Do Tight Hairstyles Trigger Traction Alopecia?

I first experimented with sporting braids as a protecting fashion through the pandemic. The fashion helped me keep my thick, coily hair after I couldn’t get my bi-weekly salon blowouts through the lockdown. I opted for lengthy field braids—modern, thick in width, and rope-like—just like the model Janet Jackson wore in Poetic Justice.

Moreover serving to me appear and feel extra put along with minimal effort, the convenience field braids afforded me couldn’t be discounted. The no-fuss fashion was the right selection for me, a low-maintenance girl who wished a simple fashion that seemed polished. I cherished the liberty they gave me. I now not needed to make investments 20 minutes each day rigorously detangling and styling my multi-textured hair. As an alternative, I might rise up and go about my enterprise rapidly, savoring the valuable time saved as an alternative of being beholden to my hair.

Thus, it was a no brainer after I selected to maintain the braided coiffure even when hair salons had been allowed to open once more. I had my field braids professionally redone each eight to 10 weeks. Nonetheless, after 18 months of getting braids constantly, I seen that my edges had been thinning. “That appears like traction alopecia to me,” a professional hairstylist informed me as he inspected my fragile hairline throughout an appointment, lastly making me query whether or not my chosen protecting fashion was “protecting” in any respect. The fact is that any coiffure that creates stress on the root of your hair (assume braids, buns, ponytails, tight headbands, and so forth) can put you prone to hair loss, shedding, or traction alopecia in additional extreme instances.

To assist me kind out if traction alopecia was the reason for my thinning edges, I reached out to Carl Truesdale, MD, a board-certified facial plastic surgeon and hair transplant surgeon; Hadley King, MD, a board-certified dermatologist; and trichologists Bridgette Hill and Sophia Emmanuel to debate all there’s to learn about traction alopecia, together with tips on how to acknowledge it, tips on how to forestall it, and how one can develop hair after shedding.

What’s traction alopecia?

Traction alopecia is hair loss brought on by repeated pulling or stress on the scalp. In line with Dr. Truesdale, extreme stress on hair follicles is extraordinarily widespread because of the rise in reputation of braids, extensions, wigs, and snatched-back hairstyles like buns and ponytails. Whereas anybody can expertise traction alopecia, the situation is widespread in Black girls, affecting one third of them, in line with analysis. “Traction alopecia can have an effect on any space of the scalp that’s pulled tightly, however it primarily impacts the hairline, the crown, and the nape,” Emmanuel tells us. “Over time, extended use of high-tension hairstyles may end up in everlasting hair loss because of irreversible injury to hair follicles.”

Dr. Truesdale says that the wrongdoer behind traction alopecia is often continual irritation that happens on the hair follicles when hair is pulled too taut. “The fixed irritation can result in thinning, breakage, and finally, balding of the affected space,” he says.

What causes traction alopecia? 

Traction alopecia might be brought on by any coiffure that excessively pulls or locations stress on the scalp. These types may embrace what some consult with as “protecting types,” together with braids, twists, locs, weaves, extensions, buns, and ponytails when carried out too tight. “They’re now not deemed protecting when carried out improperly,” Hill says. “They’re extra so ‘types of comfort’ as they will trigger extra hurt than good when carried out tightly.” Hill additionally says that utilizing cumbersome extensions in some protecting types could cause bodily stress to your strands by weighing them down and finally yanking them out. “Be aware when including hair to your fashion that it is not heavy or carries important weight,” she warns. 

Emmanuel additionally says that clip-in hair extensions could cause traction alopecia by repeatedly pulling and urgent on the scalp, which, when carried out repeatedly, can weaken hair follicles over time. Equally, improper-fitting wigs—”whether or not too small or too unfastened”—could cause friction to your edges, contributing to hair loss,” she provides, noting that the glue used for securing wigs may help in thinning your pure hairline. One other contributing issue that will trigger the weakening of the hair follicle is using taut hair equipment, like tightly wound rubber bands, ponytail holders, and comfortable headbands. 

What are the indicators of traction alopecia? 

Dr. Truesdale says early indicators of traction alopecia embrace an itchy, tender, or purple scalp, small pimple-like bumps alongside the hairline and temples from the pulling stress, and hair breakage. “Because the situation progresses, hair thinning turns into noticeable, and in extreme instances, hair follicles are completely broken,” he says. Often, damage to the follicle is visually evident when diagnosing traction alopecia, says Dr. King; nonetheless, a physician can conduct a biopsy to rule out different hair loss potentialities. 

How one can deal with traction alopecia?

“If you happen to suspect you might be experiencing traction alopecia, it is important to seek the advice of with a healthcare skilled or a dermatologist,” says Dr. Truesdale. “Early analysis and remedy might help decrease hair loss and enhance your general hair well being.”

First up—loosen your tight fashion

Hill says step one to restoration is to cease sporting compromising hairstyles or utilizing dangerous methods that pull your hair tightly or trigger extreme friction so that you could relieve any stress in your follicles. This does not imply by no means to put on a ponytail or get field braids once more, however cease and take a minute to loosen your hair tie if it is tugging at your roots (or take it out earlier than mattress) and undoubtedly talk with braiders and hairstylists in case your fashion feels too tight.

Adopting practices like sleeping on a silk pillowcase to attenuate further friction or guaranteeing that the band in your bonnet is not too cosy—together with utilizing light, nourishing haircare merchandise may assist. “Hair loss would not occur the primary time you put on a good coiffure. It occurs over time. So for those who can hold the scalp wholesome going ahead, you will get your hair again on observe,” Dr. King explains. For extra superior instances, medical interventions could also be vital, Dr. Truesdale says, with therapies relying on the severity of the hair loss.

Talk about treatment choices together with your physician

The FDA-approved topical treatment minoxidil might help stimulate hair progress if no follicle scarring is concerned. Minoxidil works by bettering blood movement to the scalp, which in flip helps hold hair in its anagen section—the rising section of hair—longer—some dermatologists prefer to compound minoxidil with tretinoin to enhance its efficacy and scalp absorbency. Moreover, docs can inject topical corticosteroids (just like the FDA-approved injection Kenalog) into the affected areas to cut back irritation brought on by the situation. 

At the side of the beforehand talked about scalp therapies, Dr. Truesdale additionally likes treating the compromised space with purple gentle remedy, platelet-rich plasma remedy (also called PRP), or exosome injections to foster scalp well being and hair follicle restoration. Crimson gentle remedy works by exposing areas of hair loss to purple LED gentle to spice up dormant hair follicles into the expansion stage.

PRP includes drawing blood from a affected person and separating the enriched cells, then injecting them again into the scalp to feed the broken follicles and stimulate their stem cells for hair progress. Alternatively, exosome remedy is a more moderen scalp process that helps snap dormant hair follicles out of relaxation. Exosomes comprise progress components, varied proteins, and activated stem cell alerts, which might talk with impaired follicle cells to spur hair regeneration. 

Nonetheless, if the injury to the follicles is extreme and ends in scarring, the ensuing hair loss might be everlasting, explains Dr. King. “There’s nothing you are able to do to reverse it at that stage,” she tells us. Therefore, a hair transplant could also be your solely viable possibility if that’s the case. The process includes transferring wholesome hair follicles from areas from the again or sides of the scalp—the place hair isn’t usually inclined to balding—to fill within the spots that skilled irreversible hair loss by changing them with new ones, explains Dr. Truesdale. 

What can we do to stop traction alopecia? 

The easiest way to keep away from traction alopecia is to keep away from tight hairdos altogether, advises Dr. Truesdale. Go for looser types to cut back stress on the hair as an alternative, suggests Hill. If you happen to put on hair extensions, braids, wigs, clip-ins, locs, or twists, guarantee they don’t seem to be so tight, put on them carefully, and swap up your coiffure usually to offer your hair follicles a relaxation in between.

And keep in mind, when deciding on a braiding professional, search a licensed hairstylist or an skilled artist with a method that minimizes scalp irritation. Most significantly, do not be afraid to talk up for those who expertise discomfort, and have them instantly undo the fashion if it is painful, says Hill. We all know it may be a bit awkward to push again within the salon chair, however utilizing your voice on the first signal of discomfort can prevent a lot of stress and ache in the long term. 

Ultimate takeaway 

Armed with the above data, I paused on regularly getting braids and began sporting a lower-tension coiffure, pronto. I additionally sought the skilled assist of a dermatologist to evaluate my hair and scalp and assist decide my finest plan of action. Fortunately, traction alopecia is preventable and reversible in lots of instances, particularly for those who act quick. Fortunately, the injury to my hairline was superficial, and the dermatologist was in a position to bolster it to its unique thickness with a mixture of Kenalog photographs and a minoxidil compound prescription. 

Will I ever cop again to the comfort of “protecting styling” once more? Most certainly, sure. I am truly contemplating braids for my subsequent week-long trip (which is completely effective), however now, I’m well-equipped with the data on tips on how to put on and take care of them correctly so my hair and scalp can thrive and flourish to the fullest.