Traction alopecia is caused by repeated and prolonged tension on the hair. It can affect people of any background or sex. However, it is commonly described in women who wear tight ponytails, plaits, weaves, dreadlocks and the use of hair extensions. It is also seen in Sikh males who twist their uncut hair beneath their turbans. The clinical pattern of hair loss depends on the causative hair care practice. Often hair can be thinner or absent in the hairline at the front or sides of the scalp. Initially, hair loss is non-scarring but if left untreated unopposed tension can lead to permanent destruction or scarring of the hair follicles. Dr Ophelia will make her diagnosis on history and clinical examination findings. To exclude other causes, a scalp biopsy might sometimes be required and characteristic findings may be found.
Education on hair care practices to limit tension and exposure to chemicals/ heat is vital in managing traction alopecia. Further treatment options can include topical treatments, oral medications or injection-based therapies.