If you’ve ever noticed a few too many strands of hair on your hair tie after a long day, you may have wondered if wearing your hair in a ponytail can cause hair loss.
The answer, surprisingly, is yes. Although it’s not very common, any hairstyle that puts tension on your hair can potentially cause a form of hair loss called traction alopecia.
Traction alopecia can cause your hair to thin, especially in areas that are more often subject to tension. Luckily, it’s almost always a treatable form of hair loss that can be reversed with a few changes to your hairstyle and hair care habits.
Below, we’ve talked about what traction alopecia is and how ponytails, buns, braids and other tight hair styles can potentially cause it. We’ve also shared several tips and strategies that you can use to treat, reverse and prevent traction alopecia.
Ponytails and other tight, tied-up hairstyles can cause a form of hair loss that’s referred to as traction alopecia.
Unlike pattern hair loss, hair loss caused by traction alopecia typically isn’t permanent, meaning your hair will grow back once the cause is treated.
However, chronic traction alopecia caused by tight braids or other very tight hairstyles may cause more serious damage to your hair and permanent hair loss.
Traction alopecia is most common in African-American women, although it can affect people of all races. It’s often an issue for athletes, ballerinas, military personnel and women who need to wear their hair pulled back throughout the day.
Although it’s more common in women, traction alopecia can also affect men who wear their hair in dreadlocks or cornrows.
Most of the time, traction alopecia is treatable using over-the-counter medication. For severe hair loss, medications such as topical corticosteroids and procedures such as hair transplantation may be used.
Traction alopecia is a form of hair loss that’s caused by any hairstyle that produces a constant pulling force on your hair roots.
You may start to develop traction alopecia if you often wear your hair in a ponytail, especially if it’s a tight ponytail that puts a lot of tension on your hair.
Over time, the tension applied to your hair can loosen the hair shaft from the follicle, causing it to prematurely enter into the resting phase of its growth cycle and shed before it’s able to grow to its full length.
In addition to tight ponytails, other hairstyles that can cause traction alopecia include cornrows, braids, buns and any other style that involves tightly tying back your hair.
Hair products that produce a pulling force on your hair roots, such as hair rollers, weaves, hair extensions and certain chemical hair treatments, may also contribute to traction alopecia.
Tractional alopecia is most common in African-American women. In fact, approximately one third of all women of African descent who wear their hair in a tight, traumatic style experience traction alopecia at some point.
The most common, noticeable symptom of traction alopecia is hair loss, particularly at or close to your hairline. You might notice that your hair begins to thin around your hairline following a symmetrical pattern, with relatively even loss from both sides.
You may also notice small white or flesh-colored bumps forming on your hair follicles, especially in areas where your hair is under significant tension.
Most cases of traction alopecia only cause temporary hair loss, especially when they’re treated relatively early. However, when traction alopecia occurs over a long time without any changes to your hair styling habits, the hair loss may become permanent.
The easiest way to treat traction alopecia is to change your hairstyle so that there’s no tension on your hair follicles.
You can do this by wearing your hair down rather than in a tight ponytail, or by loosening your ponytail so that it puts less pressure on your hair. If you wear your hair in braids, cornrows or any other tight style, consider changing to something that puts less tension on your hair.
While you sleep, try to either wear your hair down or tie it up as loosely as possible, taking care not to pull on your hair roots.
If you style your hair using heat or chemicals, try to reduce their amount and intensity, or take a break from these styling techniques until your hair recovers.
If you only have mild, early-stage traction alopecia, making these small changes may allow your hair to grow back naturally. Over time, you may notice that the thin areas near your hairline or in other parts of your scalp return to normal.
For more severe or long-lasting traction alopecia, it’s best to talk to your healthcare provider or schedule an appointment with a dermatologist.
If you have bumps on your scalp, skin irritation, tenderness or inflammation because of traction alopecia, your healthcare provider may prescribe medication. Medications used to treat traction alopecia include:
Topical or oral antibiotics
Topical or injectable corticosteroids
If you’re prescribed medication for traction alopecia, make sure to closely follow the instructions provided by your healthcare provider.
If you have noticeable hair loss from traction alopecia, using a medication such as minoxidil may help to stimulate hair growth and restore your hair faster.
Minoxidil is a topical medication that you can apply directly to areas of your scalp with significant hair loss. We offer a specially formulated 2% minoxidil for women that’s ideal for promoting hair growth and regrowing hair in affected areas of your scalp.
Most cases of traction alopecia can be treated using the options above. However, when traction alopecia becomes advanced, it can cause permanent scarring that stops your hair from growing back normally.
Once scarring has developed on your scalp, treatments like minoxidil may no longer be effective at stimulating hair growth.
If you have advanced traction alopecia that’s caused permanent hair loss, you may need to use hair transplant surgery to restore your hair.
This surgery involves transplanting hair follicles from the back and sides of your scalp to areas with noticeable hair loss. Although it’s effective, it can cost several thousand dollars, making it important to treat traction alopecia before it can cause scarring to develop.
To prevent traction alopecia, try to avoid putting excess pressure on your hair. You can do this using the techniques listed above, such as avoiding hairstyles that involve pulling on your hair, wearing your hair down often and being careful with hair styling products.
If you notice traction alopecia developing, make sure to take action as soon as possible to stop it from worsening.
Tight ponytails, braids and other hairstyles that put pressure on your hair all have the potential to cause a type of hair loss called traction alopecia.
While it’s okay to wear your hair in a ponytail, make sure not to pull it too tightly. If you like the way your hair looks when it’s tied back tightly, make sure that you give it plenty of time to rest and recover when you’re at home or asleep.
If you start to experience hairstyle-related hair loss, try to make changes to your hair care and styling habits as soon as you can to promote hair growth and prevent the hair loss from getting worse.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
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