Traction Alopecia


Braids, ponytails, and buns are some of the most common hairstyles women wear. Look around you and take notice of how prevalent tight hairstyles are across women of all ages. It should come as no surprise then, that millions of women experience hair loss from traction and pulling. And while you might not think twice about throwing your hair up in a tight bun or ponytail, over time, your body may create its own way of telling you something isn’t quite right.

Traction Alopecia is a hair loss condition resulting from continually wearing tight hairstyles as well as wearing weaves and extensions. Cessation of these styles can lead to full recovery, yet once the follicles are compromised, scar tissue forms and regrowth is not possible. Tight hairstyles aren’t the only thing to cause hair loss. Any kind of traction and pulling can cause mechanical hair loss, and it affects all types of women--from professional athletes to long-haired women to ⅓ of women of African descent who have permed or relaxed hair treatments, according to a recent study.


This type of hair loss occurs as a result of repeated mechanical pulling, tugging, or tension on the hair follicles. Most commonly, traction alopecia results from repeatedly wearing the same tight hairstyles every day. However, any type of added pressure can tug at the follicles and cause the hair to break, thin and fall out, including:

  • Dreadlock, cornrows, braids, buns, tight ponytails.
  • Excessive blow-drying, flat ironing or styling that tugs at the hair follicles.
  • Weaves and extensions that are tightly glued in and as a result tug at the hair's roots and follicles.
  • Hats, elastic headbands, hair accessories or helmets worn daily.
  • Long, heavy hair that pulls at the follicles.
  • Chemical treatments and relaxers manipulate the hair's natural texture and structure, adding pressure to the hair shaft.
  • A combination of any of the above causes can lead to irreversible Scarring Alopecia.


The earliest sign of Traction Alopecia is excessive hair shedding. If you are noticing significant hair fall or feel soreness, tightness, or irritation of the scalp, these are all indications of mechanical hair loss. If left unaddressed, the condition will progress.

Common symptoms of ongoing mechanical traction and pulling include:

  • Scalp and follicular inflammation
  • Follicular pustules (blisters)
  • Thinning around the hairline, temples and nape
  • Redness, itching, irritation or scalp ulcers
  • A widening part
  • Bald or balding patches
  • Bumps or blisters


Most hair loss cases caused by traction and pulling are reversible, and it is not always a medical issue. However, if the condition isn't addressed early on, it can develop into a more complex and damaging problem. A dermoscopy, which is a microscopic examination of the skin, can help diagnose any traction-related conditions. If you are unsure if your hair is thinning due to traction or another hair loss condition, your dermatologist can conduct a histopathology (microscopic tissue examination) to rule out Androgenetic (Hereditary) Alopecia.

There are two main hair loss issues associated with traction and pulling:

Traction Alopecia
A hair loss condition caused by repeated pulling or tugging at the hair follicles caused by tight hairstyles. Once addressed, hair follicles should heal, and regrowth occurs within a few months.

A rare condition in which people impulsively pull out their hair from their scalp, eyelashes, or eyebrows. This aggressive pulling damages the hair follicles and can lead to irreversible damage.


The most effective way to prevent mechanical hair loss is to cease wearing high-risk hairstyles such as tight ponytails, braids, buns, dreadlocks, cornrows, weaves, and extensions. If you choose to wear extensions, remove them every few months and give your hair a break. If you must wear hair tight and pulled back for occupation purposes, try looser braids and when not working let hair fall free and loose.


Simple changes to hairstyle and beauty routines can significantly improve hair loss from traction and pulling. Keep in mind that repairing the damage from hair pulling and tension takes time and patience. Hair follicles subjected to repeated strain must recover before hair regrowth can begin. The important thing is to stay consistent and remain patient to allow your follicles to heal.

What you can do:

  • Swap out elastic hair ties for fabric ties or scrunchies.
  • Wear loose braids instead of tight ones.
  • Change up your hair routine every couple of weeks to give the follicles a break from tension caused by repetitive styling patterns.
  • Ditch tight hairstyles and instead wear your hair down, or loose, as often as possible.
  • Avoid chemical treatments and relaxers, which will only further tax and damage compromised follicles.
  • Use soothing oil or root securing treatments to restore and replenish sensitive follicles.
  • Stock up on protein and iron, which are vital nutrients follicles consume.
  • Consult with your dermatologist about the best treatment plan.
  • Ask your hairstylist for loose styling suggestions.