Traction alopecia

Traction alopecia is a specific type of hair loss, distinguished by its cause — constant mechanical pulling. While in other forms of alopecia the reason may lie in hormonal imbalances or immune system issues, here the problem stems from the habit of styling hair in certain ways.

It may seem harmless at first — a tight ponytail or braid. However, such hairstyles lead to damage of the hair follicles, as regular tension over time causes hair in these areas to thin.

The good news is that, in its early stages, traction alopecia is reversible. If the damaging factor is eliminated in time and the hair is supported with proper care, it can fully recover.

The main factor is prolonged and strong pulling of the hair. This can include:

• a tight high ponytail, bun, or braid;
• cornrows, dreadlocks, hair extensions;
• elaborate hairstyles with strong fixation;
• the habit of frequently using flat irons or curling irons, pulling the hair;
• rough or abrupt brushing;
• chemical perming.

When hair is constantly pulled in the same spot, the follicle experiences strain, blood supply is disrupted, and it gradually weakens.

It is very important to note that sometimes similar hair thinning may not be due to hairstyles, but rather to hair-pulling caused by trichotillomania. This is also a mechanical habit, but not related to hairstyles or the above-mentioned reasons. It is a psychological disorder in which a person involuntarily tugs, breaks, and pulls out hair. In such cases, the diagnosis and treatment will be different, but the consequences are similar.

Traction alopecia can develop in anyone whose hair is constantly subjected to tension. However, some groups have a higher risk due to their lifestyle, profession, or habits.

1. Women with long hair who wear tight hairstyles

A convenient high ponytail, sleek bun, or braid may seem harmless, but when worn daily, they continuously pull the hair at the roots. It is especially risky if the hair tie is fixed in the same spot every time — the tension is unevenly distributed, and follicles in that area gradually weaken.

2. Athletes

Anyone who needs a neat, secure hairstyle during training and performances. To achieve this effect, hair is tightly secured with pins, nets, and fixed with gel or hairspray. Constant rehearsals and competitions without “breaks” for the hair create perfect conditions for follicle damage.

3. Children

Young girls are often given tight braids or ponytails “to keep hair out of the way.” A child’s scalp and follicles are particularly sensitive, so damage can occur faster than in adults. Also, children may not complain about discomfort, and parents may notice the problem only when the hair has already started thinning.

4. Men with long hair

More men are now wearing man buns or ponytails. Hair is often secured with ties, and if the hairstyle is high on the crown, the strain on the follicles increases.

5. Fans of cornrows, dreadlocks, and hair extensions

Such hairstyles look striking, but the braids or added strands can be heavy. The weight of synthetic or extra hair constantly pulls at the roots, and with improper care, the strain only intensifies.

6. Those who often style hair into elaborate looks with strong fixation

Performers, models, TV hosts, and those who love perfectly styled hair subject it to stress every day. Strong-hold hairspray, flat irons, pins, and clips in the same place day after day cause cumulative damage.

Conclusion: At risk are all those who pull their hair into the same shape daily, without giving it a “rest.” The more frequent and prolonged the tension, the faster the follicles lose strength.

Recognizing traction alopecia in its early stage is not always easy — changes occur gradually, and many people tend to attribute them to “seasonal shedding.” However, there are several signs that should raise concern.

1. Change in the hairline
The first thing to watch for is the areas where hair is constantly pulled: temples, frontal hairline, behind the ears, or the nape (depending on the hairstyle). Hair in these spots begins to thin, the hairline may recede, and small bald patches can appear in some places.

2. Breakage and shortened hairs
If you notice many short, broken hairs near the roots, especially in the area where hair ties or pins are placed, it’s a sign that the strands are breaking due to constant tension. At the same time, new hairs grow thinner and weaker.

3. Changes in the scalp
The skin in the tension zones may become red, flaky, or shiny. Small inflammations, pimples, or crusts may appear. This indicates that the follicles are under stress.

4. Discomfort
Itching, tingling, burning sensations, or scalp tenderness after removing a hairstyle are not normal. If the discomfort persists, it means the strain on the hair is already excessive.

5. Gradual expansion of the hair loss area
Without changes in hair care and styling habits, the patches of hair loss grow larger, and the hair becomes progressively thinner. In later stages, the skin in these areas may take on a smooth, shiny appearance — a sign of scarring, when regrowth is no longer possible without a transplant.

The first and most important step is to eliminate the cause of hair tension. This means:

• avoiding tight ponytails, braids, and buns;
• not wearing heavy hair accessories;
• choosing gentle hair extension techniques or taking breaks between extensions.

Next, a trichologist develops an individual treatment plan:

• gentle shampoos and conditioners to strengthen the hair;
• serums or lotions that stimulate hair growth;
• a course of mesotherapy or platelet-rich plasma (PRP) therapy to improve follicle nutrition;
• vitamins and supplements (based on test results);
• in severe cases — hair transplantation, if the follicles have been irreversibly damaged.

The earlier the treatment begins, the higher the chance of preserving your natural hair.

Prevention: how to avoid the problem?

1. Loose hairstyles — choose styles where the hair is not pulled tightly at the roots.
2. Breaks from styling — give your hair a “rest” at least 2–3 days a week.
3. Gentle brushing — use soft brushes and avoid tugging on the hair.
4. Minimal aggressive treatments — frequent perms, bleaching, or harsh straightening weaken the hair shaft and root.
5. Scalp care — masks, massages, and gentle exfoliation to stimulate blood circulation.

It is important not to delay seeing a doctor.
Traction alopecia will not go away on its own if the cause is not removed. On the contrary, each month of continued strain increases the damage.
If you notice hair thinning, do not wait for it to regrow naturally.
A trichologist’s consultation, simple care adjustments, and a few procedures can restore thickness — but only if you act in time.

Traction alopecia is a signal that your hair is asking for rest and care. Responding promptly is your chance to keep it healthy for many years.