What is Traction Alopecia?

Traction Alopecia is different from other types of hair loss, like alopecia areata, scarring alopecias and androgenetic alopecia, which are caused by genetic or immune factors. Traction Alopecia is hair loss caused by strain on the hair follicles, often from tight hairstyles. The continuous strain on the hair follicles pulls out strands of hair and can damage or destroy the follicles. 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 (like a cycle helmet) is used in the same way every day, from using chemical relaxers or even hair extensions.

Traction Alopecia can happen in any area where the hair is under strain, including the top of the head and the beard area.

What does Traction Alopecia look like?

The signs of Traction Alopecia include:

  • Pimples, redness, itching, and ulcers on the scalp
  • Patches of thin or broken hair in places where the hair has been under strain
  • Patches of shiny, scarred skin

How is Traction Alopecia diagnosed?

Your doctor will diagnose Traction Alopecia using your medical history, and examination of hair styling habits, trichoscopy (an examination of the scalp using a microscope) and a scalp biopsy if necessary.

Is Traction Alopecia permanent?

Traction Alopecia is not usually permanent, especially if it is diagnosed early. Often, recognizing the problem and avoiding putting strain on the hair will allow full regrowth. If Traction Alopecia is diagnosed too late, the hair follicles may have been destroyed and hair will not regrow.

What causes Traction Alopecia? 

Traction Alopecia is caused by repeated strain (or pulling) on the hair, over a long period of time. It can affect people of all ages but is more common in older people as the hair follicles weaken over time. Some of the things that can cause Traction Alopecia include:

  • Tight hairstyles, like dreadlocks, braids, cornrows, and tight ponytails.
  • Hair extensions and weaves.
  • Tight headwear, like such as helmets, tight hair grips or tight elastic headbands.
  • Very long hair, including beard hair can pull on the hair follicles.
  • Hair relaxers and other chemical treatments.
  • Using extensions and relaxers together.

Can Traction Alopecia be treated?

The first step in treating Traction Alopecia is taking away the strain on the hair. This can mean not wearing certain hairstyles or helmets or stopping use of chemical relaxers. Sometimes Dermatologists will suggest minoxidil to stimulate hair growth, or topical corticosteroids to help with itching or redness.

Additional information:

The British Association of Dermatologists have a patient information leaflet on Traction Alopecia


The Skin of Color Society also have some useful information: