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Repeatedly pulling your hair? Know about Traction Alopecia and how to prevent it


Do you have the habit of constantly pulling your hair or tying your hair back tightly? Well, did you know it could lead to hair thinning and eventual hair loss? Traction alopecia is hair loss or baldness in patches due to the repeated pulling of hair. This happens mostly due to hairstyles that result in hair pull. Your hair styles such as ponytail, bun, or braids, cornrows, tight or wearing elastic hair ties result in this type of hair loss. Repeatedly styling your hair in such a manner can cause the hair follicles to become weak, and break off. If you do not take proper care when the signs of traction alopecia first appear then this might take a turn for the worse and cause irreversible baldness. Moreover, regular use of chemicals or heat treatment on your hair can also result in traction alopecia.    

There is no age limit for traction alopecia. It can affect adults as well as children. It is commonly seen in people with long hair due to the constant pull caused by the weight of the hair. Traction alopecia increases with age as hair follicles get weaker and more prone to hair loss.

Depending on the severity of the condition and extent of hair loss traction alopecia is divided into two categories: Acute Traction Alopecia and Chronic traction alopecia.

Acute traction alopecia happens when the hair gets pulled out suddenly after a traumatic injury. Chronic Traction Alopecia is caused due to repetitive pressure on hair follicles due to certain hairstyles. It is further classified as reversible and Irreversible traction alopecia depending on the damage caused by hair styling.

There are three main treatments for this condition. Behavioural modifications, change of hair style, topical and injectable medication. Steroids are injected directly into the scalp to strengthen hair follicles. It boosts hair growth and also heals inflammation or redness of the scalp. 

Though traction alopecia can be reversed with early diagnosis and appropriate treatment, you could always take a few steps to help avoid such a situation. Do not continue with a particular hair style for long, change it every few weeks. If you feel that the hair style is causing pain, loosen it or change the hairstyle. Keep your braids loose instead of making small, tight ones. Instead of elastic hair bands use fabric hair ties. Keep the hair loose as often as possible.

For oral medication antibiotics and biotin supplements are prescribed. Antibiotics are to prevent infection caused by mild to moderate levels  of traction alopecia. Apart from that, medicated shampoos are also administered to heal scalp infection and swelling. Biotin supplements help stimulate hair growth. 

  • For topical treatments, Minoxidil is the only accepted topical alopecia cure. It has become very popular and effective as a treatment for hair loss caused by traction alopecia. 
  • PRP Therapy i.e., Platelet Rich Plasma therapy  is a highly successful procedure and is known to produce quick results. As part of the procedure for this treatment platelets from the patient’s  blood are injected into the affected areas. This helps stimulate the dormant hair follicles. 

Laser therapy is also used to stimulate hair follicles for new hair growth. It has shown positive results and involves no downtime. However, if the damage to the hair follicle is permanent then hair transplantation is the only viable option.

What Causes Traction Alopecia?

The main cause of traction alopecia is continuous stress on the hair follicles, usually due to certain hairstyles that hold the hair tightly and high up together. The continuous pull damages the hair follicles and this leads to a swelling of the scalp with redness and pimples on it. If this continues for a long time, the swelling and tenderness caused, could lead to hair loss. 

The most common causes of traction alopecia are tight hairstyles such as braids, ponytails, cornrows, dreadlocks, weaves, buns, hair extensions or weaves. Anything that causes the hair follicle to experience a pull or stretch is harmful for your strands, and if continued on a regular basis would lead to traction alopecia. 

Apart from hairstyles, the other causes include hair styling creams or chemical treatments. Or frequent use of hairstyling tools like rollers which are kept overnight, elastic hair bands or clips that puts pressure on the scalp and use of hot combs for styling. Some cases develop because of the habit of pulling out hair while stressed. Wearing tight headgears like turbans, helmets or caps could also aggravate the problem. If you persist with the tight hairstyle, bald spots could appear anywhere on your scalp and could also lead to hair loss on temples.

Symptoms of Traction Alopecia

Though it is a form of alopecia, the symptoms of traction alopecia are different from those of the other forms of alopecia like alopecia totalis and alopecia areata. In traction alopecia, only that part of the scalp is affected where the hair experiences the pull, while in other forms of alopecia hair loss occurs in patches all over the scalp. 

This condition shows up with little bumps on the scalp which look like pimples. As the condition progresses, the hair starts breaking. It is commonly seen that the most affected areas are the hairs along the front and sides of the scalp. However, it may affect other areas of the scalp, depending on the hairstyle.

The other symptoms apart from the bumps and hair loss are redness of the scalp, soreness or stinging of the scalp, itching, scaling, folliculitis (inflammation of the hair follicles), thinning of hair, widening of hair partition, discomfort from sweating on the scalp and pus-filled blisters on the scalp. 

Expert Tips to Prevent Traction Alopecia

If the early symptoms are visible, you can help your case by taking the necessary precautions for if left unattended,  the hair follicles could be damaged and scarred and this may result in permanent hair loss.

To prevent traction alopecia, one has to make a conscious effort to not put stress on your hair. Avoid hairstyles which need the hair to be styled in a tight manner, or if it cannot be avoided, then leave the hair loose whenever possible. This will allow the hair to ‘destress’ and prevent hair breakage. Keep changing your hairstyle so that the stress is not on the same part of the scalp every time. Limit the use of chemical hair care products and relaxers, more so when you need to carry a tight hairstyle. 

Style your hair in loose ponytails, make loose braids especially around the hairline. If you need to wear a wig, then use satin wigs or cotton wig caps. Opt for styles where you can leave your hair down instead of keeping it tied up high and avoid making a tight or twisted bun. Avoid hair extensions as they put a lot of pressure on the hair follicles.

Can Traction Alopecia Be Reversed?

Traction alopecia can be reversed but you need to treat it quickly before the scarring sets in. If you discontinue the hairstyle that was responsible for the condition then the hair will grow back but if you continue with the same style, then the hair loss could be permanent.

Therefore, it is advisable to take action when the symptoms start first showing. It takes about 6 months to cure your alopecia if the treatment is followed properly. If the condition is not acute, then in most cases, it takes 4 to 6 months to recover. But if not then it may take up to 1 year for the damaged hair follicles to heal and regrow hair.

How Does Minoxidil Help with Traction Alopecia?

Topical Minoxidil helps in hair regrowth in traction alopecia. There have been studies that show that Minoxidil 5 percent foam can effectively help promote hair regrowth in patients with androgenetic alopecia. Though androgenic alopecia signifies a hereditary hair loss condition but it has similar effects as traction alopecia. Applying 2% or 5% minoxidil solution/foam to the affected areas on the scalp twice daily has been found to stimulate hair growth. There have been many cases of traction alopecia treatment where after application of Minoxidil, there has been hair regrowth even after substantial damage.  

Though Minoxidil gives good results for traction alopecia, if the scalp appears smooth and shiny that means the follicle has died. In this case minoxidil doesn’t work. For it to work its magic, the follicle has to be alive. Though traction alopecia with early detection can be easily treated but if left untreated for a long period of time it can cause permanent hair loss. In this case Minoxidil will not help and you might have to opt for a hair transplant which can be very expensive. So, it is best to make some lifestyle and behavioural changes in order to avoid traction alopecia and act early if the symptoms appear. 


The first thing you need to do to stop hair loss due to traction alopecia is to stop pulling your hair back and opt for hairstyles that don’t damage your hair. Any sort of styling that interferes with the natural flow of your hair is bound to create those undesirable side-effects. For more options to treat and solve your traction alopecia problems, do visit us at Traya and take the help of our experts to rejuvenate your hair follicles and regrow your hair.

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