Traction Alopecia in Two Adolescent Sikh Brothers: An Underrecognized Problem Unmasked by Migration

The document reports on two adolescent Sikh brothers who developed traction alopecia, a form of permanent hair loss, due to prolonged physical damage to the hair shaft from wearing a turban tightly since early childhood. The condition was unmasked after they migrated to Austria and stopped wearing their traditional headgear, revealing a band-like scarring alopecia at the frontal hairline. A punch biopsy confirmed the diagnosis, showing a marked loss of hair follicles and fibrous tracts without significant inflammation. The paper emphasizes that traction alopecia in Sikh males is likely underreported and suggests that early modification of hair care routines could prevent this irreversible hair loss. For those with permanent alopecia, hair transplantation remains the only effective treatment. The study highlights the influence of cultural and religious practices on hair care and the potential for such practices to cause hair loss.