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Traction Alopecia: Causes, Symptoms and What Can Help

Traction Alopecia: Causes, Symptoms and What Can Help

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    Key Takeaways

    • Traction Alopecia is a condition caused by hairstyles or headwear repeatedly pulling on your hair.
    • If the cause of traction alopecia is not addressed, the effect may be long-term.
    • Certain hair products and accessories may accelerate the effects of traction alopecia, like rubber bands, flat irons, or hair extensions.
    • By changing your hairstyle, wearing looser headwear and focusing on recovering hair, you may be able to reduce the effects of traction alopecia.
    • For more information about reducing traction alopecia and recovering from hair loss, consider booking a free 15-minute discovery call with a hair growth advisor.

    Traction alopecia is a hair condition in which headwear or tight, binding hairstyles may be gradually pulling your hair out. This condition may cause gradual hair loss as prolonged or repetitive tension on the hair roots may cause permanent damage if not treated.

    Traction alopecia may respond well to treatment if addressed early (1). In this article, we will outline exactly what traction alopecia is, what causes it, and how to treat it.

    Note that this information is general in nature and does not constitute medical advice. Individual results may vary.

    What is traction alopecia?

    Traction alopecia is a form of hair loss that may be caused by gradual pulling and tension on the hair roots due to tight hairstyles, such as braids, ponytails, or buns (2). The condition may cause signs such as redness, thinning or itching, and may be reduced if it is caught early enough.

    What causes traction alopecia?

    Traction alopecia may be caused by a tight, binding hairstyle like a bun or ponytail, repeatedly pulling or putting tension on the hair follicles, which may eventually pull the hair out entirely (3). This damage may also be caused by constrictive headwear, and it may be permanent if damage to the follicles is not addressed in time.

    Symptoms of traction alopecia:

    Some key signs that your hairstyle or headwear is causing traction alopecia include:

    • Receding hairline: Due to pulling and friction, you may notice your hairline receding at the temples, forehead, or nape of the neck.
    • Scalp inflammation: Redness, red or white bumps and scaling are all signs that you may be affected by traction alopecia.
    • Tender scalp: Due to the hair pulling, you may feel pain, soreness, itching or stinging in the affected areas.
    • Broken hairs: The repeated damage may be causing multiple short, stubby and broken hairs, particularly near the forehead.

    How to help reduce the risk of traction alopecia:

    There are many methods you may use to reduce the risk of traction alopecia before it begins affecting your hair, including:

    Hairstyling

    One of the most immediate ways to reduce traction alopecia may be to reduce the pulling or tension certain hairstyles or hair accessories cause to your hair follicles. Generally speaking, if a hairstyle feels like it may hurt, it may be causing traction alopecia.

    Consider wearing your hair looser, wearing looser headwear, switching hairstyles or limiting extensions.

    Be mindful of your hair products

    Certain hair care products may be causing your hair to loosen or become thinner, which may increase the likelihood of hair loss due to a tight hairstyle (3). Some products or hair styling features that could be encouraging traction alopecia include:

    • Relaxers: Hair products with chemical relaxers may be causing the hair shaft to become weaker, which may increase the chances of hair being pulled out (2).
    • Rubber bands: Standard rubber or elastic bands may be more likely to rip hair out when used. Try to use softer material bands instead, like soft fabric or silk.
    • Extensions: Heavy extensions may be causing your hair to rip out due to the additional weight.
    • Flat irons/blow-dryers: Keep flat irons and blow-dryers on low settings to avoid causing potential damage or breakage that may be exacerbated by tight hairstyles.

    How to help reduce traction alopecia

    Traction alopecia may be reduced by examining your hair care routine and determining if any hairstyles or headwear could be pulling your hair. Other methods for reducing traction alopecia include:

    Products and Treatments

    The following products may help with reducing or recovering from traction alopecia:

    • Prescription medication: Some medications may help regrow hair that may have been pulled out by a tight hairstyle. Please be sure to consult a registered health practitioner to determine the best medication for you. (4)
    • Scalp oils: Scalp massages may be able to improve circulation and add moisture that may assist hair growth and recovery.
    • Sulphate-free hair care: Gentle hair cleansers may be able to help nourish the scalp, which may increase follicle recovery and hair growth.
    • Procedural treatments: For more advanced conditions, an AHPRA-registered practitioner may recommend specific treatments or therapies. Individual results of these treatments may vary. A consultation is required to determine suitability.

    ‘The two main medications that we use are finasteride and minoxidil. One is primarily used to hold onto the hair that you have, and the other is used to help regrow hairs that become miniaturised."

    Hair Transplant Doctor Dr David Ballantyne (AHPRA No. MED0001212633)

    When to get professional help?

    If you experience strong scalp pain, inflammation, or notice your hairline receding, it may be best to get in contact with a registered health practitioner. You may also want to book a free 15-minute discovery call with a hair growth advisor if your hair is still not growing back after six to eight weeks of wearing looser hairstyles.

    Treatments at Gro Clinics

    Gro Clinics is a hair restoration clinic with AHPRA-registered practitioners located across Australia and New Zealand. Our locations include Sydney, Brisbane, Melbourne, Gold Coast, Perth and Auckland.

    Gro Clinics offers tailored treatment plans that follow a personalised assessment of each client. We create a plan suited to you based on your history, underlying health conditions and a discussion of your specific goals and treatment suitability.

    Our services include:

    • A free 15-minute discovery call with a hair growth advisor.
    • An in-person conversation with our team and scalp evaluation.
    • AHPRA-registered practitioners.
    • Structured, in-clinic training and hands-on education before performing or assisting in procedures for all medical and clinical teams.
    • Flexible payment options for eligible patients.
    • Post-procedure support and annual check-ins.

    Traction alopecia FAQs

    Can you regrow hair from traction alopecia?

    Yes, you may be able to regrow hair you have lost from traction alopecia. Depending on how early you act, you may reduce further damage to your hair follicles caused by a tight, pulling hairstyle and regrow pulled hair before the follicle is too damaged.

    What hairstyles can lead to traction alopecia?

    The following hairstyles may lead to traction alopecia and hair loss:

    • Braids and locs: Tightly binding hairstyles like cornrows, box braids, dreadlocks and sisterlocks may cause pulling on the hair, which may increase the risk of traction alopecia.
    • Tight up-dos: Sleek or tightly pulled ponytails, pigtails, top knots or similar styles may be damaging your hair follicles.
    • Extensions and weaves: Heavy hair extensions, glued weaves or wigs that anchor heavily may be pulling hair out due to weight.
    • Head coverings: If you frequently wear a tight hat, bandana, swim cap, turban or other headwear that rubs against the hairline, it may be causing repeated hair pulling.

    When is it too late for traction alopecia?

    If hair follicles have been destroyed, ripped out or replaced by scar tissue, it may be too late to reduce or resolve traction alopecia. If hair has not regrown within a year, it may also be too late to reduce the damage.

    Does minoxidil help traction alopecia?

    Yes, minoxidil may help with traction alopecia by stimulating the blood flow to the hair follicles, which may help promote growth (5). However, success may depend on the severity of the damage, and treatment may be more effective if it is used during the early stages of hair loss.

    How bad can traction alopecia get?

    If it is not treated, traction alopecia may lead to permanent, irreversible hair loss as the hair follicles may be damaged past recovery. This is because chronic pulling may destroy hair follicles, which may keep the hair from being able to grow back.

    Where does traction alopecia start?

    The first signs of traction alopecia typically start along the hairline, most notably at the temples, forehead or the area directly above the ears. These are typically the areas where a tight hairstyle may be pulling the hardest.

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    We'll walk you through the process, answer general questions, and explain next steps if you're interested in an in-clinic assessment. This call is for general information only and not a medical consultation.

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    IMPORTANT INFORMATION

    Hair Transplant Procedure Risk & Recovery Information

    This document provides general information about hair transplant procedures, including associated risks and recovery. It is intended for public access and does not replace a clinical consultation with a registered medical practitioner. All procedures at Gro Clinics are performed by registered medical practitioners. Individual outcomes, risks, and recovery timelines vary. Speak with your Gro doctor for information specific to your situation.

    1. What Is a Hair Transplant Procedure?

    A hair transplant is a medical procedure in which hair follicles are extracted from a donor area (typically the back or sides of the scalp) and implanted into areas experiencing hair thinning or loss. At Gro Clinics, this is performed using the Follicular Unit Extraction (FUE) technique.

    The procedure involves the use of local anaesthetic, small circular incisions to extract individual follicular units, and their implantation into the recipient area. It is performed under sterile conditions by a registered medical practitioner.

    Hair transplants are a higher risk non-surgical cosmetic procedure. They require careful consideration, a thorough clinical consultation, and informed decision-making. This document is designed to support that process.

    2. Alternative Options

     hair transplant is not the only option for addressing hair loss. Alternatives include, but are not limited to:

    • Hairpieces or hair systems
    • Prescription medications such as minoxidil or finasteride (subject to clinical assessment and prescription)
    • Other hair restoration procedures such as FUT (Follicular Unit Transplantation)
    • No treatment - hair loss is a natural variation and does not require medical intervention

    Your Gro doctor will discuss all relevant options with you during your consultation. A hair transplant may not be appropriate for everyone.

    3. Common Side Effects

    The following side effects are commonly experienced following a hair transplant procedure. They are generally temporary and resolve with time and appropriate aftercare.

    Pain and Discomfort - Discomfort is common during and after the procedure. The degree varies between individuals. Local anaesthetic is administered to manage pain during the procedure.

    Swelling - Swelling of the forehead or eyelids may develop and usually resolves within approximately one week.

    Minor Bleeding and Bruising - Spot bleeding may occur at the donor or recipient site and is typically controllable with pressure.

    Redness or Inflammation - Redness in the implanted area usually resolves within 3 months but may persist for up to 6 months or longer in some individuals.

    Crusting and Scabbing - Small scabs may form in the recipient area, typically resolving within 7-10 days.

    Itching, Numbness or Tingling - These sensations may occur and typically resolve within 6 to 9 months. In rare cases, nerve-related numbness or discomfort may persist for longer.

    Ingrown Hairs - Ingrown hairs are possible as transplanted follicles regrow.

    Pigmentation Changes - Temporary darkening or lightening of the skin in treated areas may occur, usually resolving within months.

    Telogen Effluvium (Shock Loss) - Temporary shedding of native (non-transplanted) hairs may occur following the procedure and usually resolves over time.

    4. Less Common and Rare Complications

    The following complications are less common but possible. Some may require additional medical treatment.

    Infection / Folliculitis - Infection risk is inherent to any procedure involving incisions. Folliculitis (inflammation of hair follicles) may occur and will be monitored. In rare cases, further medical intervention may be required.

    Scarring - FUE involves small circular incisions which may leave tiny white scars in the donor area. Hypertrophic or keloid scarring is rare but possible, depending on individual healing.

    Poor Graft Growth - In some cases, transplanted grafts may not grow as expected. Factors including smoking, underlying medical conditions, and non-compliance with aftercare can affect graft survival. There is no guarantee of complete or uniform growth.

    Overharvesting and Donor Area Thinning - Excessive removal of grafts may lead to noticeable thinning in the donor area, particularly in individuals with limited donor hair.

    Poor Angulation or Unnatural Appearance - If grafts are not implanted at the correct angle, direction, or density, hair may grow in an unnatural pattern. Corrective procedures may be required.

    Reaction to Anaesthetics or Medications - Allergic reactions to local anaesthetics or other medications used during the procedure may occur, ranging from mild to severe.

    Cysts - Small, benign cysts may form in the recipient area if hair follicles become trapped under the skin.

    Persistent Redness or Visible Extraction Sites - Some individuals, particularly those with fair skin, may experience prolonged redness or visible extraction marks beyond the usual healing period.

    Prolonged Swelling - While swelling typically resolves within a week, in rare cases it may persist for longer.

    Skin Necrosis (Very Rare) - Poor blood supply or excessive trauma may lead to localised skin death (necrosis). This risk is higher in smokers or individuals with vascular conditions.

    Excessive Scarring (Very Rare) - While FUE is associated with minimal scarring, some individuals may develop more noticeable scarring due to individual differences in healing.

    Need for Further Procedures - In some cases, corrective surgery or additional sessions may be required to refine the outcome or address areas of poor growth.

    5. Recovery Information

    Recovery from a hair transplant requires time and careful aftercare. The following is general guidance - your Gro doctor will provide specific post-operative instructions tailored to your procedure.

    Immediate Post-Procedure (Days 1-7)

    • Swelling, redness, and tenderness in both donor and recipient areas is expected
    • Small scabs will form and should not be picked or scratched
    • Strenuous physical activity should be avoided
    • Direct sun exposure to the scalp should be avoided
    • You may need time away from work depending on the nature of your role

    Weeks 2-4

    • Scabbing typically resolves by day 7-10
    • Some transplanted hairs may shed - this is normal (telogen effluvium) and does not indicate failure
    • Continued avoidance of strenuous activity is recommended

    Months 3-12

    • Initial hair regrowth typically begins around 3 to 4 months post-procedure
    • Noticeable improvements in thickness and density are generally visible from around 6 months
    • Full results are typically visible around 12 months post-procedure
    • In some cases, results may continue to improve up to 18 months

    Recovery timelines vary between individuals. Factors including age, general health, the size of the procedure, and adherence to aftercare instructions all affect how quickly you heal and how results develop.

    6. Limitations and Important Considerations

    • A hair transplant does not prevent future hair loss. Hair loss may continue in untreated areas. Ongoing medical treatments such as finasteride or minoxidil may be recommended to help maintain results.
    • There is no guarantee of permanent, complete, or uniform hair restoration. Outcomes depend on factors including genetics, age, health, hair characteristics, and adherence to aftercare.
    • Additional sessions may be required. Depending on ongoing hair loss or desired density, further procedures may be needed in the future.
    • 90% graft survival is a general expectation, not a guarantee. Individual graft survival rates vary and cannot be predicted with certainty in advance.
    • Results take time. Full results are typically not visible until 12 months post-procedure. Assessing outcomes before this point may not reflect the final result.

    7. Who May Not Be Suitable for a Hair Transplant

    A hair transplant is not appropriate for everyone. Your Gro doctor will assess your suitability during a clinical consultation. Factors that may affect suitability include:

    • Insufficient donor hair density
    • Certain medical conditions or medications
    • Active scalp conditions
    • Smoking (which increases complication risk)
    • Unrealistic expectations of outcome
    • Age - particularly younger individuals where the pattern of future hair loss cannot yet be predicted

    If you are not suitable for a hair transplant, your Gro doctor will discuss alternative options with you.

    8. Making an Informed Decision

    A hair transplant is a significant medical procedure. The decision to proceed should be made carefully, with full understanding of the risks, recovery, limitations, and alternatives outlined in this document.

    Before proceeding, you should have the opportunity to:

    • Ask all questions and receive clear answers from your treating doctor
    • Understand the realistic range of outcomes for your individual situation
    • Consider alternatives
    • Review and sign a detailed consent form
    • Take adequate time to make your decision without pressure

    If you have concerns about your suitability, the procedure, or any aspect of your care, speak directly with your Gro doctor. You are not obligated to proceed and may withdraw consent at any time prior to the procedure.

    This document is provided for public information purposes only and does not constitute medical advice. It does not replace a clinical consultation with a registered medical practitioner. Individual outcomes vary. Gro Clinics procedures are performed by registered medical practitioners. This document has been prepared in accordance with AHPRA Guidelines for Advertising Higher Risk Non-Surgical Cosmetic Procedures (September 2025).