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Hair problem
Traction alopecia is hair loss caused by repeated tension at the root. It happens with tight hairstyles, extensions, hairpieces or close-fitting wigs worn for months or years. If it is detected early and the tension stops, it may be reversible. Here we explain how to recognise it and what the clinic can offer.
Reviewed by Dr Michelle Campagnoli, clinical director
How to recognise it
Traction alopecia appears where the hair is pulled most. These signs can help you tell whether your hairstyle may be putting a strain on your roots.
Tick what you recognise
Tick the signs you recognise in your case. This is not a diagnosis, it is only meant to give you an idea.
You recognise some of these signs. There may be tension straining the roots, or another cause. Only a medical assessment can say for sure.
Several signs match traction alopecia. The sooner the tension eases, the more likely the hair is to recover. Only a medical assessment can confirm it.
Book an assessment consultationSevere pain, sores, pus, crusts or round patches unrelated to your hairstyle should be seen without delay, because they may have another cause.
Front hairline. Where a ponytail or braids pull, the hair may thin and be left with fine, short hairs.
Area under tension. It may be the root of a braid, a bun or an extension, where the scalp becomes sore or develops spots.
Temples. This is the most common area: the hair is fine and suffers a lot from tension, and the patch follows the hairstyle.
Why it happens
It is the combination that counts: the force, the duration and each person's sensitivity. Choose a factor to see what makes it worse and what helps.
When the hair is pulled every day, the root is under constant tension. Over time, the follicle becomes inflamed and may weaken, especially if the hairstyle is always the same.
Keeping the same tight hairstyle day after day, with no breaks.
Varying the hairstyle, changing the point of attachment and letting the hair down regularly.
The added weight and the attachment close to the root increase traction. Close-fitting wigs and hairpieces can also pull on the front hairline and temples.
Heavy or very tight extensions, kept in for a long time.
Choosing lighter weight and gentler attachment, respecting removal deadlines and giving the scalp breaks.
In the early stages there is mostly inflammation, and the hair may recover when the tension stops. If it continues for years, the follicle may scar and the loss may become permanent.
Ignoring the pain or spots and carrying on with the same tension.
Recognising the signs early and easing the tension before the loss sets in.
Finer hair, or hair weakened by chemicals and heat, tolerates tension less well. Some treatments applied at the roots add to the effect of the hairstyle.
Straightening, bleaching and too much heat on hair that is already under tension.
Moisturising, spacing out chemical treatments and treating the hair gently.
Deficiencies, thyroid problems, stress or other forms of alopecia can coexist and make the thinning worse. The assessment helps separate what is traction from what has another origin.
Blaming everything on the hairstyle, or not linking it to the patch.
A consultation to look at the whole picture and confirm the cause.
Traction or another cause
Not every patch near the hairline comes from traction. These signs help distinguish what follows the hairstyle from what calls for further investigation.
What it looks like. The thinning follows the shape of the hairstyle, with short little hairs in the area under tension.
How it progresses. Gradually, over months or years, and it may stabilise or improve when the tension stops.
What the clinic does. The doctor examines the scalp, assesses whether the follicles are still active and proposes a plan.
Follow-up. Reviews to see how the hair responds and adjust the plan.
What it looks like. Round patches, diffuse loss or a receding hairline unrelated to the hairstyle.
Warning. Severe pain, sores, pus, crusts or scars call for assessment without delay.
What the clinic does. The doctor looks for other causes, such as alopecia areata, deficiencies, thyroid problems or other forms of alopecia.
Tell us at the consultation. Which hairstyles you wear, for how long and whether you feel pain: it helps in choosing.
Have you noticed your hair thinning where it is pulled? Book an assessment consultation, so the doctor can work out whether it is traction alopecia and what can be done.
Book an assessment consultationWhat the clinic can do
The essential step is to ease the tension. Then the doctor assesses the scalp and may propose treatments to support the follicles that are still active. The plan is always designed for you.
Regeneration
Vitamins, amino acids, minerals and hyaluronic acid, to nourish the scalp and support finer hair.
Suitable when
the scalp is irritated or the hair has been weakened by tension and the doctor considers nourishment appropriate.
Find out more→
Regeneration
Platelet-rich plasma, obtained from your own blood, to stimulate the follicle. The doctor first assesses whether it is appropriate.
Suitable when
there is thinning at the temples or the front hairline and the follicles still seem active.
Find out more→
Advanced regeneration
Regenerative solution to support follicle repair and improve hair thickness.
Suitable when
the doctor considers it useful to reinforce the plan with a regenerating active ingredient, once the tension has eased.
Find out more→What about oral therapy and other medical options? When there is scalp inflammation or an associated cause, the doctor explains the options and chooses them after the assessment and, if useful, blood tests. Results are gradual and depend on the tension stopping.
What the journey looks like
No treatment starts without an assessment consultation with the doctor. This is how it works.
The doctor asks which hairstyles or extensions you use, since when and how often, whether there is pain or spots, and examines the scalp and the areas under tension.
If useful, the doctor requests blood tests to rule out other causes, such as deficiencies or thyroid changes, and explains what to expect and how long it may take.
Combines the treatments that make sense with a change in hairstyle habits, always adapted to your lifestyle.
We look at the hair again after a few months and adjust the plan, because recovery is gradual.
Day to day
Reducing tension matters most, and it can be done without giving up your style. These are the habits that count most.
The golden rule
This is the change in habits that counts most. The sooner the root stops being pulled, the more likely the hair is to recover. If the tension continues for years, the loss may become permanent.
Changing the point of tension gives the root a rest.
In practice: alternate between a low ponytail, hair down and other styles, and change the position of the hair tie.
The scalp needs breaks.
In practice: let your hair down at home and at night, whenever possible.
Thin hair ties cut and pull.
In practice: use wide fabric hair ties, with no metal, and prefer looser hairstyles.
Pain and spots warn that there is too much tension.
In practice: if your hairstyle hurts, let it down and talk to us, without waiting.
If the hairstyle already hurts, more tension makes it worse.
In practice: do not tighten to keep it in place.
The weight pulls on the root constantly.
In practice: choose a lighter weight and respect removal deadlines.
The tension lasts for hours on end.
In practice: let it down or use a loose silk or satin tie.
Persisting with pain and spots can make the damage worse.
In practice: at the first sign, let your hair down and book a consultation.
Who will look after you
At Luxmed, the first step is always an assessment consultation with Dra. Michelle Campagnoli. She works out whether it is traction alopecia, requests blood tests if useful and designs the plan with you, without judging your hairstyles.
Hair medicine
The first signs and when to ask for an assessment.
Read the article →
Hair medicine
How to keep your style with less tension on the roots.
Read the article →
Hair medicine
Warning signs and what to do before the loss sets in.
Read the article →Other hair problems
Book a consultation
Choose how you prefer to get in touch. We will arrange the assessment consultation with Dr Michelle Campagnoli.
New Life Miraflores, Algés · Office Center, R. Santa Teresa do Menino Jesus n.º 6, 9.º C, 1495-048
Your details are used only for this contact. Any treatment depends on a prior medical assessment.
They can, if the tension is strong and repeated over a long time. The root is pulled every day and the follicle may become inflamed. A loose, occasional ponytail is usually well tolerated.
It is hair loss caused by repeated tension at the root, from hairstyles, extensions or hairpieces that pull. The thinning usually appears at the temples, the front hairline or along the parting.
They can, when they are very tight, heavy or kept in for a long time. They are not a problem in themselves: what counts is the tension and the duration. There are ways to wear them with less risk.
It can, if the alopecia is detected early and the tension stops. If it persists for years, the follicle may scar and the loss may become permanent. The doctor assesses what stage you are at.
It usually follows the shape of the hairstyle, with fine little hairs in the area under tension, and there may be pain, spots or redness. Only a medical assessment can confirm it and rule out other causes.
The essential step is to ease the tension. The doctor assesses the scalp and, depending on the case, may propose NCTF hair treatment, hair PRP, hair exosomes or oral therapy. Nothing is decided before the consultation.
It varies greatly from person to person and depends on how long the tension has been there. Results are gradual and usually become noticeable after a few months. The doctor explains what to expect.
Not always. At the consultation, the doctor helps you find a way to keep your style with less tension, for example with looser hairstyles and breaks. We respect your cultural and professional choices.
When you notice your hair is thinner at the temples or the front hairline, or you have pain or spots after a tight hairstyle. The earlier, the better the chances of recovery.
They help look after the hair, but on their own they do not ease the tension that causes the problem. The most important thing is to change the habit and, if needed, ask for an assessment.
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The assistant does not give diagnoses or replace a consultation. The plan and cost of any treatment are set at the medical assessment.