Recently I have been approached more and more with people suffering traction alopecia. This can be a disturbing form of hair loss as it does not follow the usual patterning and many people are still not aware of the damage that can be caused and also that in some instances cannot be reversed.

Traction alopecia is a form of hair loss caused by a pulling force being applied to the hair shaft against the scalp. This commonly results from the sufferer frequently wearing their hair in a particularly tight style like a ponytail, braid, or dreadlocks, also there is another form related to this alopecia known a Trichotillamania, when the person themselves constantly tangles and pulls their hair into tight curls causing the same symptoms. The constant pulling and twisting against the skin causes the follicle to slowly weaken and the regrowth quality of the hair decreases until finally in severe cases can cause baldness in the localised area.
Traction alopecia is the technical name for tension hair loss—simply, localised hair loss caused normally by self induced styling creating damage to the hairs' roots from constantly pulling hair too tight in the same direction. Traction alopecia occurs gradually, dependent on your hair characteristics some may suffer more than others, and is merely a cosmetic issue as hair around the points of pressure begins to thin but it does not spread to others areas of the scalp that have not been subjected to the same pressures. Severer forms of traction alopecia can cause permanent localised hair loss. The condition is not a disease, and has no medical symptoms.

Preventing Traction Alopecia
The easiest way to prevent traction alopecia is simply to vary your hair style and not putting as much pressure on the hair root. Wearing hair in a tight style for a single day is unlikely to cause the condition but constant application of the pressure will in almost every individual over time exacerbate the condition. Varying tight and looser, softer hairstyles will help to prevent thinning hair, as will varying the pressure and direction in which the hair is coaxed. It is prudent to leave the hair loose for sometimes and in severe cases do nothing to the hair in terms of pressure for a year to allow the hair and skin to relax. It is possible in some cases for the hair root to repair to a degree but this must be taken as a warning and no further traction applied to the scalp.
There is no real treatment to encourage the hair to regrow stronger again although some have tried minoxidil 2% and other stimulants, as well as natural oils such as vitamin E oil to help the scalp if there is any tension. Time can be the best healer, and although difficult to leave it will be the only way to judge whether an improvement can be made to the damaged hair.

A hair transplant is not always a credible solution, it really depends on the severity of the traction alopecia and the surface area it has covered, and it must be checked that the same has not occurred in the "donor safe zone". Dependent on hair type, sometime with very curly hair a low density can be placed and when the hair grown longer give enough appearance of thickness to hide the area well.