Traction alopecia

Traction alopecia
Classification and external resources
Traction alopecia in a Yorkshire terrier caused by hair barrette
ICD-10	L65.8 (ILDS L65.852)
DiseasesDB	32586
eMedicine	derm/895

Traction alopecia is a form of alopecia, or gradual hair loss, caused primarily by pulling force being applied to the hair.^{[1]:761[2]:645} This commonly results from the sufferer frequently wearing their hair in a particularly tight ponytail, pigtails, or braids. It is also seen occasionally in long-haired people who use barrettes to keep hair out of their faces. Traction alopecia is recession of the hairline due to chronic traction, or hair pulling, and is characterized by a fringe along the marginal hairline on physical exam.^[3][4]

Cause

It is commonly seen with certain hair styles or braiding patterns that pull the hairline forcefully towards the vertex of the scalp,^[5][6] and has been reported more often in African American women, in whom it can cause scarring^[7][8] It has also been seen in female ballerinas,^[9] and in cultural traditions where the hair is voluntarily not cut in religious obeisance, the latter caused by progressively increasing weight of the hair itself.^[10] Traction alopecia is mechanical in etiology, rather than androgenic, and treatment is typically not pharmaceutical. Management includes cessation of the chronic traction, cosmeses, with surgical restoration reserved for more severe cases.^[8]

Traction alopecia is a substantial risk in hair weaves, which can be worn either to conceal hair loss, or purely for cosmetic purposes. The former involves creating a braid around the head below the existing hairline, to which an extended-wear hairpiece, or wig, is attached. Since the hair of the braid is still growing, it requires frequent maintenance, which involves the hairpiece being removed, the natural hair braided again, and the piece snugly reattached. The tight braiding and snug hairpiece cause tension on the hair that is already at risk for falling out. Traction Alopecia is one of the most common causes of hair loss in African American women. Other causes include:

• Hairstyle. Although the aforementioned style is one of the culprits, hairstyles such as dreadlocks and single (extension) braids can also have the same effect.^[11] Men and women who have suffered from traction alopecia have found that the hair loss occurs most at the hair line - primarily around the temples and the sides of their heads.^[12]
• Headgear. Compressive safety helmets worn tightly and closely to the scalp are a cause of traction alopecia. The lining of tightly fitted safety helmets like those worn for activities such as motorcycling, cycling, skiing and snowboarding are responsible for the constant rubbing and tugging of localised areas of the hair and scalp. Frequent wearers or those who use such helmets for prolonged periods seem more likely to suffer traction alopecia.^{[citation needed]}

See also

• Croydon facelift - hairstyle that can cause this
• Cicatricial alopecia
• List of cutaneous conditions

References