There are a plethora of pros when it comes to wearing wigs. Not only do they provide a fast and easy solution on days when you'd rather not deal with your own strands, but they can also be beneficial when it comes to protecting your natural hair from damage — until they're not.
Traction alopecia is a type of hair loss caused by constant pulling or pressure on the follicle and can develop as a result of wearing certain types of wigs and other protective styles, making some Black women more prone to the condition.
"Traction alopecia is a lifestyle disorder," says New York City-based dermatologist Dr. Elyse Love. "Black women are not biologically more likely to experience traction alopecia. However, haircare practices in the Black community are more likely to include traction-causing maneuvers. Detangling, heavy braids, long weaves, and styling of leave-out hair are common causes of traction alopecia."
With many of us spending more time at home for the foreseeable future, there's truly no better time to learn more about traction alopecia, and discover not only how to treat it, but also how to prevent it from coming back.
That's why we spoke to Dr. Love, along with fellow board certified dermatologist Dr. Crystal Aguh, who was also featured in the traction alopecia-focused documentary Pretty Shouldn't Hurt, as well as Jesseca Dupart, CEO and founder of Kaleidoscope Hair Products, to tell you everything you need to know.
What Types of Wigs Can Cause Traction Alopecia?
"Wigs that are super tight can cause traction alopecia," says Dupart. "Also any wigs that require gluing or bonding, which is not healthy for the hair, especially if there is an unskilled person applying. Synthetic bands in wigs can also cause problems, especially for those with sensitive skin."
That said, while lace front and clip-in wigs can offer complete coverage of your natural hair, wearing them regularly can not only cause hair damage, but also thinning and eventual baldness in certain areas.
What Areas of the Scalp Are More Prone to Thinning?
According to both Dr. Aguh and Dr. Love, traction alopecia commonly causes thinning around the hairline, due to the delicate nature of the hair in that area of the scalp. "This hair is also more likely to undergo pulling and tugging in an attempt to 'lay' or 'tame' the edges," says Dr. Love, which is more common practice when wearing a U-wig or half wig.
However, it can show up in other places as well. "Hair on the vertex scalp (crown) is also particularly susceptible to traction alopecia," she adds.
How Long Does It Take for Traction Alopecia to Develop?
In Dupart's former work as a stylist and now as a haircare specialist, she's seen her fair share of hair loss stories, and says the timeline is different for everyone.
"It depends on your go-to style or chemical process, and whether you wear a ponytail, weave, wig, or have a poor diet," she explains. "With hair friction, it usually takes time for the breakage or follicle damage. Those tight hairstyles that give an instant facelift also can slowly recede the hairline."
This is why it's important to be mindful of wearing tight wigs too often, and also opting for more tension-free styles.
When Is It Time to See a Dermatologist or a Trichologist?
The moment you notice any hair thinning, give your wigs a break and make an appointment to see either a dermatologist or trichologist. Because while there's a chance your developing alopecia could be caused by your style, there's a number of other ailments that could be contributing to the problem as well.
"I want to stress that you should avoid trying to self-diagnose, especially if your hair loss is worsening," says Dr. Aguh. "Traction alopecia can look very similar to other forms of hair loss such as alopecia areata, hormonal thinning, and a form of hair loss called frontal fibrosing alopecia. If you have not noticed improvement in hair loss after avoiding extensions and taking good care of the hair, you should have a formal evaluation by a board-certified dermatologist."
The MD goes on to explain that different forms of hair loss require different forms of treatment, and in order to find a solution, you must first be properly diagnosed. And the sooner you see a doctor, the better. "The great thing about traction is it is reversible in the early stages," adds Dr. Love.
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What Are Some Treatment Options?
"Anti-inflammatory injections can be helpful for traction alopecia that is slow to recover," says Dr. Love. "In addition, topical minoxidil can help speed up the recovery process. Platelet-rich plasma also has shown early promising data for stimulating regrowth in traction alopecia."
However, for severe cases, Dr. Aguh says the only option would be to get a hair transplant, which can be quite expensive. "All the more reason to make sure traction alopecia is diagnosed early," she adds.
To keep your hair strong and healthy, Dupart recommends using Miracle Drops from her line around the hairline two to three times a week, which contain nourishing ingredients like aloe vera and peppermint oil, as well as the Therapeutic Shampoo on wash days.
"[This] haircare line is created for scalp and hair restoration and overall therapy for your hair," she explains. "It has a cool-minty sensation that purifies the scalp and hair follicles to help grow healthy hair."
All three experts also agree that regular gentle scalp massages can help increase blood flow to the scalp. But it's important to note that no matter which route you choose, the hair regrowth process is slow, and it can take several months to see results.
How Can I Style My Hair to Hide Any Thinning?
When it comes to styling, this is a great time to get creative. "The key is to not put tension or adhesives on or around affected area," says Dupart. Depending on where the thinning is present, you can brush your hair in the opposite direction to provide coverage, or opt for a wig that doesn't add any tension to the hair.
But if you're in a bind, make an appointment with a reputable hairstylist who can help, since to prevent thinning all together, or to avoid making matters worse, Dr. Love says you have to be mindful of what you're doing to your hair.
"Ultimately, the best treatment is a change in styling practices that minimizes pulling on the scalp," she explains. "This will likely include being more mindful about who you pay to style your hair."
How Can I Prevent Traction Alopecia From Coming Back?
Avoid wearing wigs, or any form of protective styles that are too tight, says Dr. Aguh. Dr. Love also adds that it's important to revise your entire haircare routine.
"I think as we as Black women need to rethink the way we feel about our hair, and change the way we treat our hair," she explains. "Our hair does not deserve the punishment we give it."
As we detangle on wash day, the derm says to make sure we use conditioners with lots of slip to decrease tension on the scalp. Also make sure to detangle from ends to roots to avoid added pressure on both the hair and scalp. And whether you go with wigs, or any other look as your protective style of choice, make sure you're not leaving your appointment with a headache or any type of pain on your scalp.
"These are all signs of inflammation," Dr. Love shares. "The goal should change from making the style last the longest to making a beautiful style that supports the hair and scalp."
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