Tight braids and hair loss (Traction Alopecia)
Many African American women seek our expert advice for a hair loss problem that is common to them: thinning and baldness along their entire hairline. Unlike the most common cause of thinning hair, androgenetic alopecia or genetic hair loss, this situation can be prevented. It is called traction alopecia.
Longstanding pulling on the hair destroys follicles stopping their ability to create hair shafts or fibers. This is seen most often in African American women who had tight braiding throughout their childhood and lifetime. The history 
of the problem is always the same: braids that were tightly knotted, which stayed in for weeks at a time. Dr. Matthew Lopresti and I always advise women of color or anyone for that matter, never to tightly braid their children’s hair for long periods of time.
There is hope to correct the baldness, which typically runs for the entire hairline and can be observed above the ears and even along the scalp neckline. If the person has realistic expectations and adequate hair to donate from the back of the head, then we can perform a hair transplant procedure to repopulate the affected areas with growing hair. However, it is best not to create the problem in the first place.
Though it is a common custom and is adorable to tightly braid young children’s hair, there is a steep price to pay if traction alopecia develops later in their lives from this braiding.
Dr. Robert Leonard
Founder of Leonard Hair Transplant Associates