Traction alopecia is common, often preventable and, caught early, often reversible. Caring for it well starts with understanding, respect and good questions.
From the editors
Many clients with textured hair have had experiences in salons and clinics that left them feeling judged, misunderstood or simply unseen. Some have been told their styling choices were the problem before anyone asked a single question. Others have been told nothing at all while a condition quietly progressed.
This edition is about doing better on both counts. Traction alopecia is a real and often preventable form of hair loss, and every practitioner who works with hair should be able to recognise its early signs. But recognition is only useful if it comes with respect, and with an understanding of why people choose the styles they do.
We explain what traction alopecia is and how tension builds over time. We look at how to hold a consultation that begins with curiosity rather than assumptions, and at gentler alternatives that clients can genuinely consider. We also set out, plainly, the signs that mean a client should see a doctor without delay.
We hope it is useful whether textured hair is the centre of your work or something you see only occasionally. Either way, every client deserves a practitioner who knows what to look for and how to ask.
The Trichollective editorial team
Understanding
Hair loss caused by repeated or prolonged pulling is common across many hair types and cultures. It is also one of the few forms of hair loss where early action can make a real difference.
Photograph Alexia / Unsplash
Words by the Trichollective editorial team
Traction alopecia is hair loss caused by tension on the hair follicle over time. It can follow tight braids, cornrows, locs, weaves, extensions, tight ponytails and buns, and the repeated use of heavy accessories or tight headwear. It is seen in people of every background, including dancers, athletes and anyone who regularly wears their hair pulled back firmly. It is more often discussed in relation to textured hair because some common styles for textured hair can place sustained tension on the follicles, especially at the hairline.
The hairline at the temples and forehead is the most commonly affected area, because it takes the most strain in many styles. It can also appear around the ears, at the nape, or wherever extensions or tight partings are attached. Clinicians sometimes notice a thin line of short hairs retained along the very front of the hairline, with thinning just behind it. It is one of the features that can point towards traction.
In its early stages, traction alopecia is often reversible. If the tension is reduced, the follicles can recover. With prolonged strain over many years, the follicles can be damaged permanently and replaced by scar tissue, and hair will no longer grow from those sites. This is why early, sensitive conversations matter so much.
“Early traction alopecia is often reversible. Long-standing traction may not be.
None of these signs alone means a client has traction alopecia, and other conditions can look similar. Your role, unless you are medically qualified, is to notice, describe, discuss and refer where needed. A dermatologist can confirm what is happening and assess whether any scarring is present.
Most importantly, clients who understand the early signs can protect their own hair. A clear explanation, given kindly, may be the most useful thing you offer.
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