Last Updated on December 17, 2020 by Dr Sanusi Umar MD

Updated on: 12/15/2020 by Sanusi Umar MD.


What is Traction Alopecia? Traction alopecia is a hair thinning and baldness that results from harsh hairstyles that exert pulling tension on hair roots. The term “tension hair loss.”  has been used by some doctors for this reason. Examples of traction alopecia causing hairstyles include braids, tight or heavy weaves, ponytails, etc. Because these hairstyles remain popular among African American women, traction alopecia affects their demographic in greater numbers. In traction alopecia, hair loss begins in the areas of maximum hair pull, such as the edges or hairline. Hair loss sets in gradually over time. All hairstyles that exert a pulling force on the root of the hair cause traction hair loss if done over a long and sustained period of time. Worst of all: hair lost because of tension alopecia will not grow back, resulting in permanent hair balding.


This video shows the patient’s years of harsh grooming practices that have taken their toll on her hairline, as hair follicles sustained trauma from tight ponytails, braids, and other hairstyles that involve a pulling force. Looking for the best cure for permanent traction alopecia hair loss, she found Dr. Sanusi Umar. Using his specialized Dr.UPunch Curl tool, Dr. U was able to successfully extract viable curly-hair follicles for implant into the areas of hair loss – a feat considered nearly impossible with conventional approaches to afro-textured hair FUE. 

Braids and Weaves: The Main Causes of Traction Alopecia

To avoid hair loss women should learn about traction alopecia prevention and treatment

What causes traction alopecia: Although convenient, weaves cause traction hair loss along the hairline.

Much of the procedure in braiding involves pulling the hair down or up, depending on the style, and applying immense pressure for tight intertwining. The purpose of braids, whether individual braids or cornrows, is for the look to last. For this reason, hairstylists intertwine the hair with intensity. Some stylists also use gel to control flyaways. Unfortunately, the alcohol found in gels makes the situation worse, since alcohol thins out the hair.

Weaves also put women at just as much risk as braids for tension hair loss especially in the hairline margins. Styling hair in weaves typically involves harsh chemicals coupled with intertwining. In addition, some women use glue as a binding source for weaves. The glue used in hair braiding actually contains chemicals so strong that improper removal could lead to instant balding!

Even women who use their expertise to apply and remove glue run the risk of gradual hair loss. Frequent use of the harsh chemicals found in hair glues also causes damage to follicles, hastening balding. Also, because braiding serves as the foundation for weaving, hairstylists usually pull the hair tight and style it in a manner that requires constant pulling and re-positioning. Extensions, a form of elongation that is similar to the weave, may also lead to gradual hair loss in women as added hair places more weight on the roots.

Hair Relaxers: Another Cause of Hair Loss

Although they do not involve constant pulling, hair relaxers contain harsh chemicals that melt the hair. Many women—in particular, African American women—use artificial straighteners to make hair more manageable. The chemicals, however, usually damage hair. This damage creates weak strands that break off at the ends.[1]

Constant use of relaxers also brings about a condition related to tension hair loss known as Central Cicatricial Centrifugal Alopecia (CCCA).

CCCA progresses in different stages:

  • Chemicals used in relaxers begin thinning out hair near the crown area. Excessive heat can also contribute to follicular damage.
  • Women notice gradual hair loss. At this point, the damage has progressed too far to reverse the effects.
  • Some women, addicted to the results brought about by relaxers, continue to use harsh treatments.
  • The condition takes its toll and baldness takes effect.

Traction Alopecia Symptoms

Women should learn to recognize traction alopecia symptoms

Alopecia from braids, among other styles, can contribute to gradual hair loss in women.

Women should watch for traction alopecia symptoms like hair loss at the hairline and temple area. They can avoid gradual hair loss by staying away from using harsh products and hairstyles. Such styles include:

  • Braids
  • Cornrows
  • Extensions
  • Weaves
  • Tight Ponytails
  • Press and Curls, when sought after every week

As for products, women should stay away from gels with high levels of alcohol. These substances dry out the hair. Women who use hair relaxers should always avoid any product that contains alcohol. Mixing alcohol with the chemicals present in straightening formulas will result in certain damage to the hair, and eventual hair loss.

Women should also avoid hair bleaching in the fight against gradual hair loss in women. Every color treatment makes the hair weaker and more prone to breaking off at the tips. Dyeing also stunts the growth of hair at the root. Hair bleach works by breaking down the components in hair every time follicles are bleached.

Traction Alopecia Treatment Options

Women who have suffered gradual hair loss have several tension alopecia remedies to combat and conceal the effects. These include:

  • Covering up thinning or balding with wigs and hairpieces.
  • Taking pharmaceuticals such as Rogaine and Propecia to combat hair loss.
  • Undergoing Follicular Unit Extraction (FUE).

Though wigs and hairpieces remain popular, they have some definite drawbacks. For starters, wigs are not a traction alopecia cure–they do not regrow hair. Wigs can prove expensive, and often look like fake hair. Worse, the elements—like extreme rain or snow—can damage the wig, making it look even more obviously fake. Men and women also have frequent trouble matching the color of a hairpiece to the color of their remaining hair.

Medications like Rogaine or Propecia have shown some success in preventing baldness, though seldom work to actually regrow hair. Patients must take the medications every day, or else the positive effects of the drug will begin to wear off. This daily use means hair loss medications can become expensive, especially in the long run. Worse, because tension alopecia results from damage to the follicles rather than genetics, hair drugs have very limited success in traction hair loss regrowth.

For treatment for traction alopecia, doctors prefer the FUE procedure. Of all the treatments for hair loss available, only FUE has shown success in restoring full, healthy, natural-looking hair regardless of the cause.

Traction Alopecia Regrowth with Dr.UGraft™ & Dr.UPunch Curl™

Dr. Sanusi Umar has gained world-renowned notoriety for his innovations as a dermatologist and hair transplant specialist. As an expert in his field, he offers minimally invasive surgery that carries little risk of complications. The outcome, of Dr. Umar’s work, however, has dramatic results.

Patient Examples: Traction Alopecia Treatment with Dr.UGraft System™

The patient below suffered from traction alopecia as a result of harsh/tight hairstyles. She consulted Dr. U about the About Traction Alopecia. Dr. U recommended a linear-scar-free FUE hair transplant using the Dr. UGraft System.

Traction alopecia prevention and treatment: This patient had abused her hair for years with braids, weaves, and tight ponytails. She later underwent the Dr.UGraft procedure to restore her hair.

Traction alopecia prevention and treatment: This patient had abused her hair for years with braids, weaves, and tight ponytails. She later underwent the Dr.UGraft procedure to restore her hair.*


The patient below similarly consulted Dr. U to reverse the female tension hair loss in the temple areas after years of wearing tight ponytails.

Tension hair loss affects women of all ethnic groups since tight ponytails and harsh grooming habits can contribute to thinning.*

Tension hair loss affects women of all ethnic groups since tight ponytails and harsh grooming habits can contribute to thinning.*


Basic FUE tools have shown little effectiveness and a high rate of failure in FUE extraction of Afro-textured haired individuals. The tightness of the hair curl and skin thickness in patients with Afro-textured hair make it impossible for basic tools to extract hair follicles safely. To combat this and other issues with traditional FUE, Dr. Umar invented the first and only FUE tool specifically for consistent extraction of tightly curled Afro-textured hair. Known as the patented Dr.UPunch Curl™, the device works with all hair types, including in the tightly-wound hair found in most African American men and women.[2]

When performed in an office setting, this minimally invasive surgery allows Dr. Umar to transplant hair from anywhere on the body to the head. This allows Dr. Umar to restore hair in even the most extreme cases of baldness. This further allows Dr. Umar to restore hair in other areas of the body as well, including the eyebrows or eyelashes. This miracle innovation has earned Dr. Umar world-renown status. He has restored hair to scores of individuals, regardless of the cause of baldness.

Black men and women are the most affected demographic when it comes to tension alopecia, though the condition can affect anyone. The Dr.UGraft procedure can fully service people of all ethnicities, making it the ideal traction alopecia treatment, or solution for hair loss of any kind.

Video: Traction Alopecia Before and After Treatment with Dr.UGraft™

Watch the video below to see the full results of the patient’s traction alopecia treatment with Dr. U.


Best Treatment for Traction Alopecia in Black Female - Dr.UPunch Curl


Update September 2018: The patient above saw her results continue to improve with time. Here are her full results from her Dr.UGraft linear-scar-free FUE hair transplant procedure.

This Los Angeles woman found the best traction alopecia cure with Dr.UGraft™. Years later, her results continue to impress her.

Men and women suffering hair loss as a result of traction alopecia, or any other condition, can consult with Dr. Umar for free! During this free, online consultation, Dr. Umar will do his best to offer suggestions and a treatment plan to cure baldness.


Frequently Asked Questions for Traction Alopecia:

In regards to traction alopecia prevention and treatment, is there a traction alopecia cure?

Can traction alopecia be cured? Yes. Patients wanting to avoid hair loss due to tension alopecia must always avoid painful, tight hairstyles like tight braids. Furthermore, patients should also avoid the use of harsh chemicals in hair products like hair bleach or alcohol-based gels that can dry out hair or damage follicles.

How do I know what type of hair loss I have?

Patients who have noticed receding or thinning hair should always contact a physician, even in cases of small hair loss. Light loss of hair can foreshadow more extreme hair loss later in life. A doctor can determine the actual causes and classifications of balding, as well as a treatment method.

Do all men and women who wear their hair in braids or cornrows eventually bald due to tension hair loss?

Not necessarily, though tightly pulled braids or other similar hairstyles dramatically increase the chances for the kind of follicular damage that causes hair loss. Men and women can recognize the signs of hair loss by noticing a receding hairline or the edges of the hair shrinking.

I thought baldness was genetic, I didn’t realize hairstyles or pulling could make me lose hair. Is there anything else that causes baldness?

Yes. As this article already mentioned, a number of hair products can also contribute to hair loss, notable hair bleaches, or styling products containing alcohol. In essence, anything that causes damage to the skin can also potentially damage a hair follicle, causing hair to fall out and not grow back.

Can I still wear my hair in braids or cornrows without doing damage to my hair?

Yes. Men and women who like to wear hair in braids or similar fashion can wear the style without fear of hair damage. A good hairstylist should always make sure not to pull the hair too tightly, however, and to avoid using chemicals with an alcohol base. Men and women alike, regardless of hair type, should make sure to practice proper hair care, including regular conditioning, and avoidance of over-shampooing.

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  1. Shetty, Vinma H et al. “Chemical hair relaxers have adverse effects a myth or reality.” International journal of trichology vol. 5,1 (2013): 26-8. doi:10.4103/0974-7753.114710
  2. Umar Sanusi. Comparative Study of a Novel Tool for Follicular Unit Extraction for Individuals with Afro-textured Hair Plastic and Reconstructive Surgery 2016; DOI: 10.1093/asj/sjw089. Published September 27, 2016.

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