Prevention & Protection Against Tight Braid Hair Loss

By Dr. John Frank, M.D. – IAHRS, ABHRS,ISHRS, AHLA, XM Radio: ‘The Bald Truth’, New York City, March 7, 2012

Traction Alopecia Prevention & Protection For Tight Braid Hairstyles

Alopecia is a general term that means hair loss. There are many different types of alopecia, from androgenetic alopecia, which is a genetic condition that causes baldness, mostly in men, to alopecia areata, which is when a person’s white blood cells attack and kill their hair follicles because of an underlying autoimmune disorder.

Traction alopecia, however, is a unique type of hair loss condition because it is not caused by disease or genetics. Rather it is caused by lifestyle and hair fashion choices. Specifically, anything that puts prolonged tension (i.e., pulling or “traction”) on a hair follicle can negatively affect that follicle’s ability to grow hair.

Any hairstyle that pulls against the hair roots can cause prolonged tension leading to permanent bald spots. This include such hairstyles as tight ponytails, pigtails, cornrows (a common African America braided done right up against the scalp) and even the more commonly popular hair extensions¹ and hair weaves. In short, any hairstyle that creates a constant pull on the hair roots can damage them, even turbans.

(Note that African Americans can be particularly prone to this type of hair loss, not because black hair tends to be more fragile than other types of hair, but because braided African American hair styles can cause a fair amount of pulling on the hair roots).

Traction Alopecia Prevention

This type of hair loss is not immediately permanent, i.e., if you remove the tension, the hair follicles will recover and hair growth will resume on its own. However, if you maintain traction (pulling) long enough, or if your braiding is excessively tight, it can cause permanent damage. (Hint: if it hurts, you’re probably immediately starting to damage your hair follicles). Once permanent damage occurs, there is no cure for this type of traction alopecia. The only treatment option is a hair transplant to restore the lost hair.

While it’s best to avoid tightly braided hairstyles, following these simple recommendations can help protect your hair from permanent damage:

Regularly change up hair styles, e.g., change where the braids are every other day or so, or switch from braiding one day to ponytails the next.
Take a break. Go without any hair pulling style for a few days each week. This will give your hair roots time to recover.
Never use excessive pulling in any hairstyle.
Start braiding that the tips, not at the roots, of the hair. This helps to reduce the amount of pulling during the braiding.
If possible, removed braids and rubber bands before bed.
Before removing any braids, use a good conditioner. This will decrease hair friction and minimize pulling on the hair roots has you work out any knots. When working out any knots, hold the hair so that pulling on the hair roots is minimized.
Be on the lookout for any patchy areas of hair loss in areas where pulling occurs. This is an early sign of traction alopecia and its nature’s way of saying, “stop!”
Cornrows may be problematic anytime they are used, unfortunately.

If you do notice any hair loss, see a qualified hair loss specialist as soon as possible to assess any damage, and – don’t panic: caught early, you can reverse traction alopecia by simply avoiding whatever hair pulling hairstyle you’ve been using.

References

1. Hair extensions ‘can lead to permanent baldness. Pat Hagan, Mail Online UK, 31 December 2008