Alopecia is the medical term for hair loss, but it can come in many forms. The most common form of hair loss is androgenetic alopecia, which is more commonly known as male (or female) pattern baldness. Another very common form of hair loss is traction alopecia, which means hair loss as a result of tight hairstyles that pull on the scalp. Traction alopecia is reversible if it doesn’t go on too long, but it can become permanent if the signs are neglected or ignored.
Traction alopecia was identified in 1907 by an Austrian doctor named Trebitsch practicing medicine in Greenland. He found that women who wore a particular hair style common in Greenland, which involved a tight ponytail, lost hair along the hairline.
Who is Susceptible to Traction Alopecia?
The people most susceptible to traction alopecia include women, people of color, those with very long hairstyles, those who frequently wear helmets, wigs, tight hats, and people in professions that commonly wear their hair pulled back such as gymnasts, military personnel, ballerinas, and surgical teams. Even within those professions, the people most commonly affected are women and people of color who have to tie back their hair, potentially damaging their scalp. One-third of women of African descent deal with traction alopecia.
The first symptoms of traction alopecia include:
- Receding hairline
- Widening hair part
- Scalp redness
- Stinging or soreness of the scalp
- Headaches
- Scalp sensitivity after letting hair down
- Itching
- Folliculitis, which is hair follicle inflammation
- Scaling
- Scalp blisters
What Are the Main Causes of Traction Alopecia?
Anything that pulls on the scalp repeatedly and for long periods of time can lead to traction alopecia. That can include having very long hair for years because the weight of the hair can pull on the scalp. Similarly, tight hairstyles are a culprit. People of African descent often suffer from traction alopecia because weaves, braids, and dreadlocks pull on the scalp and hair relaxers can cause hair breakage. Those who pull their hair due to anxiety can also suffer from traction alopecia.
Can I Lose My Hair From Traction Alopecia?
You could lose your hair if you:
- Don’t change your hairstyle regularly or regularly wear your hair down
- Wear your hair in a tight ponytail or bun
- Frequently style your hair in tight braids, dreadlocks or cornrows
- Sleep in rollers every night
- Use hair extensions or weaves
- Have very long hair for a long time
- Twist your beard (for facial traction alopecia)
How to Prevent Traction Alopecia
Unlike genetic forms of hair loss, traction alopecia is entirely preventable. Here is a list of ways to protect yourself from this form of hair loss:
- Alternate styles that constrain your hair with wearing it down
- If you must put your hair in a bun, keep it loose and low
- Don’t use hair relaxers
- Avoid using rubber bands and elastic for ponytails
- Take breaks between wearing weaves or extensions
- Avoid chemical processing – it can weaken hair
- Use thicker style braids or dreadlocks – thin braids pull hair more tightly
- Don’t sleep in rollers
- Use low heat settings for rollers, curling irons, and blow dryers
- Select wigs with a satin cap – it pulls less on your hair
- Don’t wear headbands or use clips, hairpins, etc. every day
Can Traction Alopecia Be Reversed?
Yes, if caught early enough before permanent hair follicle damage is done. If you think you’re suffering from traction alopecia, consult a dermatologist or hair restoration doctor. Steroids and anti-inflammatory medication could treat the inflammation and if there are outbreaks or pustules, antibiotics may be required.
Some stylists, especially those in the African American community, have developed hairstyles that camouflage traction alopecia without pulling further on the scalp. These stylists can often also show clients how braids, wigs, extensions, and dreadlocks can be worn safely without contributing to traction alopecia. If, however, traction alopecia has gone untreated for too long, the hair loss could be permanent. In that case, surgical hair restoration might be required.
What Happened to Ayanna Pressley’s Braids?
On January 16, 2020, Representative Ayanna Pressley of Massachusetts went public about her hair loss issues. As told to The Root in a video segment, Pressley talked about her hair history, how she felt she found herself in the Senegalese twist hairstyle, and then the heartbreak as her hair began to fall out until she recently became totally bald.
Rep. Pressley only refers to the hair loss as “alopecia” in the video, but it sounds like traction alopecia maybe have been part of it. The accompanying print story by The Root refers to both traction alopecia and alopecia areata, which are autoimmune conditions that attack hair follicles, making donor transplants less likely to be an option.
Regardless of the exact medical condition involved, it becomes plain as Rep. Pressley tells her story how difficult it is to reconcile one’s self-image with drastic hair loss, especially as a woman in the public eye. Over the years, Rep. Pressley had many women and young girls praise her for her African braids, which made the hair loss even more stressful.
Rep. Pressley told The Root that she wanted to free herself of the shame, which is why she removed her wig, revealing her bald head in the video. Rep. Pressley is still coming to terms with the change to her self-image, but knew she had to make a public statement before appearing in public without hair to avoid incorrect impressions. When she wore her hair in braids Rep. Pressley was often labeled “militant” instead of simply embracing a style that felt empowering. Hopefully, Rep. Pressley’s revelation will lead to new discussions about hair loss in women.
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