eMedicine Specialties > Dermatology > Diseases of the Adnexa

Traction Alopecia: Follow-up

Author: Basil M Hantash, MD, PhD, Instructor of Dermatology and Plastic Surgery, Department of Dermatology, Division of Plastic Surgery, Stanford University School of Medicine
Coauthor(s): Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Contributor Information and Disclosures

Updated: Jan 27, 2009

Follow-up

Deterrence/Prevention

  • Patients should discontinue any practices that exert traction on the hair.
  • These practices to avoid include the following:
    • Hairstyling practices such as braiding and chemical hair straightening
    • Use of tight curlers and nylon brushes
    • Wearing the hair in a chignon

Prognosis

  • Traction alopecia is reversible in a few months if the hairstyling practice in question is discontinued.
  • Traction alopecia may lead to permanent hair loss if it is undetected for a protracted period.

Patient Education

  • Instruct patients to discontinue hairstyling practices that cause traction alopecia.

Miscellaneous

Medicolegal Pitfalls

  • Potential medical/legal pitfalls include the late diagnosis of traction alopecia.
    • Failure to detect this condition early in its course may result in permanent hair loss.
    • Thus, meticulously inspecting the scalp in all patients is crucial. This practice promotes the early rather than late diagnosis of traction alopecia, which allows the physician to make recommendations to reverse the ongoing hair loss.

Special Concerns

  • Special attention should be paid to the pediatric population, especially individuals who engage in hair- grooming practices such as braiding.
    • As mentioned earlier, the failure to recognize this condition early may lead to irreversible hair loss.
    • Thus, examination of the scalp in all pediatric patients is critical.
 


More on Traction Alopecia

Overview: Traction Alopecia
Differential Diagnoses & Workup: Traction Alopecia
Treatment & Medication: Traction Alopecia
Follow-up: Traction Alopecia
Multimedia: Traction Alopecia
References
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References

  1. Kanwar AJ, Kaur S, Basak P, Sharma R. Traction alopecia in Sikh males. Arch Dermatol. Nov 1989;125(11):1587. [Medline].

  2. Singh G. Letter: Traction alopecia in Sikh boys. Br J Dermatol. Feb 1975;92(2):232-3. [Medline].

  3. Harman RR. Traction alopecia due to "hair extension". Br J Dermatol. Jul 1972;87(1):79-80. [Medline].

  4. Trueb RM. "Chignon alopecia": a distinctive type of nonmarginal traction alopecia. Cutis. Mar 1995;55(3):178-9. [Medline].

  5. Hwang SM, Lee WS, Choi EH, Lee SH, Ahn SK. Nurse's cap alopecia. Int J Dermatol. Mar 1999;38(3):187-91. [Medline].

  6. Renna FS, Freedberg IM. Traction alopecia in nurses. Arch Dermatol. Nov 1973;108(5):694-5. [Medline].

  7. Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Determinants of marginal traction alopecia in African girls and women. J Am Acad Dermatol. Sep 2008;59(3):432-8. [Medline].

  8. Ozcelik D. Extensive traction alopecia attributable to ponytail hairstyle and its treatment with hair transplantation. Aesthetic Plast Surg. Jul-Aug 2005;29(4):325-7. [Medline].

  9. Whiting DA, Olsen EA. Central centrifugal cicatricial alopecia. Dermatol Ther. Jul-Aug 2008;21(4):268-78. [Medline].

  10. Steck WD. Telogen effluvium: a clinically useful concept, with traction alopecia as an example. Cutis. Apr 1978;21(4):543-8. [Medline].

  11. Ackerman AB, Walton NW III, Jones RE, et al. Hot comb alopecia/follicular degeneration syndrome in African American women is traction alopecia. Dermatopathol Pract Concept. 2000;6:320-36.

  12. Earles RM. Surgical correction of traumatic alopecia marginalis or traction alopecia in black women. J Dermatol Surg Oncol. Jan 1986;12(1):78-82. [Medline].

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  18. Ikeda T, Yamada M. [Factors in telogen affluvium and traction alopecia]. Acta Dermatol Kyoto Engl Ed. May 1967;62(2):109-13. [Medline].

  19. Kanwar AJ, Ghosh S, Thami GP, Kaur S. Alopecia and cutis verticis gyrata due to traction presenting as headache. Int J Dermatol. Sep 1992;31(9):671-2. [Medline].

  20. Laude TA. Approach to dermatologic disorders in black children. Semin Dermatol. Mar 1995;14(1):15-20. [Medline].

  21. Monk BE, Neill SM, du Vivier A. Fashion causes traction alopecia. Practitioner. May 1986;230(1415):401-2. [Medline].

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Further Reading

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Keywords

traction alopecia, traumatic alopecia marginalis, chignon alopecia, nurse's cap alopecia, nonmarginal traction alopecia, alopecia linearis frontalis, hot comb alopecia, follicular degeneration syndrome, hair loss, marginal alopecia, trichotillomania

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Contributor Information and Disclosures

Author

Basil M Hantash, MD, PhD, Instructor of Dermatology and Plastic Surgery, Department of Dermatology, Division of Plastic Surgery, Stanford University School of Medicine
Basil M Hantash, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for Dermatologic Surgery, Sigma Xi, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

James W Patterson, MD, Director of Dermatopathology, Professor of Pathology and Dermatology, Departments of Pathology and Dermatology, University of Virginia Medical Center
James W Patterson, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Medical Association, American Society of Dermatopathology, Medical Society of Virginia, Royal Society of Medicine, Society for Investigative Dermatology, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: 3M Pharmaceutical Grant/research funds Other; Graceway Pharmaceuticals Grant/research funds Other

Managing Editor

Warren R Heymann, MD, Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey
Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Glen H Crawford, MD, Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital
Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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