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Traction Alopecia

What is Traction Alopecia?

Traction Alopecia is a condition where there is hair loss because of pulling and tension on hair follicles due to tight hair styles, such as pony tails, braids, cornrows, French rols, and dreadlocks for example.

What is the cause of Traction Alopecia?

The cause of Traction Alopecia is tension induced inflammation that leads to damage and destruction of hair follicles.

What are the symptoms?

The earliest changes that develop include redness, flaking, and puffiness or pustules of the hair follicles which is called “Traction Folliculitis”. With ongoing tension on the hair due to the pulling nature of the hairstyle, hair loss eventually appears at the front and sides of the scalp or other areas depending upon the type of hair style being worn. The hair tends to become thinner  at first, but progressively disappears due to scarring and the inability for hair to grow back due to follicle damage. Itching or tenderness may sometimes be present as welll

How is it diagnosed?

The doctor, usually a dermatologist, will examine this area and inquire with the patient on how the hair is worn. Based upon the history and visual inspection, a diagnosis can usually be made. If there is a possibility of other diagnoses, a skin biopsy is performed.

What tests are needed?

Usually, no testing is needed.  A skin biopsy might be done to check for other possibilities

What is the expected duration?

If caught early, this can be stopped or reversed. If the tension on the hair is prolonged, scarring and permanent baldness can develop.

How can it be prevented?

Choose a hairstyle that is loose and does not cause bumps and inflammation to occur.


In addition to changing the hairstyle, topical and localized injections of steroid and antibiotic medications can help to heal the scalp.. Avoiding any tight braids or anything pulled back is the treatment.

When to contact a professional

Contact a professional at the first sign of bumps, redness or flaking associated with a braided hair style.


There can be improvement with visible results within several months, or as much as a year later with treatment as long as the hair style is changed. If hair loss and scarring are present, hair transplant surgery might be required to see improvement in hair growth.

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