Complications of Traction Alopecia







Early Stages

Early histological findings include:

  • Trichomalacia (thinned-out hair)
  • Increased catagen and telogen hairs
  • Normal number of telogen follicles
  • Preserved sebaceous glands
  • Late Stages

As the condition progresses, histological findings include:

  • Development of vellus hairs
  • Reduction and replacement of sebaceous glands and terminal hair follicles by fibrotic tracts
  • Mild to absent inflammation
  • Prevention

To prevent traction alopecia, it is essential to reduce tension on the hair:

  • Change hairstyles regularly to avoid continuous tension.
  • Avoid rubber or elastic bands that can pull out hair.
  • Limit chemical processing if using weaves or braids.
  • Keep hairstyles loose and low on the head.
  • Minimize the use of heat styling tools and avoid sleeping in rollers.
  • Use satin wig caps if wearing wigs to reduce tension on the scalp.


Traction alopecia is reversible if detected and treated early. By discontinuing the hair practices that cause tension, hair can regrow normally. However, if these practices continue, the hair loss may become permanent.


Early signs of traction alopecia include small bumps on the scalp resembling pimples. As the condition progresses, symptoms include:

  • Redness of the scalp
  • Bumps
  • Soreness or stinging
  • Itching
  • Scaling
  • Folliculitis
  • Pus-filled blisters

The hair follicles can become so damaged and scarred that they can no longer produce new hair. Unlike other forms of alopecia, traction alopecia usually affects only the hair that has been pulled.


Mayo Clinic. (2023). Traction Alopecia. Retrieved from

National Health Service (NHS). (2023). Traction Alopecia. Retrieved from

DermNet New Zealand. (2023). Traction Alopecia. Retrieved from

Stanford Health Care. (2023). Traction Alopecia. Retrieved from

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