I first experimented with carrying braids as a protecting fashion in the course of the pandemic. The fashion helped me preserve my thick, coily hair after I couldn’t get my bi-weekly salon blowouts in the course of the lockdown. I opted for lengthy field braids—modern, thick in width, and rope-like—much like the model Janet Jackson wore in Poetic Justice.
Moreover serving to me appear and feel extra put along with minimal effort, the convenience field braids afforded me couldn’t be discounted. The no-fuss fashion was the right selection for me, a low-maintenance lady who wished a simple fashion that seemed polished. I beloved the liberty they gave me. I not needed to make investments 20 minutes day by day fastidiously detangling and styling my multi-textured hair. As a substitute, I might rise up and go about my enterprise shortly, savoring the dear time saved as a substitute of being beholden to my hair.
Thus, it was a no brainer after I selected to maintain the braided coiffure even when hair salons have been allowed to open once more. I had my field braids professionally redone each eight to 10 weeks. Nonetheless, after 18 months of getting braids persistently, I seen that my edges have been thinning. “That appears like traction alopecia to me,” a professional hairstylist instructed me as he inspected my fragile hairline throughout an appointment, lastly making me query whether or not my chosen protecting fashion was “protecting” in any respect. The truth is that any coiffure that creates stress on the root of your hair (suppose braids, buns, ponytails, tight headbands, and so on) can put you prone to hair loss, shedding, or traction alopecia in additional extreme circumstances.
To assist me type out if traction alopecia was the reason for my thinning edges, I reached out to Carl Truesdale, MD, a board-certified facial plastic surgeon and hair transplant surgeon; Hadley King, MD, a board-certified dermatologist; and trichologists Bridgette Hill and Sophia Emmanuel to debate all there may be to learn about traction alopecia, together with how you can acknowledge it, how you can stop it, and how one can develop hair after shedding.
What’s traction alopecia?
Traction alopecia is hair loss attributable to repeated pulling or stress on the scalp. Based on Dr. Truesdale, extreme stress on hair follicles is extraordinarily widespread as a result of rise in reputation of braids, extensions, wigs, and snatched-back hairstyles like buns and ponytails. Whereas anybody can expertise traction alopecia, the situation is widespread in Black ladies, affecting one third of them, based on analysis. “Traction alopecia can have an effect on any space of the scalp that’s pulled tightly, however it primarily impacts the hairline, the crown, and the nape,” Emmanuel tells us. “Over time, extended use of high-tension hairstyles can lead to everlasting hair loss as a result of irreversible injury to hair follicles.”
Dr. Truesdale says that the wrongdoer behind traction alopecia is often power irritation that happens on the hair follicles when hair is pulled too taut. “The fixed irritation can result in thinning, breakage, and finally, balding of the affected space,” he says.
What causes traction alopecia?
Traction alopecia could be attributable to any coiffure that excessively pulls or locations stress on the scalp. These types can even embrace what some check with as “protecting types,” together with braids, twists, locs, weaves, extensions, buns, and ponytails when achieved too tight. “They’re not deemed protecting when achieved improperly,” Hill says. “They’re extra so ‘types of comfort’ as they will trigger extra hurt than good when achieved tightly.” Hill additionally says that utilizing cumbersome extensions in some protecting types may cause bodily stress to your strands by weighing them down and ultimately yanking them out. “Be aware when including hair to your fashion that it is not heavy or carries important weight,” she warns.
Emmanuel additionally says that clip-in hair extensions may cause traction alopecia by repeatedly pulling and urgent on the scalp, which, when achieved repeatedly, can weaken hair follicles over time. Equally, improper-fitting wigs—”whether or not too small or too unfastened”—may cause friction to your edges, contributing to hair loss,” she provides, noting that the glue used for securing wigs may help in thinning your pure hairline. One other contributing issue that will trigger the weakening of the hair follicle is the usage of taut hair equipment, like tightly wound rubber bands, ponytail holders, and comfortable headbands.
What are the indicators of traction alopecia?
Dr. Truesdale says early indicators of traction alopecia embrace an itchy, tender, or pink scalp, small pimple-like bumps alongside the hairline and temples from the pulling stress, and hair breakage. “Because the situation progresses, hair thinning turns into noticeable, and in extreme circumstances, hair follicles are completely broken,” he says. Often, damage to the follicle is visually evident when diagnosing traction alopecia, says Dr. King; nonetheless, a health care provider can conduct a biopsy to rule out different hair loss potentialities.
The right way to deal with traction alopecia?
“When you suspect you might be experiencing traction alopecia, it is important to seek the advice of with a healthcare skilled or a dermatologist,” says Dr. Truesdale. “Early analysis and therapy might help reduce hair loss and enhance your total hair well being.”
First up—loosen your tight fashion
Hill says step one to restoration is to cease carrying compromising hairstyles or utilizing dangerous strategies that pull your hair tightly or trigger extreme friction so that you could relieve any stress in your follicles. This does not imply by no means to put on a ponytail or get field braids once more, however cease and take a minute to loosen your hair tie if it is tugging at your roots (or take it out earlier than mattress) and positively talk with braiders and hairstylists in case your fashion feels too tight.
Adopting practices like sleeping on a silk pillowcase to attenuate further friction or guaranteeing that the band in your bonnet is not too comfortable—together with utilizing mild, nourishing haircare merchandise can even assist. “Hair loss does not occur the primary time you put on a good coiffure. It occurs over time. So if you happen to can preserve the scalp wholesome going ahead, you will get your hair again on monitor,” Dr. King explains. For extra superior circumstances, medical interventions could also be vital, Dr. Truesdale says, with remedies relying on the severity of the hair loss.
Focus on treatment choices along with your physician
The FDA-approved topical treatment minoxidil might help stimulate hair development if no follicle scarring is concerned. Minoxidil works by bettering blood circulation to the scalp, which in flip helps preserve hair in its anagen part—the rising part of hair—longer—some dermatologists prefer to compound minoxidil with tretinoin to enhance its efficacy and scalp absorbency. Moreover, medical doctors can inject topical corticosteroids (just like the FDA-approved injection Kenalog) into the affected areas to cut back irritation attributable to the situation.
Together with the beforehand talked about scalp therapies, Dr. Truesdale additionally likes treating the compromised space with pink gentle remedy, platelet-rich plasma remedy (often known as PRP), or exosome injections to foster scalp well being and hair follicle restoration. Crimson gentle remedy works by exposing areas of hair loss to pink LED gentle to spice up dormant hair follicles into the expansion stage.
PRP includes drawing blood from a affected person and separating the enriched cells, then injecting them again into the scalp to feed the broken follicles and stimulate their stem cells for hair development. Alternatively, exosome remedy is a more moderen scalp process that helps snap dormant hair follicles out of relaxation. Exosomes comprise development components, numerous proteins, and activated stem cell alerts, which might talk with impaired follicle cells to spur hair regeneration.
Nonetheless, if the injury to the follicles is extreme and ends in scarring, the ensuing hair loss can be everlasting, explains Dr. King. “There’s nothing you are able to do to reverse it at that stage,” she tells us. Therefore, a hair transplant could also be your solely viable possibility if that’s the case. The process includes transferring wholesome hair follicles from areas from the again or sides of the scalp—the place hair shouldn’t be usually inclined to balding—to fill within the spots that skilled irreversible hair loss by changing them with new ones, explains Dr. Truesdale.
What can we do to stop traction alopecia?
One of the simplest ways to keep away from traction alopecia is to keep away from tight hairdos altogether, advises Dr. Truesdale. Go for looser types to cut back stress on the hair as a substitute, suggests Hill. When you put on hair extensions, braids, wigs, clip-ins, locs, or twists, guarantee they don’t seem to be so tight, put on them sparsely, and swap up your coiffure typically to provide your hair follicles a relaxation in between.
And bear in mind, when deciding on a braiding professional, search a licensed hairstylist or an skilled artist with a way that minimizes scalp irritation. Most significantly, do not be afraid to talk up if you happen to expertise discomfort, and have them instantly undo the fashion if it is painful, says Hill. We all know it may be a bit awkward to push again within the salon chair, however utilizing your voice on the first signal of discomfort can prevent a lot of stress and ache in the long term.
Last takeaway
Armed with the above data, I paused on regularly getting braids and began sporting a lower-tension coiffure, pronto. I additionally sought the skilled support of a dermatologist to evaluate my hair and scalp and assist decide my finest plan of action. Fortunately, traction alopecia is preventable and reversible in lots of circumstances, particularly if you happen to act quick. Fortunately, the injury to my hairline was superficial, and the dermatologist was capable of bolster it to its unique thickness with a mix of Kenalog pictures and a minoxidil compound prescription.
Will I ever cop again to the comfort of “protecting styling” once more? Most certainly, sure. I am truly contemplating braids for my subsequent week-long trip (which is completely fantastic), however now, I’m well-equipped with the data on how you can put on and take care of them correctly so my hair and scalp can thrive and flourish to the fullest.
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