Early on, traction alopecia might show up as little bumps on your scalp that look like pimples. As the condition progresses, the main symptom is missing and broken hairs. The hairs along the front and sides of your scalp are most often affected. However, it also notices hair loss on other areas of the scalp, depending on hairstyle.

The changes are usually seen in girls and young women, particularly those whose hair has always tended to be thin. The pattern of hair loss is determined by the cosmetic procedure, hair being lost where there is maximal tug. The term marginal alopecia is applied in which hair loss is mainly around the edge of the scalpaat the side or at the front. The bald areas show short broken hairs, folliculitis (inflammation of the hair follicles) and sometimes scarring.
Patients are often slow to accept that they are responsible for the hair loss, and notoriously slow to alter their cosmetic practices. Even if they do, regrowth is often disappointingly incomplete.

Traction alopecia includes:

• a receding hairline typically around the forehead, temples, or nape
• small pimples appear on the scalp or at the base of braids
• redness, itching, and ulcers on the scalp
• the hair parting widens
• patches of thin or broken hair in places where the hair has been under strain
• patches of shiny, scarred skin in more advanced cases

This condition is common in African-American women, although it can affect people of any ethnicity. Some traction alopecia cause is as follows:

• Certain hairstyles, including dreadlocks, braids, cornrows, and tight ponytails.
• Hair extensions or weaves, extensions are glued or tightly tied to the base of the hair, which may cause tension at the hair roots.
• Headwear, such as sports helmets or tight elastic headbands, may cause the hair to thin where the headwear makes contact with the hair.
• Hair accessories, including hair slides or grips that are worn in the same way every day.
• Very long hair, can be heavy, pulling on the hair follicles. Very long or tightly tied beards can also result in traction alopecia.
• Hair relaxers and other chemical treatments. These change the structure of the hair shaft in a way that makes hair loss more likely.
• Using extensions and relaxers together. This was the most significant risk factor for traction alopecia.

Treatment can be simple as changing hairstyle techniques. Here are some steps to treat this condition:

• Avoid tight hairstyles if possible. If a person’s religion or profession requires tight hairstyles, they should tie their hair as loosely as possible and wear their hair loose or down whenever possible.
• Avoid or limit chemicals, including relaxers. Avoid putting relaxer onto already relaxed hair.
• Change hairstyles every few weeks to prevent strain on one area of the scalp.
• Try hair growth products. Around 40 percent of people using a minoxidil product regrow some hair after 3 to 6 months.
• Use anti-inflammatories. Steroid creams can reduce swelling on the scalp caused by traction alopecia.

If the hair still does not regrow after a few months, the hair follicles may be damaged. If there is substantial scarring, the hair may not be able to grow back.

Consult a doctor or dermatologist to find out the best course of treatment. In severe cases, hair transplants or camouflage techniques are an option.

To treat traction alopecia, see a dermatologist. The doctor will examine scalp. Patient might take a sample of tissue called a biopsy to look for other possible causes of hair loss.

Doctor might prescribe one of these treatments for traction alopecia:

• antibiotics to prevent infection in any open sores
• topical steroids to bring down swelling on your scalp
• antifungal shampoos
• minoxidil (Rogaine) to regrow hair
• biotin supplements to strengthen your hair

If patient have lost a lot of hair and it’s not growing back, a hair replacement procedure may be an option.

• Oxford hand Book of medical Dermatology
• Clinical Dermatology
• Andrew’s Diseases of the skin