Traction alopecia

What it is

Traction alopecia is hair loss caused by repeated pulling on the hair roots from tight braids, weaves, cornrows, ponytails, locs or wigs secured with glue or clips. It usually starts at the temples and edges.

How it works

Each hair sits in a follicle anchored by a small muscle and surrounding tissue. Constant pulling inflames the follicle; at first hairs break or shed and regrow, but months to years of tension can scar the follicle so it stops producing hair permanently.

Why it matters on darker skin

Tightly coiled hair is more fragile at the root and is often styled in tension-based styles, so traction alopecia is very common in women of African descent, and also seen in men with tight locs or buns.

Causes and triggers

Tight braids, cornrows, weaves sewn or glued at the hairline, heavy locs, tight ponytails and buns, wig clips and bands, and chemical relaxing combined with tension.

What helps — and why it works

Loosen styles and alternate between tight and loose styles. Keep braids and weaves in for no longer than 6 to 8 weeks, choose larger, lighter braids, and avoid extensions on already thin edges. Early loss can regrow once tension stops; a doctor may suggest treatments to calm inflammation. Loosen styles immediately: removing tension stops ongoing damage. Expected timeline: shedding settles in weeks; regrowth over 3–6 months if not scarred. Alternate styles and rest hairlines: gives follicles time to recover. Expected timeline: ongoing. See a doctor early: anti-inflammatory treatment and minoxidil can help in early stages. Expected timeline: assessed after 3–6 months.

What to avoid and why

Avoid styles that hurt, cause bumps or pimples at the roots, or make your scalp feel tight. Avoid gluing wigs directly onto the hairline and sleeping in tight rollers.

Common mistakes

• Edge-control gels and very tight 'slick' styles every day.
• Re-braiding the same tight style straight after taking one out.
• Waiting until the hairline is smooth and shiny — that suggests scarring.

Handling textured hair gently

Coily and curly hair is naturally the most fragile hair type because each bend in the strand is a weak point and natural oils travel down it slowly. That makes handling — how often and how firmly hair is combed, styled and pulled — as important as which products you buy. Detangle only when hair is wet and coated in conditioner, working in sections from the ends towards the roots with fingers or a wide-tooth comb. Keep heat to the lowest effective setting and always use a heat protectant. Sleep on satin or silk, or wear a satin bonnet, to reduce friction. Between wash days, a water-based leave-in followed by a light oil or cream helps hold moisture. Give the scalp attention too: it is skin, and needs regular cleansing, especially under wigs, weaves and braids, to prevent build-up, itch and infection. Any style that hurts, causes bumps or leaves the scalp tender is too tight and should be loosened. Hair grows about one centimetre a month, so changes in care take two to three months to show in length and thickness.

Scalp health and product choice

Choose a shampoo that suits the scalp and a conditioner that suits the lengths: the scalp may need cleansing or a medicated shampoo while the ends need moisture. Fragrance, essential oils and heavy waxes can irritate a sensitive scalp or cause build-up, and heavy oils on the scalp may worsen dandruff. Look for a clear ingredient list and a NAFDAC number, and patch-test new dyes and relaxers 48 hours before every use. Products that promise dramatic growth are usually untested; the treatments with the best evidence for pattern hair loss are medicines such as minoxidil, which should be started only after speaking to a pharmacist or doctor. Signs that you need medical advice rather than a new product include patches of hair loss, scarring or shiny skin, pain, pus, or shedding that continues for more than six months.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.