Traction Alopecia: The Root of the Problem

Traction alopecia (TA) is a condition that affects one-third of women of African descent who engage in traumatic hairstyling practices such as tight buns, ponytails, weaves, hair extensions, and tight braids like cornrows and dreadlocks, as well as those involved in certain religious and occupational styling. The risk of developing TA increases with the degree of pulling, the duration of traction, and the use of chemical relaxers. Clinically, TA presents as marginal alopecia or non-marginal patchy alopecia, with the preservation of the fringe sign being a diagnostic clue, differentiating it from frontal fibrosing alopecia (FFA). Dermoscopy and histopathology are useful tools for diagnosis, helping to distinguish TA from other conditions like alopecia areata, FFA, and patchy central centrifugal cicatricial alopecia. As there is no cure for TA, it is crucial for clinicians to educate at-risk populations about the condition and the hairstyling practices that increase the risk of hair loss.