Traction alopecia is a common form of black hair loss. While this type of alopecia is seen worldwide, and common to Sikh men and Japanese women due to their traditional hair styles, it is most widely seen in African-American women and men.
Alopecia’s are believed to be the fifth most common dermatological complaint among Black people, with chemical and traction alopecia’s the most common.Population studies show a prevalence of 17.1% in African schoolgirls and of 31.7% in women inflicted, with numbers steadily rising.
There are 2 types of traction alopecia, marginal and non-marginal. Marginal traction is caused by appliances such as tight curlers and rollers, where the hair loss pattern reflects the use of these objects. Whereas a non-marginal pattern occurs created through effects like hair buns creating hair loss in the area where the bun actually sits. This type of alopecia for this reason is often seen in nurses.
Traction alopecia is mainly caused by damage to the dermal papilla and hair follicle, through steady pressure over time. Normally induced by various hair styling practices (e.g. use of braids, hair rollers, weaves, twists, locks, or “cornrows”) Cornrows are most frequently blamed due to the repeated steady high pressure overtime.
The pulling causes hair to loosen from its roots; however, hair loss occurs secondary to follicular inflammation and atrophy. Often the loss is symmetric and along the hairline adjacent to the temples.
Traction Alopecia can also occur due to over processing of the hair.Chemical treatments which use products such as dyes, bleaches, or relaxers can damage the keratin structure rendering the hair extremely fragile. The hair then falls out very easily with brushing or combing.
A form of scarring alopecia also may occur in post-menopausal women, associated with inflammation of hair follicles and subsequent scarring
Individuals usually complain of itching and dandruff at first which is usually followed by patchy areas of hair loss. Other signs may include:
Scalp shows signs inflammation with scales and pustules.
Symmetrical hair loss.
In the initial stages, this hair loss is reversible but with prolonged traction,once scaring occurs and hair follicles are damaged beyond repair, alopecia can be permanent.
Hair styles that put unnecessary strain on the hair root must be changed for looser, less traumatic hair styles.
If you are going to wear your hair braided then it is advisable request that your stylist does not pull or plait them tightly and likewise hairdressers specialising in braids and locks should warn their clients of the possible dangers of prolonged tension.
To summarise the key to stopping traction alopecia is detecting it early. African-American women, who suspect they may be vulnerable to traction alopecia should change their hair styles and seek professional advice.