Before you choose to leave your bed, you suddenly start noticing loose strands on your pillow. Days later, the number of loose strands increase to double on your pillow. And eventually, those strands are all over your place and clogging your drains. The unpleasant and unwelcomed hair loss has been happening from past few months when you were busy ignoring it.

Hair loss can occur due to ageing, hormonal imbalance, nutritional deficiency or tying your hair really tight. Yes, certain hairstyles exert terrible pressure that can lead to hair loss. Such kind of hair loss is termed as “Traction Alopecia.”

Tightly pulled hairstyles cause traction alopecia. It is common among ballet dancers and other sports professionals who wear tight buns or ponytails for long periods. Children and adults are both affected, but it is more common in older people because hair follicles naturally weaken over time.

In the early stage, its reversible and the hair can regrow. If left untreated, hair follicles can become irreversibly damaged, and hair does not regrow. It does not have any genetic predilection. It is most likely due to the habitual routine of managing your hair.

Possible causes of traction alopecia include trendy hairdos like dreadlocks, tight braids and ponytails, cornrows or getting hair extensions which use glue or tightly tied up at the base that generates lots of tension at the roots. Hair accessories like hair slides, if worn every day can also contribute to hair loss. Chemical treatment using hair relaxers makes hair shaft more vulnerable to damage. Lye based hair relaxers contain sodium hydroxide that weakens the internal protein structure, reduces the tensile strength and makes hair more brittle.

A tight bun occasionally won’t do any harm, but if done regularly, it can lead to hair loss. The typical signs include:

· Receding hairline around the forehead or nape.

· Small pustules appearing on the scalp associated with redness, itching and ulceration.

· Patches of scarred skin in advanced cases.

· Burnt skin in case of relaxing or chemical treatment.

In the early stage, various patches of hair loss are visible along the area of the scalp undergoing tension. The pattern of hair loss depends upon the direction of tied hair. The first clinical sign is erythema around follicles which progress into folliculitis. Broken hair and pustules are often seen within follicles. As it advances, in the presence of traumatic hairstyle, it progresses into irreversible scarring alopecia. No new hair grow after follicular atrophy.


Over styling and using too many products, doubtlessly damage your hair. Changing hairstyles frequently and wearing loose braids can help. Avoid elastic hair ties and keep hair loose as often as possible. Invest in deep conditioning regime to recover the damage. Improvise your dietary intake. Consume a diet rich in protein, iron and green leafy vegetables like spinach and broccoli, beans and nuts. Give a break to your sessions of blow dry, straightening and curling.


The management at early stages is merely the relief of the traction forces by changing the hairdo. Avoid any heat or chemical treatment or combing wet hair. Medical management includes combating the inflammation on follicles. Topical and intra-lesional corticosteroids are being used on the area of hair loss along with antibiotic therapy. The advanced lesion does not respond to medical treatment. Hence surgical intervention is required. Hair transplantation is usually done at this stage, along with grafting and flap surgery. It is advised to see a hair specialist before undergoing any kind of treatment. If intervened at earliest, it is absolutely reversible. It is necessary to spread the word about the habits leading to hair loss.