their hair, but the good news is that traction alopecia is entirely preventable if changes are made. Some of the ways to prevent this problem are described below.

Avoid Tight Hairstyles

Hairstyles such as cornrows, braids, and ponytails should be avoided as all these result in persistent tension being applied to the hair. These styles commonly cause damage to the hair thatresults in alopecia. Wearing the hair in a less tight style can make a big difference.

Avoid Extensions

The excess weight carried by hair extensions can also cause constant tension to the hair, persistently pulling on a woman’s own hair and eventually damaging the real hair fibers and follicles. The glue that is used to attach the extensions can also cause significant damage to the original hair.

Alter Styling Technique

Using heat-based equipment such as straighteners or curlers to style the hair subjects the hair to extremely high temperatures, which can cause significant damage to the hair, particularly if this is done regularly.

Avoid Dying Hair Regularly

Frequent coloring can also damage the hair as chemicals and bleaches in the dyes remove moisture from it, making it dry, brittle, and more susceptible to snapping.

Try Going Natural

The most effective way of preventing traction alopecia is to wear the hair naturally. Women who are uncomfortable doing this all the time, should at least try to wear the hair naturally sometimes, so that it has a chance to repair and restore itself.

Further Reading

• All Alopecia Content
• Alopecia - What is Alopecia?
• Causes of Alopecia
• Female Pattern Hair Loss
• Causes of Female Pattern Baldness