mhn news & blog

September 10, 2011

The Scoop on Traction Alopecia

The diagnosis of Traction Alopecia is on the rise, particularly in young African American women. It can occur to both sexes and is least frequent in older adults. Children, teens, and young adults are all susceptible. It is found more frequently in women who wear hair weaves, braids or tight pony tails.


Traction Alopecia may occur when hair is pulled tightly for a long time. Many of today’s popular hairstyles can trigger this disorder. Tight braids, cornrows, heavy hair weaves, and dreadlocks are common causes. Other culprits are strong hair dyes, excessive bleaching, and long-term use of hair straighter.

The hair loss often occurs on the top front, and temporal areas of the head. It can, however, occur anywhere on the scalp. The damage is usually:


  • At the scalp site of a ponytail
  • Along the hair line
  • In the areas adjacent to braids and cornrows
  • To hair shafts (they become brittle)


Constant pulling on hair, or extended use of chemical treatments, inflames hair follicles, and damage papillae. Chemicals can distort the structure of keratin and diminish the tensile strength of affected hair. When this happens, hair does the same thing we do when really burnt-out. It shuts down. The hair goes into a resting phase, and no new hair shafts are created.


  • Hair follicles are an organ of our skin; their job is to manufacture hair. All follicles have oil, or sebaceous glands connected to them. Someone with an abundance of these tiny glands will grow a thick head of hair.
  • Keratin is the main material in the outer layer of our skin, our hair, and nails. A keratin filament is fibrous, tough, and insoluble. It is what makes hair strong.
  • The papillae (from the Latin word papula) are tiny nipple-like protrusions on human skin. (Some form the ridges we call fingerprints.) Dermal papillae bring nutrients and oxygen to hair follicles, and lower layers of skin.


If you experience any of the following, it is important to seek professional advice as soon as possible. Why? When Traction Alopecia is caught early, hair can re-grow and become healthy again. Knowledgeable hair stylists should be able to detect the problems resulting from hair tension and chemicals, but yours may not be informed. It is important you know what to look out for.


  1. Requiring a pain reliever, like Advil, after getting cornrows or hair braids.
  2. A receding hairline.
  3. Scalp pain at the site of ponytails, braids, etc.
  4. Redness or bumps along the hairline.
  5. Pustules on the scalp.
  6. Hair that breaks off excessively when brushing.


If Traction Alopecia is discovered early, before follicles are hopelessly damaged, hair can grow back. The process may take six months or longer, and during that time it is highly recommended that the hair cannot be in contact with chemicals, or pulled. Usually, no creams or medication are required. However, Low Level Laser Therapy may be suggested and then discontinued when the hair is healthy again.

If your scalp is infected, topical antibiotics are usually recommended by physicians. Cortisone cream may be used to reduce inflammation of hair follicles.

In late-stage Traction Alopecia, hair cannot grow back because the follicles are beyond repair. At that stage, many sufferers opt for cosmetic non surgical hair replacement or surgical transplants. Unfortunately, the percentage of people requiring hair restoration today because of Traction Alopecia, are between the ages of 19 to 24.


If you have scalp pain after getting your hair done, ask for your stylist to loosen it up. If that doesn’t help, seek expert advice. If you love braids, cornrows, or dreadlocks, just don’t wear them continually. Your hair follicles need some time to rest and re strengthen. If you frequently dye or straighten your hair, it may help to switch products occasionally, or find non-chemical alternatives. Even cutting back on exposure to chemicals will help.

The best advice is to avoid tight hair styles and chemical over processing altogether, but that is unlikely to become a trend. Look for a trained professional that can create the look you want without pulling the hair too tight, and that can recognize the signs of over-treated hair and scalp.  If you think that you may be suffering from Traction Alopecia, call MHN for a free hair and scalp evaluation.  The good news about Traction Alopecia is that it is preventable, and if detected early, it may be reversible.