Traction Alopecia | How Do You Fix Traction Alopecia?(2023)

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What Does Traction Alopecia Mean?

Traction alopecia describes hair loss caused by repeated or chronic pulling force applied to your hair. This is one of the types of alopecia.
You can develop this condition if you frequently wear your hair in a particularly tight ponytail, pigtail, or bun; the attachment of weaves or hair extensions and tight braids (such as cornrows and dreadlocks) are considered to be the highest-risk hairstyles.

Traction Alopecia- caused by repeated or chronic pulling force applied to your hair.
Traction Alopecia – caused by repeated or chronic pulling force applied to your hair.


Mainly if you use chemicals or heat on your hair and compromise the hair shafts with ultimate strength resulting in hair breakage.

You can reverse traction alopecia if you stop tugging your hair back. However, hair loss can be irreversible if you don’t act quickly enough.
Traction alopecia was first time discovered by a doctor in Greenland early 1900s. He found that women who wore tight hairstyles like ponytails and pigtails had lost the hair along their hairlines.

This article provides critical knowledge about the causes, treatment, and prevention of traction alopecia.

Symptoms of Traction Alopecia:

Hair strands can be pulled out, and hair follicles can be damaged by repeated strains. This results in redness, itching, and even pus-producing ulcers or infections.

Symptoms of tension alopecia include:

  • A receding hairline is often located around your temple, forehead, or nape.
  • Small pimples form on your scalp or at the base of your braids.
  • The parting enlarges areas of thin and broken hair where your hair has been under strain for a long time.
  • Damaged hair follicles lead to redness, itching, ulcers, or infections.
  • You can also see shiny, scarred skin patches in more severe cases.

Wearing tight hairstyles occasionally is not a problem, and some everyday hair loss is common. American Academy of Dermatology study shows that humans shed between 50 and 100 hairs daily, often replaced by new hair growth.

Although traction alopecia is not a medical problem, it can have psychological consequences.

What Causes Of Traction Alopecia?

Traumatic hairstyle: 

  • It is commonly seen with certain hairstyles like a particularly tight ponytail, pigtail, braid, or braiding pattern that pulls the hairline forcefully toward the vertex of the scalp. Although it can affect people of any ethnicity, this condition is most common in African-American women (as some wear their hair tightly and are pulled back).
  • Hair follicles may become stressed and pulled by very long hair. Another factor contributing to traction alopecia is very long or tightly bound beards.
Traction Alopecia: Dreadlocks can cause hair loss around the hairline
Traction Alopecia: Dreadlocks can cause hair loss around the hairline
  • The hair is already at risk of falling out due to tight braiding and tight hairpieces or clips. Single (extension) braids and dreadlocks can both have the same result. Hair loss around the hairline—most commonly around the temples and sides of the head—occurs most frequently in both men and women who have had traction alopecia.


  • It happens more commonly in some professions where women wear their hair in a tight bun, including; ballerinas and gymnasts. 
  • Traction alopecia can occur in nurses who wear tight-fitting caps with pins at the side or back of the head.
  • Hair loss may also be caused by the hijab’s style and the hairstyle worn underneath it.
  • Sikh men and women can develop traction alopecia if their hair is tied too tightly under their turban for an extended period.
Traction alopecia - wearing compressive safety helmets tightly
Traction alopecia – wearing compressive safety helmets tightly
  • Traction alopecia results from wearing compressive safety helmets tightly and closely to the scalp. These safety helmets worn for motorcycling, cycling, skiing, and snowboarding are responsible for the persistent rubbing of localized hair and scalp areas.


Chemical treatments like harsh hair relaxers and dyes cause the hair shaft’s structure to change, increasing the risk of hair loss. It is seen almost exclusively in African American women, and this condition is known as CCCA (central cicatricial centrifugal alopecia).

According to a study by the National Library of Medicine, traction alopecia was highest in most women (58.7 percent) who had chemically treated hair (49.2 percent relaxed and 9.6 percent permed hair) vs (2.3 percent) men. It would mean the traction alopecia is highest if your usual hairstyle was extensions attached to relaxed hair.

What Are The Treatment of Traction Alopecia?

The hairstyle that causes traction alopecia to include:

  • Braiding
  • Cornrows
  • Tight ponytails or buns
  • Hair extensions 

Traction alopecia treatment is determined by factors such as the severity of the disease and the presence or absence of permanent alopecia. The disease’s stage determines the course of treatment. Traction alopecia has been divided into three phases: prevention, early traction alopecia, and long-term traction alopecia.


In the prevention stage, the measures include educating children, young people, and parents about proper hair care habits. This intervention is essential because this is the time when hair follicles are most fragile.

Early Traction Alopecia:

In the stage of early traction alopecia, when the follicles are still undamaged, the strategy should be to change the hairstyle regularly to avoid strain on any area of the scalp.

  • You should avoid or limit chemicals used as much as possible such as relaxers, dyes, or heat, and brush on the affected area. The best example is that some professionals who frequently wear their hair in tight buns may also experience traction alopecia.
  • If there is evidence of inflammation, such as scaling or erythema, or tenderness in the scalp. Then it would be best if you used topical or intralesional corticosteroids to treat inflammation.
  • You can treat pimples with anti-inflammatory antibiotics, either orally or topically. 
  • A study in the American Journal of Clinical Dermatology (2019) found that topical minoxidil can help promote regrowth but doesn’t apply if the scalp is inflamed.

Long-Term Traction Alopecia:

In the long-standing disease stage, surgical options are considered. It has been discovered that hair transplantation techniques such as micro-grafting, mini-grafting, and follicular unit transplantation are effective.

How To Prevent Traction Alopecia Due To Tight Hairstyles Or Hairdos?

Hair loss can occur in anyone who frequently wears a tightly pulled hairstyle. There is a medical term for this particular sort of hair loss, and it’s known as traction alopecia.
You can lower your risk of developing this kind of hair loss by following these dermatologists’ recommendations.

Avoid hairstyles that pull on your hair frequently;

It’s fine to wear your hair tightly pulled back every now and then, but you shouldn’t do it every day. Constant pulling can cause hair strands to break or fall out. Continuous pulling can cause hair follicle damage over time. If you harm your hair follicles, your hair will not grow back, leading to permanent hair loss.

Hairstyles that continuously pull on your hair include:

  • Buns, ponytails, and pigtails that are tightly pulled
  • Cornrows
  • Dreadlocks
  • Hair extensions or weaves
  • Tightly braided hair

Ease the hairstyle;

Loosen your hairstyle a little when wearing it pulled back, particularly around your hairline. If your hairstyle feels painful or the style is too tight, You can reduce the constant pulling by doing the following: 

Loosen Braid Or Hairstyle
Loosen your hairstyle a little when wearing it pulled back, particularly around your hairline


  • Loosen braids, particularly near your hairline.
  • Wear braided hair for no more than two to three months.             
  • Choose thicker braids and dreadlocks.

Change hairstyle;

By changing styles, it’s best to give your hair time to recover. For example, after wearing Cornrows (which pull at the roots of your hair and can cause hair loss) for a few months, try loose braids or go natural.

Take these safety measures if you’re wearing a weave; 

Hair weaves and extensions are excellent ways to give your hair more length and volume. Dermatologists advise the following actions to take to stop them from causing hair loss:

  • Because the pulling can increase your risk of developing traction alopecia, you should wear them for short periods.
  • In this case, if they hurt or irritate your scalp, remove them right away.
  • Choose woven fabrics that are sewn in rather than glued in.

Change your hairstyle right away if you have any following issues: 

These are warning signs that hair loss may result from your hairstyle or products:

  • Pain from pulling hair too tightly,
  • scalp stinging
  • Your scalp has crusts.
  • Tenting (parts of your scalp are being pulled up like a tent) 
  • Damaged hairs around your forehead
  • A receding hairline

If you notice any of the above signs, it’s high time to stop or quit pulling on your hair so it can grow back.

4 Home Remedies To Help Treat Traction Alopecia

It would be best if you rushed to the dermatologist at the first appearance of the signs mentioned above and the symptoms. However, traction alopecia treatment can be done safely at home if your alopecia is still in its early stages.

Adding Protein To Your Diet

Your body requires protein for hair growth. Some healthy dietary protein sources include eggs, fish, nuts, beans, lean meats, and seeds.

Only some people need the same amount of protein as its requirement varies based on muscle mass and physical activity.

Add Iron To Your Diet

Iron, like protein, is one of the most important nutrients for promoting hair growth. If you face hair loss, try to take iron-rich foods like spinach, peas, and lean proteins such as meat, poultry & dried fruit. 

Use the Massage And Inversion Methods

Oil is optional, but because some oils have been indicated to stimulate hair growth, they may be worth incorporating.

First, massage your scalp with an essential oil to stimulate your hair follicles. Next, use your fingers to gently massage your scalp for 4 to 5 minutes in a circular motion, alternating clockwise and anticlockwise.

Second, to increase blood flow to your scalp, hang your head upside down:

  1. Hang your head below your heart while sitting on a chair with your knees apart.
  2. Use your hands to flip all your hair forward, so it’s hanging upside down.
  3. Try to hold this position for at least 4 minutes. If you feel dizzy or uncomfortable, do not continue. Slowly sit straight to avoid a blood rush.
  4. After 1 or 2 hours, wash your hair with a mild shampoo.
  5. Repeat daily for one week each month.

Pumpkin Seeds Hair Oil:

According to experts pumpkin seed oil has proven results in hair growth. A study conducted on 76 male patients with traction alopecia received 400 mg of pumpkin seed oil per day for 24 weeks. Have observed a 40% increase in their hair count.

When to see a board-certified dermatologist?

If you have hair loss, it’s always early enough to see a board-certified dermatologist. People develop hair loss for many reasons, and your hairstyle may be the cause. It’s also possible that something else is causing your hair loss, such as stress or hereditary hair loss. Dermatologists can get to the root of the problem.
The sooner you find out what’s causing your hair loss and take steps to stop it, the better your results.

Bottom Line:

The early phases of traction alopecia are completely reversible. Recognizing the issue and avoiding tight hairstyles will typically lead to complete hair restoration.

The hair may not grow back in the later stage because the follicles may become damaged. In these circumstances, a patient would want to ask about hair transplants with a health professional.

A person should consult a physician or dermatologist if they are worried about hair loss. A specialist can identify the root of hair loss and recommend the most effective course of action.

Frequently Asked Questions:

Q. Does hair grow back from traction alopecia?

A. Traction alopecia is hair loss caused by tight hairstyles, such as cornrows or ponytails, that pull on the hair and damage the hair follicles. If the hair follicles are damaged enough, they may not be able to produce new hair. In some cases, the hair may grow back once the cause of the traction alopecia is addressed and the hair and scalp are allowed to heal.

However, if the damage to the hair follicles is permanent, the hair may not grow back.

If you are experiencing traction alopecia, it is essential to stop wearing tight hairstyles and to seek treatment from a dermatologist or other healthcare provider. Treatment may include medications to promote hair growth and prevent further hair loss, as well as lifestyle changes, such as wearing looser and avoiding tight hairstyles altogether.

Q. Does slicking your hair back cause a receding hairline?

A. Slicking your hair back on its own will not likely cause a receding hairline. A receding hairline is usually a genetic trait and is not caused by specific hairstyles.

However, if you use tight ponytails or other tight hairstyles to slick your hair back, or if you use harsh chemicals or heat to style your hair, you may be causing damage to your hair and hair follicles. This damage can lead to hair loss, including a receding hairline.

It is important to avoid tight hairstyles, uses gentle hair care products, and avoid using heat and chemicals on your hair too frequently. Suppose you are concerned about hair loss or a receding hairline. You should consult a dermatologist for further advice and treatment options.

Q. How long does traction alopecia recover or grow back?

A. The amount of time it takes for the hair to grow back after traction alopecia depends on the extent of the damage to the hair follicles and the effectiveness of the treatment. In some cases, hair may grow back within a few months of treatment, although it may take longer for the hair to fully grow and for the scalp to heal.

If the hair follicles have been severely damaged, it may be more difficult for them to grow back or not grow back at all. In these cases, it may be necessary to seek treatment from a dermatologist, who can recommend medications and other medicines to promote hair growth and prevent further hair loss.

It is also essential to address the cause of the traction alopecia and avoid tight hairstyles or other practices that can damage the hair and scalp. This can help prevent further hair loss and allow the scalp to heal.

Q. How common is traction alopecia?

A. Traction alopecia is a form of hair loss caused by tight hairstyles that pull on the hair. It is most common in people who wear their hair in tight braids, cornrows, or ponytails for long periods. However, it can also occur in people wearing tight hair rollers or hats.

It is also more common in people with certain ethnicities, such as African Americans, due to the texture and structure of their hair. But it can affect people of any race, and it is generally more common in women than men.

Q. When does traction alopecia become permanent?

A. Traction alopecia is often reversible if it is caught and treated early. Still, if you continue wearing tight styles for years can cause permanent damage to your hair follicles. At this point, the hair will not regrow even if you switch to looser styles.

Q. What does traction alopecia scarring look like?

A. Traction alopecia scarring may manifest as a shiny, smooth patch of the scalp with no hair growth. It can also cause redness, bumps, and pus-filled blisters on the scalp. Additionally, the scalp may feel sore, sting, or itch.

In general, the longer the hair has been pulled and the tighter the hairstyle, the more likely it is that scarring will occur.

Q. Is traction alopecia an autoimmune disease?

A. No, traction alopecia is not an autoimmune disease. It is caused by repeatedly pulling on the hair, whereas alopecia areata is an autoimmune disorder.

Q. Is traction alopecia infectious?

A. No, traction alopecia is not infectious. It is caused by repeatedly pulling on the hair, which can worsen if the pulling continues. However, it is possible that the scalp can become infected from open sores caused by the pulling.

Q. Can biotin fix traction alopecia?

A. Biotin is a water-soluble vitamin that helps to strengthen hair and nails. It is found in foods like eggs, salmon, and avocados. Biotin supplements are prescribed to treat traction alopecia that results in hair folliculitis.

Besides that, the supplement is also known to help promote hair growth. Taking biotin supplements may be a good option for treating hair loss if you have a biotin deficiency. You’ll usually see improvement after a few months of taking the supplement. 

However, it should be noted that biotin alone is not enough to reverse traction alopecia. In the case of traction alopecia, the first step is to stop or modify the hair-styling practices that are causing excessive tension in the hair follicles. This may involve wearing the hair differently or using different hair-styling products.

In addition to biotin, other treatment options for traction alopecia include, topical minoxidil, topical or injectable corticosteroids, antibiotics, antifungal shampoo, and hair health supplements.