There are some forms of hair loss that we see disproportionately in the Black community. One is traction alopecia. Traction alopecia is induced from hairstyling. We see it most commonly in people who wear braids, twists, weaves, sew-ins, crochets that are too tight, or in people who wear wigs that are glued on. Traction alopecia usually starts at the front hairline, although depending on the cause, can occur at the, the back hairline as well, or it might be right up at the crown if someone wears a lot of tight ponytails or buns. In the short term, traction alopecia is reversible.

However, over time it can become irreversible, so it is really important if you start to notice your hairline creeping back, it means it's time to take a break from braids or twists or whatever style caused the problem in the first place. One of the challenges I see is that as people start to develop hair loss, they use the very styles that caused the hair loss in the first place to try to conceal the hair loss that they have. And one of my concerns is that traction alopecia has become so common, particularly among Black women, that it's almost accepted in its early stages, so that by the time people come to seek help from a doctor, they have lost so much hair and had so much follicle damage that it can make it difficult to regrow hair.

I'll say two more things. One is that once you stop those styles that cause the problem, the hair loss does not continue. So the sooner you recognize that you're having a problem, the sooner you can do something about it.

Also, there are other conditions that can mimic traction alopecia. So if you are a person who has not been wearing braids or twists or weaves or glued-on wigs, and you're noticing hair loss at the front hairline, you should make an appointment right away so that we can make sure that there's not a different condition that you're, that you're living with. I think it's important to know that the hairstyles that we wear commonly, like braids and twists and sew-ins and locks, are not inherently bad. It is important to make sure that they are not too tight. It's also important to know that some people are just more prone to traction alopecia than others.

There are some people who can put braids in every six to eight weeks for six months at a time and have no problems at all with traction, and there are other people who wear braids once and notice significant hair loss. Part of that is a function of how tight the hairstyle is, and part of that is a function of who you are as an individual. Some people are just more prone to traction alopecia than others. There are treatment options that dermatologists have at our disposal when managing patients with traction alopecia. Sometimes we will use either topical anti-inflammatory agents, like topical steroids or non-steroid anti-inflammatories.

Sometimes we'll even inject steroids into the dermis to help reduce inflammation. We'll also often use either a topical or a prescription oral medication to help stimulate regrowth. But the most important thing you can do is protect those edges and minimize the styling that caused the problem in the first place.