When the hairstyle is the cause

This is the one form of hair loss that is almost entirely preventable, and the one women are most often blamed for, which is not fair, because nobody tells you until it has already happened.

Traction alopecia comes from sustained pull on the follicle. Not one tight ponytail. Years of them. The hair is dragged in the same direction, day after day, until the follicle gives up.

Where it shows first

Along the front hairline and above the ears. The temples go first, then the line creeps back. Early on you will see short, fine, broken hairs where thick ones used to be, and sometimes small bumps or tenderness after a style is put in. If a hairstyle hurts, that is not the style settling. That is traction.

The styles that do it

Not one of these is wrong in itself. The problem is tension plus time.

• Tight ponytails and buns worn the same way every day, especially on wet hair
• Braids or cornrows put in tightly, or left in too long
• Clip-in or bonded extensions attached to the same small section repeatedly
• Wigs secured with tight elastic or adhesive on the same hairline band
• Sleeping in a tight tie

Heat and chemical relaxing do not cause traction alopecia, but they weaken the shaft, so the same pull does more damage.

Why the timing matters more than anything else

Early traction alopecia is reversible. Take the tension off and the follicle recovers. Late traction alopecia is not: after long enough the follicle scars, and a scarred follicle does not grow hair again, no matter what is put on it. The window between those two states is the whole story, and it closes quietly.

So the useful action is boring: change the style now, not after you have finished the current set of braids. Alternate where the parting sits. Leave it down when you can. Let it dry before tying. If a stylist is putting a style in and it hurts, say so while it is going in.

If the hairline has already gone

Where the loss is established, a dermatologist is the right first call. They can tell scarred from unscarred, which nobody can do by looking in a mirror. Where hair will not come back, cover is a reasonable choice and not a defeat.

Toppers work when the loss is at the part and crown; wigs when it is broader. Whichever way you go, the same rule applies: nothing that clips or attaches should pull on the remaining hairline. That is worth saying out loud at the fitting, and a good fitter will already be thinking about it.

Consultations at HEADS are ₱500, credited in full against a purchase, at 1 Antonio Arnaiz Ave, Laguna Tower, Ground Floor, Corner Unit, Makati City 1200 (The Residences at Greenbelt, corner of Greenbelt Drive and Esperanza Street).

The questions, in short

Will my hairline grow back?

If the follicles have not scarred, usually yes, once the tension stops. It takes months. A dermatologist can tell you which case you are in.

Are braids always bad?

No. Braids put in loosely and taken out in good time are fine. Tension and duration are what matter.

Can I still wear a wig if I have traction alopecia?

Yes, provided it does not grip the same hairline band. Say so at the fitting and the attachment can be planned around it.