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Traction Alopecia

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Hair loss is medically known as alopecia. There are many types of hair loss. Traction alopecia is
caused by repeated trauma of hair loss. It also can happen from pulling your hair back into tight
hairstyles. TA or Traction alopecia affects almost one-third of women of Africa who generally
wear various tight and traumatic hairstyles for a long period of time. That causes them hair loss.
The risk of traction alopecia is increasing day by day by the extent of pulling, duration of traction
and also overuse chemical relaxations.

Traction alopecia is commonly seen in Afro-Caribbean hairstyles like tight braids. Hair loss
occurs mainly in the temporal regions, preauricular region, and above the ears. But it also
involves other parts of the scalp, particularly where “cornrow‘ patterns are adopted. There is a
possibility that it can be associated with a headache relieved when the hair is loosened. The
pattern of the alopecia is characteristic and reflects the distribution of the traction. Problems can
start from childhood, where they could be initially reversible. Temporal thinning can be a part of
genetic hair patterns seen in those with no traction.

The regular use of tight buns, the attachment of different kinds of hair extensions, high and tight
ponytails, and tight braids which are mostly known as dreadlocks are believed to be risky
hairstyles and the cause of traction alopecia. TA can also happen because of the religious and
occupational traumatic hairstyles. It may start slowly but in later stages, the disease might
progress into irreversible scarring alopecia if the risk and traumatic hairstyles continue
without appropriate intervention.

According to history, we can find that TA is associated with religious practice. The religion
Sikhism which originated in Punjab, a region of India, prohibits its men and women followers
from cutting their hair to convey respect for God’s creation of man. From 11 to 16 years of age,
the Sikh men participate in a ceremony called ‘Dastasr Bandi‘ in which he tries on their first
turban. From that time onward, that person will tightly twist all of his hair into a knot that sits on
the front part of his head. Then he will tightly wrap his turban around the hair to cover the top of the
head and it will be worn for 24 hours before being removed so that he can comb his hair and
wrap a new turban. It can cause traction alopecia.

In Turkey, we can see that Turkish women wear a turban which is different from the Sikh men
consisting of two layers. The first layer is securely wrapped around the hair and head with the
second layer wrapped on top of the first layer. In a study by Polat, we find Turkish women
who wore their turban for 10 years or more noted to have an extension of hair loss.

We can see this in the most common clinical presentation including marginal alopecia and
non-marginal patchy alopecia. A clue for the clinical diagnosis is the preservation of the fringe
sign as opposed to its loss in the frontal fibrosing alopecia or FFA. In the diagnosis and
detection of ongoing traction by the presence of hair casts, dermoscopy can be very helpful.
Histopathology can distinguish traction alopecia from alopecia areata, FFA, and patchy central
centrifugal alopecia. For that reason, it is crucial that clinicians educate the high-risk population
about traction alopecia (TA), and those who practice it may convey the risk of hair loss.
If someone has traction alopecia, they may have some of the symptoms mentioned below-

  • Redness
  • Itching
  • Folliculitis or pustules
  • Thinning hair or hair loss

It is very important to act quickly to avoid more damage to your hair if you have these
symptoms. Despite the fact that there is no cure, hair can regrow if treated early. But fortunately,
there are treatment options available to help you like behavioral modification, topical
applications, and injectables.

If you have any symptoms of traction alopecia you must ignore tight and traumatic hairstyles like –
tight ponytail, braiding, cornrows or dreadlocks, tight buns, using hair extinguishers. It will help
you a lot and you will be able to have healthy hair

Victor E. Lbarra

Victor E. Lbarra


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