Stephanie Johnson


Thoughts and happenings

Your Ponytail could be making you bald

Your Ponytail could be making you bald

In a recent dermatological study in Africa, nearly 22% of girls between the ages of 17 and 21 years of age were going bald due to repeated, regular tight hairstyles. That same study found 31% of all of the women examined and reviewed had the same issue.

As licensed cosmetologists and practicing beauty professionals, we understand the desire to have a glamorous look. We can also understand the need to have that look as easily as possible in our, often, hectic mornings.

What happens, however, when the need for quick and easy becomes a problem?

The Fringe Sign...


What is Traction Alopecia?

Traction Alopecia is the loss of hair caused by the repeated, persistent pulling forces on the hair follicles form traction-inducing hairstyles.

In a recent review of 19 studies, researchers say that they can confirm a "strong relationship" between certain scalp-pulling hairstyles and the development of traction alopecia.

This issue has been found among all races, religions and practices. In fact, there have been characteristics of this issue in dermatology since the 1940's.

“Persistent pulling force applied to the hair is the main cause of traction alopecia”


One of the most prevalent characteristics described by dermatologists is what they call: "The Fringe Effect".
Usually witnessed as shortened and more fine ("baby") hair around the hairline. Most see it when it starts affecting around the face and temples - which is why it is named this way.

This sign is present before you get to "clinical" hair loss and will persist through the end stage of scarring alopecia. 
Late stage / scarring Alopecia is where the follicles have - basically - had enough. We call this follicular dropout. The hair follicles are rendered unable to create more hair which is permanent baldness. 

Other signs and symptoms of Traction Alopecia can include:

  • Redness / Irritation
  • Itching / flaking 
  • "Casting" - white "crust" like nodules on the hair, near the follicle
  • Pimples ("bumps") in the hairline near the follicle
  • "Tenting" - the dimpling of the skin around the follicles because of the force of the pull


According to Dr. Crystal Aguh, the contributing factors for experiencing Traction Alopecia are "based on the degree to which follicles are exposed to tension, weight, heat, and hair-altering chemicals."
Dr. Aguh lists high-risk hairstyles as: Braids, Dreadlocks, tight or "ballerina" buns, and tight ponytails.
Environmental or mechanical factors contribute to your hair's ability to handle any hairstyle that has tension. If your hair is chemically processed or over-processed (feels like hay when dry and slimy when wet), then your hair is going to break easily. 
Users of hot tools (flat irons, wands, etc) are also weakening their strands. Hair is most fragile when it is wet so special care during that time is also of value.
Another issue is the use of improper or incorrect products. Inexpensive (bargain or drug store) brands are often contributing to your dryness without you realizing it. Don't spend $300 at Sephora on your face then put $5 shampoo on your tresses. 
The right care and protection (heat protection, leave in conditioners, etc) DO make a difference. If it can happen to your skin, it can happen to your hair. Protect it.
Poorly installed extensions can cause hair trauma, too, so be sure you're getting the right system for your hair's strength and ability.

Genetic factors to consider: 
If you have curly hair, you're twice as likely to suffer this degree of damage. The asymmetrical shape of the curly hair follicles, and the curvature of the hair shaft, leaves more spots of vulnerability.
Fine hair, of course, has less cuticle protection and it is, naturally, less able to handle the same tension a thicker cuticle could.


First and foremost, you have to stop putting your hair up in these styles. Taking the ponytail down before bedtime doesn't count. Once traction alopecia has shown the fringe sign, it can take 6 to 9 months of treatment to get that fringe hair back. 

If your hair length is an issue, there are ways to have low, loose styles that allow for a happy compromise.

Another tip is to reduce the amount of chemical processes you put your hair through. If you've been doing that yourself, a visit to a stylist can help you get a better - safer - routine.
Of course, you have to consider what products are a part of your routine. Do you use quality products? Are you using the right ones for your hair? Do you protect your hair? This matters and a stylist can help.

If you're already experiencing The Fringe Effect, then you may want to consider investing in a quality product that can stimulate hair growth and strength. As long as you haven't reached scarring, there are many products that have been shown to help. 


“Traction Alopecia is entirely preventable, and early intervention can stop or reverse it.””


It is important to remember that this preventable issue can only be helped if caught early and action is taken. Once late traction alopecia (scarring) sets in, the only solution is a hair transplant.
Talk to your hairstylist today about ways that you may be able to help your hair have a better tomorrow.

Aguh, Crystal M.D. All hairstyles are not created equal: What the dermatologist needs to know about black hairstyling practices and the risk of traction alopecia. Journal of the American Academy of Dermatology (JAAD) and John’s Hopkins Medical School10/10/2016 (Print)
Christiana Oyinlola Akingbola, Jui Vyas. Traction Alopecia: A neglected entity in 2017. Indian Journal of Dermatology Volume 83, Issue 6: Pages 644-649
Department of Dermatology, School of Medicine, Cardiff University, Cardiff, CF, UK (Web)
Gavazzoni Dias, Maria Fernanda Reis. Hair Cosmetics: An Overview. International Journal of Trichology 7.1 (2015): 2–15. PMC. Web. 29 Oct. 2017.
Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Hairdressing is associated with scalp disease in African schoolchildren. Br J Dermatol 2007;157:106-10.
Muñoz Moreno-Arrones, Oscar Vañó-Galván, Sergio. Bitemporal hair loss related to Traction Alopecia. Dermatology, Online Journal, University of California Davis. 01/01/2016 (Web)