Traction Alopecia: How long is too long?

Early Traction Alopecia: Regrowth is Possible

Traction alopecia is a form of hair loss that comes from the tight pulling of hair.  Braids, weaves cornrows, ponytails, man buns, and other hair styles all can contribute to traction alopecia. The most important thing one can do in cases of suspected traction alopecia - is to stop the hair care practice that was likely responsible as soon as possible.

In general, cessation of hair care practices in early traction alopecia is associated with a high chance of regrowth.  However, cessation of hair care practices in long standing traction alopecia is associated with a much lower chance of regrowth.  There are no definitive guidelines for what constitutes early and what constitutes late. In general though, traction hair styles that have gone on for less than a few weeks are often highly regrowable. 

Work up/Evaluation for Traction Alopecia

Diagnosing traction alopecia is said to be a 'clinical diagnosis' - meaning that special tests are usually not needed. For example, a biopsy is seldom needed in cases of traction alopecia. However, a biopsy can be helpful if there is any other diagnosis that is being considered such as a scarring alopecia. Blood tests are advisable for many patients with traction. I advise blood tests for iron, thyroid, vitamin D, and zinc as starting points. Other blood tests could be important depending on the patient's history.  

 

Treatment of Traction Alopecia

As mentioned above, the most important step is simply stopping the hair care practice that caused the pulling in the first place. A physician can help determine whether treatments such as minoxidil, or use of corticosteroids for a short period of time could also be helpful. Taking vitamin or mineral supplements will potentially help if a patient has a particular deficiency. Otherwise, they are likely not going to be helpful.