Information on Traction Alopecia

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Young black woman with afro hairstyle standing in urban backgrou

Hair loss can also be caused by some exter­nal fac­tors like pulling of hair. The hair loss caused by pulling of hair too tight­ly is known by the name of Traction Alopecia. The arti­cle describes the dis­ease and its acute and chron­ic form.

Traction alope­cia is caused by chron­ic trac­tion (pulling) on the hair fol­li­cle. Traction alope­cia most­ly occurs in African-American women and men who braid their hair too tight­ly. It is also com­mon in oth­er eth­nic groups known for tra­di­tion­al hair styles that involve pulling the hair.

There is also seen a pro­nounced trac­tion alope­cia in the beard area of this Sikh man. The Sikh men do not cut scalp or beard hair. The beard hairs are pulled straight and then twist­ed and tight­ly knot­ted. Daily knot­ting often results in this form of trac­tion alope­cia.

Hair loss by pulling of hair
Hair loss can also be caused by some exter­nal fac­tors like pulling of hair

Men who attach hair­pieces to their exist­ing hair also suf­fer from this type of hair loss. The trac­tion alope­cia in such cas­es can also lead to per­ma­nent hair loss if the hair­piece is attached in the same loca­tion over a long peri­od of time.

If we put the exam­ples from eth­nic groups aside, trac­tion alope­cia occurs most often in pre-teenagers, teenagers, young adults then it does in old­er men and women.

It is a very unfor­tu­nate state that hair styles and fash­ions and hair styling meth­ods are caus­ing bald­ness and hair loss among today’s younger gen­er­a­tions. The hair loss in all such cas­es is most­ly due to Traction alope­cia. The hair loss is caused by long term hair pulling and break­age due to very tight hair braid­ing, hair weaves and corn­rows.

The over use of hair style aids such as sponge hair rollers or curl­ing irons may also pro­mote trac­tion alope­cia. Traction alope­cia often shows as dis­tinct patch­es of hair loss in those areas where the hair and hair fol­li­cles have been put under exces­sive strain. The hair loss may occur any­where on the scalp depend­ing on the nature of the hair style or process that is caus­ing the trac­tion alope­cia. Prolonged trac­tion alope­cia can lead to cica­triza­tion of the new hair fol­li­cle and per­ma­nent hair loss.

Traction alope­cia is a very com­mon cause of tem­po­rary hair loss. Typically, trac­tion alope­cia in the ear­ly stages involves affect­ed hair fol­li­cles being pushed into the tel­o­gen rest­ing state along with local­ized trau­ma to the hair fol­li­cles as a result of hair fibers being forcibly pulled out.

Traction alope­cia is reversible if diag­nosed in the ear­ly stages. Permanent hair loss can occur too slow­ly for imme­di­ate detec­tion. Hair loss is often occurs in the front, and hair line but is also sub­ject to the imme­di­ate adja­cent area to where the hair is being pulled and dam­aged.

An effec­tive treat­ment is to sim­ply avoid hair styling that puts exces­sive strain on the hair. Even with removal of the cause of trac­tion alope­cia it may take up to three months for the hair to recov­er. Areas of scalp sub­ject­ed to chron­ic trac­tion alope­cia may nev­er ful­ly recov­er.

Traction alope­cia is gen­er­al­ly a non-scar­ring, non-inflam­ma­to­ry form of hair loss although long term use of hair styles involv­ing trac­tion over 3 or more years may result in a mild immune cell infil­trate and irre­versible scar­ring dam­age to some hair fol­li­cles. Any form of chron­ic trac­tion alope­cia will even­tu­al­ly lead to fibro­sis around hair fol­li­cles and total destruc­tion of some hair fol­li­cles. Once destroyed the hair fol­li­cles will not re-grow under any cir­cum­stances hence chron­ic trac­tion alope­cia can be described as a scar­ring cica­tri­cial alope­cia.

Permanent trac­tion alope­cia does not respond to med­ical treat­ment such as minox­i­dil or finas­teride due to non-genet­ic nature of hair loss. The only way one can treat trac­tion alope­cia is with hair trans­plants. Follicular unit hair graft­ing has been iden­ti­fied as the only prac­ti­cal solu­tion to treat­ing trac­tion alope­cia. Number of patients with trac­tion alope­cia com­ing to hair trans­plant clin­ics is gen­er­al­ly increas­ing and the treat­ment is pro­vid­ing them good response.

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