Do Tight Hairstyles Trigger Traction Alopecia?

I first experimented with sporting braids as a protecting fashion in the course of the pandemic. The fashion helped me preserve my thick, coily hair once I couldn’t get my bi-weekly salon blowouts in the course of 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 feel and look extra put along with minimal effort, the benefit field braids afforded me couldn’t be discounted. The no-fuss fashion was the proper selection for me, a low-maintenance lady who wished an easy fashion that regarded polished. I beloved the liberty they gave me. I now not needed to make investments 20 minutes day by day fastidiously detangling and styling my multi-textured hair. As a substitute, I may stand up and go about my enterprise shortly, savoring the dear time saved as a substitute of being beholden to my hair.

Thus, it was a no brainer once I selected to maintain the braided coiffure even when hair salons have 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 observed that my edges have been thinning. “That appears like traction alopecia to me,” a professional hairstylist instructed 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 pressure on the root of your hair (assume braids, buns, ponytails, tight headbands, and so forth) can put you vulnerable to hair loss, shedding, or traction alopecia in additional extreme instances.

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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 find out about traction alopecia, together with the way to acknowledge it, the way 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 pressure on the scalp. In response to Dr. Truesdale, extreme stress on hair follicles is extraordinarily frequent 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 frequent in Black girls, affecting one third of them, in keeping 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 as a result of irreversible harm to hair follicles.”

Dr. Truesdale says that the offender 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 in the end, 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 pressure on the scalp. These kinds also can embody what some discuss with as “protecting kinds,” together with braids, twists, locs, weaves, extensions, buns, and ponytails when executed too tight. “They’re now not deemed protecting when executed improperly,” Hill says. “They’re extra so ‘kinds of comfort’ as they’ll trigger extra hurt than good when executed tightly.” Hill additionally says that utilizing cumbersome extensions in some protecting kinds may 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’s not heavy or carries vital weight,” she warns. 

Emmanuel additionally says that clip-in hair extensions may cause traction alopecia by repeatedly pulling and urgent on the scalp, which, when executed repeatedly, can weaken hair follicles over time. Equally, improper-fitting wigs—”whether or not too small or too free”—may cause friction to your edges, contributing to hair loss,” she provides, noting that the glue used for securing wigs might also 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 cushty headbands. 

What are the indicators of traction alopecia? 

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

deal with traction alopecia?

“When you 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 prognosis and remedy may 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 to be able to relieve any pressure in your follicles. This doesn’t suggest 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 reduce further friction or guaranteeing that the band in your bonnet is not too cosy—together with utilizing mild, nourishing haircare merchandise also can assist. “Hair loss would not occur the primary time you put on a decent coiffure. It occurs over time. So if you happen to can maintain the scalp wholesome going ahead, you may get your hair again on observe,” Dr. King explains. For extra superior instances, medical interventions could also be vital, Dr. Truesdale says, with remedies relying on the severity of the hair loss.

Focus on remedy choices together with your physician

The FDA-approved topical remedy minoxidil may help stimulate hair development if no follicle scarring is concerned. Minoxidil works by bettering blood circulate to the scalp, which in flip helps maintain 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, medical doctors can inject topical corticosteroids (just like the FDA-approved injection Kenalog) into the affected areas to scale 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 crimson gentle remedy, platelet-rich plasma remedy (also called PRP), or exosome injections to foster scalp well being and hair follicle restoration. Purple gentle remedy works by exposing areas of hair loss to crimson 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 development. Then again, exosome remedy is a more moderen scalp process that helps snap dormant hair follicles out of relaxation. Exosomes comprise development elements, varied proteins, and activated stem cell alerts, which may talk with impaired follicle cells to spur hair regeneration. 

Nonetheless, if the harm to the follicles is extreme and leads to 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 choice 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 will not be usually vulnerable 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? 

One of the simplest ways to keep away from traction alopecia is to keep away from tight hairdos altogether, advises Dr. Truesdale. Go for looser kinds to scale back pressure on the hair as a substitute, suggests Hill. When you put on hair extensions, braids, wigs, clip-ins, locs, or twists, guarantee they are not so tight, put on them carefully, and change up your coiffure usually to provide your hair follicles a relaxation in between.

And bear in mind, when choosing 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 if you happen to 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 numerous stress and ache in the long term. 

Remaining takeaway 

Armed with the above information, I paused on continuously getting braids and began sporting a lower-tension coiffure, pronto. I additionally sought the skilled support of a dermatologist to evaluate my hair and scalp and assist decide my greatest plan of action. Fortunately, traction alopecia is preventable and reversible in lots of instances, particularly if you happen to act quick. Fortunately, the harm to my hairline was superficial, and the dermatologist was capable of bolster it to its authentic 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 high-quality), however now, I’m well-equipped with the data on the way to put on and look after them correctly so my hair and scalp can thrive and flourish to the fullest.