Traction alopecia

Traction alopecia is hair loss caused by repeated pulling on hair follicles, often where tightly styled hair places the greatest tension. Early loss may be reversible, but prolonged tension can permanently damage follicles.

Hair follicle: A skin structure that produces a hair shaft and cycles through phases of growth, regression, and rest. Traction acts on follicles beneath the skin, not just on visible hair shafts.
Hairline: The boundary where scalp hair meets the forehead and temples. Repeated tension commonly produces thinning along this exposed boundary.
Alopecia areata: An autoimmune disorder that causes nonscarring hair loss, often in sharply defined patches. Its smooth patches arise from immune activity rather than repeated mechanical pulling.
Traction alopecia prevention: Measures that reduce repeated pulling on hair and lower the risk of traction-related follicle injury. Looser styles and reduced tension address the cause before follicles are permanently damaged.
Hair shaft: The visible, keratin-rich portion of a hair that extends above the skin surface. Pulling transmitted through the shaft can stress the follicle anchoring it.
Trichoscopy: Dermoscopy-based examination of the hair and scalp using magnification. Magnified scalp features can support recognition of traction-related hair loss.
Frontal fibrosing alopecia: A scarring hair-loss disorder that often recedes the frontal hairline and affects eyebrows. It can resemble traction at the hairline but involves inflammatory follicle destruction.
Protective hairstyle: A hairstyle intended to limit environmental damage or manipulation of the hair. Some styles protect hair shafts yet still cause traction when tight or worn continuously.
Anagen: The active growth phase of the hair cycle, during which the follicle produces a hair shaft. Growing hairs are firmly anchored, so sustained pulling can injure their follicles.
Hair pull test: A clinical maneuver that gently pulls a small bundle of hairs to assess active shedding. The test can help assess ongoing shedding alongside a traction history.

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