Facts not fiction: traction alopecia treatment

Traction alopecia- close-up of beautiful black woman smiling

If you sweep your hair back only to see your scalp peeking through at the sides, you might be experiencing traction alopecia—and be desperate for treatment. But as scary as something that means balding sounds, it’s not all bad news. With traction alopecia, most women’s hair does grow back. However, first you need to know fact from fiction and what to do.

Hair thinning and loss in women

Women in her 30s noticing hair loss on the sides and holding up her hair brush with lots of hair strands inside of the bristles- traction alopecia treatment

There are many reasons why you might be losing more than the average 50 to 100 strands a day that’s completely normal. But if you think you have traction alopecia because you’re thinning only at the sides, you’ll want to have an understanding of alopecia itself before you dive into how to treat it. Alopecia is the medical term for hair loss. Despite what lots of people think, both women and men suffer from unwanted hair loss and balding. In fact, more than 50% of women experience hair loss during their lifetime.

Many different types of alopecia exist. The root cause of each type can be slightly different. For example, the most common type of alopecia is female-pattern hair loss, or androgenic alopecia. (Also called androgenetic alopecia.) Female-pattern hair loss is primarily genetic. With the condition, hair follicles act super sensitive to the hormone dihydrotestosterone, or DHT. DHT shrinks hair follicles, causing hair loss. Over time, these follicles stop growing new hairs.

Hormone imbalances can also lead to hair loss. Autoimmunity causes several other types of hair loss as well. Examples include frontal fibrosing alopecia and alopecia areata. Once considered relatively rare, both are becoming much more common.

What causes traction alopecia

Illustration of strong woman pulling rope in tug-of-war concept. Similar to causes of traction alopecia (pulling)

So what exactly causes traction alopecia? Key word: traction. Each time you pull your hair back tightly, it’s kind of like a game of tug-of-war between your hair follicles and your hairband. There’s a lot of pulling between the two. Traction alopecia occurs at any age. But as we get older, it becomes more common—especially if we repeatedly wear more severely pulled-back styles.

Traction alopecia used to be primarily seen in ballerinas and swimmers who wore tight swim caps. Traction alopecia also disproportionately affects black women, whose gorgeous braids may pull at the hair along the hair line. It’s also common to see it more in women as they age. The biggest reason? Our hair follicles become weaker as we get older. Hairstyles that used to not lead to hair loss for you may just put too much stress on your hair follicles.

What you can do for traction alopecia treatment

Beautiful black woman wearing hair down in braids- traction alopecia treatment

Our society places so much emphasis on thick, shiny hair. Seeing your strands thin or spotting your scalp due to hair loss feels like cause for panic. But as hard as it is, try not to stress too much. Stress is a known cause of hair loss and will make any thinning you have even worse. First, take a deep breath and keep calm.

Call your physician, and make an appointment with a dermatologist if you can

Having a chat with your physician is helpful. They can run some labs to see if your hair loss is being compounded by your thyroid, menopause, or nutrient deficiencies. Also make an appointment with a dermatologist. Dermatologists are your most knowledgeable healthcare providers about the skin and the hair. Getting in with a dermatologist allows them to look at your scalp and follicles for inflammation, evaluate the pattern of your hair loss, and discuss what’s really and truly happening. Being diagnosed is ultra important. It gives you peace of mind about what you’re dealing with. And it also ensures that you’re getting the right treatment for your type of alopecia.

If your diagnosis is traction alopecia

There’s no real formal treatment for traction alopecia. But before you let out an inward scream from frustration, hear this: traction alopecia generally corrects itself over time. Instead of medications, the real way to help your hair grow back is to stop pulling your hair into any restrictive styles. The best thing to do? Wear your hair down as much as possible. Absolutely 100% need to pull it back? Make your ponytail loose. Don’t wear headbands or scarves tight either.

For other types of alopecia, different treatments may be warranted—like finasteride or dutasteride and even Plaquenil. But, for traction alopecia, just stopping hairstyles that are tugging on the hair is enough for most women. That said, be prepared to wear you hair down for a while. Hair growth is a process. It doesn’t happen magically fast, but it will happen over time. If your dermatologist recommends it, rubbing minoxidil, or Rogaine, into that area of your scalp can help encourage new growth. (Rogaine is available over-the-counter. Staring at all the options in the store? You’ll want to get the type of minoxidil that’s a 5% foam.) They may also recommend supplements, like Viviscal, to ensure you’re getting nutrients to promote growth.

How important is it to stop pulling your hair back?

With traction alopecia, if you want hair regrowth, it’s necessary to give those hairstyles a rest. Like we said, traction alopecia almost always leads to regrowth with those steps. But if you don’t make changes to your hairstyling? Your hair loss could become permanent. That’s because the follicles will eventually scar from all of the pulling. Once it does, you won’t be able to expect new strands to come in.