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Traction Alopecia: Your Hair’s Silent Cry for Help

Tugging, pulling and yanking are actions we often think of when it comes to getting a grip on something — be it a jar lid or an annoying knot in our shoelaces. 

But what if these seemingly harmless acts could be unknowingly putting your locks at risk? That’s the sneaky truth behind traction alopecia, a condition where everyday grooming habits tug and pull at your hair, causing it to gradually thin and fall out. 

Join us as we explore what causes traction alopecia, how to spot its signs, what treatments are available, and most importantly, how to prevent it from happening to you.

What is traction alopecia?

Unlike other types of hair loss, which are often due to causes out of your control, traction alopecia can be prevented. 

“Traction alopecia is a form of hair loss caused by prolonged or repeated tension on hair follicles or roots,” said Trevor Thompson, MD, a dermatologist with Banner Health. “This tension can be caused by hairstyles that pull on the hair.”   

It is commonly seen in women but can affect anyone who puts chronic or continuous strain on their hair. 

The most common types of hairstyles that can cause this are:

  • Tight ponytails: Pulling your hair back into a tight ponytail may seem like a quick and easy fix to get it out of your face, but it can put a lot of stress on your hairline.
  • Braids: While braids can be a fun and stylish choice, especially for protecting your hair, be cautious of braids that are too tight or left in for too long.
  • Extensions and weaves: Hair extensions and weaves can add length and volume to your locks, but if they’re attached too tightly or left in for too long, they can damage your natural hair.
  • Locs: While locs (or dreadlocks) are a culturally significant hairstyle, the process of creating and maintaining them involves tightly twisting sections of hair. This tension can strain the hair roots, especially if the locks are too tight.

Other causes for traction alopecia may be due to wearing tight or narrow headbands and hair rollers overnight and chemical treatments like perms, relaxers and keratin treatments.

How to spot the signs of traction alopecia

Traction alopecia is different from most other forms of hair loss. In other forms, hair loss may happen all over the scalp in patches. With traction alopecia, however, it most often affects the front hairline.

“You may notice broken hairs or patches of hair loss on the anterior hairline and around your temples and ears,” Dr. Thompson said. “You may also see redness or irritation on your scalp, pimples, scaling or itching around the hair follicles causing hair loss.”

Traction alopecia can cause your hairline to recede or become uneven due to the constant pull on the hair follicles. “Initially the hair loss may be transient but often progresses to a scarring hair loss where the hair does not grow back,” Dr. Thompson said.

Treating traction alopecia

If you spot any signs, get in touch with your health care provider or a dermatologist. They will look at your scalp to look for other possible causes of hair loss. Treating the condition early means you have a better chance of repairing the hair follicles and regrowing your hair.

The most important treatment is to try and avoid prolonged use of hairstyles that put more strain on the hair roots in favor of hairstyles such as a loose bun or a loose, short ponytail to reduce stress on the hair. 

“For hair loss, there is medication or topical solutions like minoxidil (Rogaine) that can also help you regrow healthy hair,” Dr. Thompson said. 

You can also use a good moisturizing conditioner and avoid using heat and chemicals on your hair.

For more severe cases, your provider may recommend low-level laser and light therapies or a hair replacement or hair transplant procedure

Steps you can take to prevent traction alopecia

  • Loosen up: To prevent traction alopecia, leave your hair loose and natural as much as possible. If you need to pull your hair up in a ponytail or bun, keep it loose and low on your head.
  • Give it a break: It’s important to give your hair a break from tight hairstyles every now and then. Consider alternating between different hairstyles throughout the week to give your hair a chance to relax.
  • Choose quality: When getting extensions, weaves or braids, make sure to choose a reputable stylist who knows how to properly install them without causing damage to your natural hair. If you use plaiting braids, try to use thicker ones as thinner ones pull hair more.
  • Be gentle: Treat your hair with care by using gentle hair products, avoid excessive heat styling and chemical treatments and be mindful of how you handle your hair during styling. 
  • Sleep smart: Avoid sleeping with tight curlers or rollers, as they can put unnecessary tension on your hair. Instead, consider wrapping your head with a silk scarf or using a satin pillowcase to protect your hair while you sleep. 


Traction alopecia is hair loss that happens due to continuous pulling or tugging on the hair follicles or roots by certain hairstyles like tight braids, buns, extensions and ponytails. It causes hair loss usually around the front and sides of the scalp. 

Traction alopecia is preventable if caught early. If you stop wearing your hair in tight hairstyles, your hair will grow back naturally. But if you continue styling your hair the same way, it can lead to permanent hair loss. 

If you spot the signs of traction alopecia, talk to your health care provider, dermatologist or a Banner Health specialist. Remember, your hair deserves love and care, so treat it gently and it will thank you in return. 

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