Traction Alopecia

Traction alopecia is hair loss that results from repeated tension on hair follicles, commonly caused by tight hairstyles such as braids, ponytails, buns, hair extensions, or prolonged chemical and heat styling that weakens the hair shaft. It most often affects the hairline, temples, and other areas under constant strain; early signs include broken hairs, thinning along the margin, widening part lines, and scalp tenderness or itching. When the source of tension is removed early, follicles may recover and hair can regrow, but chronic or severe traction can damage follicles permanently and lead to scarring.

Diagnosis is typically based on history and scalp examination, with tools such as trichoscopy or a scalp biopsy used when it is important to distinguish scarring from non-scarring loss. Management focuses on stopping damaging styling practices and adopting gentler hair care; medical treatments like topical minoxidil or anti-inflammatory therapy may help when follicles are still viable. In cases of established scarring where regrowth does not occur, surgical options such as hair transplantation may be considered after appropriate evaluation.