Key takeaways
- Traction alopecia is hair loss caused by repeated or prolonged tension on the follicle.
- A review of Black hairstyling practices found a strong association between tight, scalp-pulling styles and traction alopecia.
- Style matters: the review describes loose, low-hanging styles and updos as low risk, and notes it can be stopped or reversed if caught early.
What it is
Traction alopecia is gradual hair loss from damage to the follicle caused by pulling. It is considered preventable, and early intervention can stop or reverse it.
What the evidence says
A review in the Journal of the American Academy of Dermatology grouped hairstyling practices by risk. Tight ponytails, braids, buns, and styles that add weight or pull the scalp in one direction were linked to traction alopecia. Heat straightening was not significantly associated on its own but can weaken the shaft, raising the likelihood of hair loss when tension is also applied. Untreated, unprocessed hair tolerates more traction. A summary of the review reports an estimated one-third of Black women are affected, and suggests leaving braids in no longer than two to three months and giving weaves and extensions a break after six to eight weeks.
What the evidence does not establish
This is a literature review drawing largely on clinical observation, not a controlled trial of specific styles, and the timelines above are guidance rather than proven thresholds. The authors also stress that simply telling people to abandon these styles is not realistic for everyone; the goal is lowering tension and risk.
Who may want to pay attention
People who wear braids, weaves, extensions, locs, or tight updos, especially if they notice tenderness, bumps, or thinning at the hairline or temples.
Sources
- Haskin A, Aguh C. All hairstyles are not created equal: what the dermatologist needs to know about black hairstyling practices and the risk of traction alopecia. J Am Acad Dermatol. 2016;75(3):606–611. doi:10.1016/j.jaad.2016.02.1162 Source
Last reviewed October 2026. Educational information only, not medical advice. Findings from one study or review do not apply identically to every person or product.