Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 3/19/2021
If you wear your hair in a style that puts pressure on its roots, you may be at risk of developing a form of hair loss called traction alopecia.
This form of hair loss tends to develop when a continuous pulling force, such as from a ponytail, braids or even tightly slicked back hair, damages the roots of your hair.
Hair loss from traction alopecia can become permanent if it’s left untreated, making it important to act quickly if you’re experiencing this type of hair loss.
Below, we’ve provided more information about what traction alopecia is and how it may start to affect your hair. We’ve also explained the treatment options available to stop traction alopecia, prevent permanent hair loss and help you to regrow your hair.
Traction alopecia is a form of hair loss that develops due to a continuous pulling force on your hair roots. It’s most common in people of African descent, particularly women, but can affect people of all races and sexes.
Unlike male pattern baldness, hair loss from traction alopecia doesn’t have anything to do with DHT or other hormones.
Instead, this form of hair loss develops as a result of damage to your hair follicles. Over time, the tension caused by certain hairstyles or simply excessively long hair can physically destroy the hair follicle and prevent your hair from growing.
You may be at risk of developing traction alopecia if you:
Wear your hair in a ponytail, man bun or other tied back hairstyle
Style your hair in braids, cornrows or dreadlocks
Use certain chemicals to style or treat your hair
Use a hairpiece or other device that pulls on your hair
Have long hair that puts pressure on your scalp
Your risk of developing traction alopecia tends to increase as you get older. People who need to style their hair back, such as military personnel, athletes, gymnasts and others may have an increased risk of developing this form of hair loss.
The most noticeable symptom of traction alopecia is hair loss, which usually occurs around the front and sides of your scalp. You may also notice hair in other areas of your scalp, especially parts where your hair is subject to tension due to your hairstyle.
Hair loss from traction alopecia is usually symmetrical. You may notice that tiny skin-colored or white bumps develop around your hair follicles in affected areas of your scalp.
One common sign of traction alopecia hair loss is “fringe sign.” This occurs when you lose hair in certain areas of your scalp, but retain some hair at the frontal rim of your hairline.
In addition to hair loss, other symptoms of traction alopecia can include red skin, itching, scaling and the development of folliculitis and/or pustules.
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Traction alopecia is almost always treatable when it’s detected early. Most of the time, you can prevent traction alopecia from worsening by changing the way you style your hair.
If you normally wear your hair in a tight hairstyle, such as braids or a man bun, try switching to a loose style that doesn’t put any extra pressure on your hair follicles. If you style your hair using products that contain chemicals, try to reduce the amount that you use.
Traction alopecia may cause your skin to become scaly and inflamed. If you notice this, it’s best to talk to your healthcare provider or schedule an appointment with a dermatologist.
Your healthcare provider may prescribe medication to control inflammation, irritation and other skin issues. Medications used to treat traction alopecia include:
Topical or injectable corticosteroids
If you’re prescribed any of these medications or care products, make sure to use them exactly as instructed by your healthcare provider.
To speed up hair regrowth, you may want to try a topical medication like minoxidil. This works by improving blood flow to your scalp and encouraging your hair follicles to transition from a resting phase into active growth.
Minoxidil comes in liquid or foam form. Our guide to applying minoxidil for hair growth goes into more detail about how you can use this medication to stimulate hair growth in areas affected by traction alopecia.
Although traction alopecia is easy to treat when it’s detected early, it can cause permanent hair loss when it’s left untreated for a long period of time.
If you have permanent hair loss from traction alopecia, medications like minoxidil aren’t likely to be effective. This is because long-term traction alopecia damages the hair follicles so badly that they’re largely replaced by a form of scar tissue.
If you’d like to restore this hair, you may need to undergo hair transplant surgery. You can learn more about this type of procedure in our full guide to hair transplants for hair loss.
Although traction alopecia is much less common than male pattern baldness, it may be an issue if you wear your hair in a ponytail, dreadlocks, braids or other tight, pulled back hairstyle.
Since traction alopecia can cause permanent hair loss, it’s best to take action as soon as you’re aware that you’re losing hair.
Most of the time, you can prevent traction alopecia from getting worse by changing to a hairstyle that puts less tension on your hair follicles. You should also try to avoid using chemicals or heat treatments that can damage your hair.
Finally, to speed up your hair regrowth, consider using science-based medication like minoxidil to stimulate blood flow and keep your follicles actively growing.