There are several ways a person can lose their hair.
For some, it happens naturally as a person ages. For others, specific experiences — such as childbirth, major surgery or physical or psychological stress — can trigger hair loss.
But sometimes, dramatic hair loss can be a symptom of something within your control: how you style your hair.
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Known as traction alopecia, this type of hair loss causes your hair to thin out gradually or fall out in clumps. It can happen at any age, and it’s permanent.
Here’s what you need to know about the painful form of hair loss — and how to prevent it.
What causes it
The good news about traction alopecia is that it’s completely preventable, says Dr. Cory Torgerson, a head and neck surgeon at the Toronto Hair Transplant Clinic.
“Alopecia simply means hair loss, and traction alopecia means … hair loss being caused by a pulling force applied to the hair,” he told Global News.
The most common “pulling forces” are too-tight braids, weaves, wigs and ponytails.
“It’s not an instant thing. It (only happens when) there’s been a repetition to wearing your hair in this way,” Torgerson said.
Dr. Crystal Aguh supports these claims. She’s the director of the Ethnic Skin Program and assistant professor of dermatology at Johns Hopkins Medicine in Baltimore, Md.
“It’s a type of hair loss that occurs as a result of typically months and years of very tight hairstyles,” she said.
“Early on, you might notice a bit of thinning … but over time, that thinning can actually become permanent and very noticeable.”
Signs and symptoms
There are ways to know if your hair is styled in a way that’s causing traction at the root.
For starters, you will experience mild to moderate sensitivity when you take your hair out of the style.
“If it’s very itchy or bumpy, or if you have red bumps or irritation, these are some warning signs,” said Torgerson. “Give that area a break.”
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In Aguh’s experience, discomfort and headaches can also signify the beginning of traction alopecia.
“If someone’s wearing braids, they notice that they’re getting a lot of itching … at the insertion of their braid, that can be a sign of impending hair loss.”
If those signs are present early on — or when the hair is initially styled — “the damage is already done,” said Aguh.
Who it affects most
Both men and women can be affected by traction alopecia. However, it more commonly affects women since they are more likely to have ponytails or other tight hairstyles.
Traction alopecia is more often seen in Black women — due to the widespread use of braids, weaves and wigs — and Sikh men, because of daily turban wear.
“We know that Black women are more likely to wear braids,” said Aguh.
“We also know that relaxing the hair (a treatment that makes curly hair easier to straighten) before applying some sort of tight hair, such as a wig or weave, makes you more likely to lose the hair.”
However, traction alopecia can really be seen in anyone.
How to prevent it
Unfortunately, hair loss caused by traction alopecia harms the actual follicles of your hair. Once those have been damaged, they will never grow hair again.
“Once the hair follicles are dead, they’re dead,” Torgerson said.
That’s why it’s so important to prevent it when you first notice the signs and symptoms.
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Aguh advocates for “the one to one ratio.”
“If you braid your hair for six weeks, then your hair should be free of braids for at least six weeks,” she said.
“A lot of women will wear their hair in braids for six weeks and then they only wear it out of braids for a week. That’s obviously not enough time.”
Unfortunately, a lot of people feel they don’t have another choice — especially Black women, whose hair can be quite curly and difficult to manage otherwise.
“For some women, they don’t really feel like they have the option of not wearing their hair in braids … it can be really tough,” said Aguh.
In her view, the problem for a lot of people is that they’ve never been taught how to care for their hair when it’s not in a braided style.
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“I think it starts there — with stylists helping clients figure out what they can do to maintain the health of their hair.”
Ultimately, you need to be wary of how often you’re getting tight hairstyles and how long you’re keeping them in.
“Ultimately, it requires that you don’t use the same hairstyles or really the same damage can occur,” Aguh said.