Traction alopecia occurs when prolonged and/or repetitive tension is place on hair.


Patients at risk:

(1) Africans or Afro-Americans with tight braids

(2) Sikh males with hair tied into a knot beneath a turban

(3) Sikh males with beard tied into a knot

(4) ballerina with hair pulled tight


The risk is increased following the use of a hair relaxer which makes the hair weak.


Features of traction alopecia

(1) There is loss of hair at any site where here is placed under tension.

(2) It most often affects the frontal and temporal scalp.

(3) The alopecia is non-scarring.

(4) The fringe sign (presence of retained hairs along the rim of the area showing alopecia).

(5) Hair casts are seen on dermoscopy.

(6) Other explanations of alopecia are excluded.

(7) There is a reversal of hair loss with change in hair handling practices.


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