Traction alopecia

Traction alopecia is hair loss caused by sustained mechanical tension on the hair shaft. Common sources: tight ponytails, braids, cornrows, locs, weaves, extensions, hair systems, religious or cultural head coverings worn very tight, and certain athletic or work-related styles.

Early traction alopecia presents as thinning along the affected lines (typically the frontal and temporal hairline). Released from tension, follicles often recover.

Sustained traction over years can convert into a scarring pattern in which the follicle is permanently destroyed. The classic late picture is a band of irreversible loss along the original tension line, sometimes with retained “fringe” hairs at the very edge.

Treatment is removal of the tension. For early disease, that is usually enough. Topical minoxidil may speed recovery. Once scarring has occurred, the lost area does not regrow without transplantation.

Prevention is the high-yield intervention. Looser styles, varying the tension pattern, and avoiding chemical treatments (relaxers, strong dyes) on already-traumatised hairlines reduces progression risk.