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Traction Alopecia: Symptoms, Treatment and How to Recover


Traction alopecia is a hair loss condition that occurs due to the repeated pulling or stretching of hair. This happens mostly due to hairstyles or activities that put pulling pressure on the hair. This condition develops if you often wear your hair in a tight ponytail, bun or braids, or cornrows or wear densely compressed hair ties, ill-fitting helmets, or caps. Repeatedly styling your hair in such a manner can cause the hair follicles to become weak, and this leads to hair fall. If you do not take proper care when the signs of traction alopecia first appear, this hair loss might take a turn for the worse and cause irreversible baldness. 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 the 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. Traction alopecia is further classified as reversible and irreversible, depending on the damage caused by hair styling.

There are three main treatments for this condition. Behavioral modifications, change of hairstyle, and topical or injectable medication. Here, 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 hairstyle for long and change it every few weeks. If you feel that the hairstyle is causing pain, loosen it or change the hairstyle. Keep your braids loose instead of making them small or tight. Instead of elastic hair bands use fabric hair ties or satin scrunchies. 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 infections and swelling. Biotin supplements help stimulate hair growth. 

For topical treatments, Minoxidil is one of the accepted topical alopecia cures. It has become very popular and effective as a treatment for hair loss caused by traction alopecia. 

PRP therapy, that is platelet-rich plasma therapy is a highly successful procedure and is known to produce quick results. A part of the procedure for this treatment involves extracting platelets from the patient’s blood and injecting it 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, buns, hair extensions or weaves. Anything that causes the hair follicle to experience a pull or stretch is harmful to 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, compressed elastic hair bands or clips that put 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 headgear like turbans, helmets or caps could also aggravate the problem. If you persist with a tight hairstyle, bald spots could appear anywhere on your scalp and could also lead to hair loss on the 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 can occur in other areas of 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 it. 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 that 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 ‘de-stress’ 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, and make loose braids, especially around the hairline. If you need to wear a wig, then use satin 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 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 (rogaine) helps in hair regrowth in traction alopecia. There have been studies that show that minoxidil 5% foam can effectively help promote hair regrowth in patients with androgenetic alopecia. Though androgenetic alopecia signifies a hereditary hair loss condition 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, 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 behavioral changes in order to avoid traction alopecia and act early if the symptoms appear. 


The first thing you need to do to cure your 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. Do take Traya’s FREE hair test for an accurate diagnosis of your hair problems. For more options to treat and solve your hair issues, do visit us at Traya and take the help of our experts to rejuvenate your hair.


Q1 - Can Hair Grow Back After Traction Alopecia?

Ans - Early diagnosis is the key and the condition can be conveniently reversed provided the damage to the hair follicles is not extremely severe or permanent.

Q2 - How Do You Fix Traction Alopecia?

Ans - Traction Alopecia can be treated conveniently if diagnosed early. You need to avoid putting pressure on your hair by not opting for tight hairstyles. Incorporate a number of biotins and iron-rich foods to help support the growth of hair and opt for relaxing hair massages with beneficial ingredients such as pumpkin oil. More severe problems might necessitate medical supervision and the use of antibiotics and steroids.

Q3 - How Long Before Traction Alopecia Is Permanent?

Ans - If diagnosed early the condition can be reversed in 6 months. However, a severely damaged scalp takes up to a year to regrow hair. If scar tissue formation takes place the hair will not grow back automatically and medical treatment will be necessary.

Q4 - What Is Traction Alopecia Caused By?

Ans - Traction alopecia is a hair condition caused when the hair is continuously pulled in an effort to style it into buns, braids, or ponytails. This can cause itching, redness, and pus-producing infections.


Zahra Lokhandwala

Hair Coach

Zahra is the hair coach-in-chief at Traya. She works closely with the doctors to monitor all cases. She is a fitness freak and has not touched sugar in years!

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