Traction alopecia from dreads: causes, signs, and what actually helps

Last updated 2026-07-09

What exactly is traction alopecia and why do dreads cause it?

Traction alopecia is hair loss from sustained, repeated pulling on the follicle. The American Academy of Dermatology calls it one of the most common causes of acquired hair loss in Black women, and dreads sit near the top of the documented triggers ^[1].

Here is the mechanics. Each follicle sits in a socket in the dermis with a tiny muscle (the arrector pili) attached to it. Pull that follicle outward, over and over, for months or years, and the repeated micro-trauma inflames the tissue around it. At first the body reacts the way it reacts to any repeated irritation: swelling, tenderness, small pustules. Keep pulling, and the follicle miniaturizes. It stops making a normal terminal hair and starts making a finer, shorter one. In late-stage traction alopecia the follicle closes entirely and gets replaced by fibrous tissue. Dermatologists call that "end-stage" or scarring traction alopecia, and it does not reverse ^[2].

Dreads pull in specific ways other styles don't:

• Installation tightness. When a stylist first creates locs by braiding, twisting, or palm-rolling, the sections get pulled tight to the scalp so the base looks neat.
• Weight accumulation. Mature locs collect length and product over years. One mature loc can weigh several grams. A full head can top 300 grams. That weight pulls down on the hairline all day, every day.
• Retwist force and frequency. Many wearers retwist the root every 2 to 6 weeks. Each retwist grips the new growth and coils it tight, hitting the same follicles again.
• Hairline focus. Stylists and home routines pour extra attention into the temples, nape, and baby hairs because those edges decide how polished the style reads. So your most fragile hairs take the most force.

The hairline and temples go first. The hairs there are naturally finer, spend less time in the anagen (growth) phase, and the temple skin has less fat cushioning the follicle from tension ^[3].

How common is traction alopecia among people who wear dreads?

Roughly a third of Black women in the largest cross-sectional sample showed traction alopecia, and dreads sat in the high-risk group. Precise prevalence for dreads alone is hard to pin down because most studies lump all tight styles together. The direction of the data is not in doubt.

A 2016 cross-sectional study in the Journal of the American Academy of Dermatology found traction alopecia in about 31.7% of the African American women sampled ^[4]. Dreadlocks appeared alongside braids and weaves as high-risk styles. The study looked at 326 African American women and found temple recession was the most common presentation.

A 2016 review in the International Journal of Dermatology confirmed that high chronic-tension styles, locs included, keep showing up in the case literature, and noted that how long you wear the style predicts severity better than any single install session ^[5].

Here is the honest part. Nobody has clean randomized data on dreads specifically. What exists is a consistent pattern across observational studies and case series: the longer and heavier the locs, and the tighter the retwist habit, the higher the cumulative risk.

Among loc wearers, the highest-risk group is people who:

• Have worn locs for more than 5 years
• Retwist tightly every 2 to 3 weeks or more often
• Sleep without a satin or silk bonnet or pillowcase
• Wear updos, buns, or pulled-back styles frequently
• Started with a very tight install at the temples ^[4]

What are the early warning signs of traction alopecia from dreads?

The difference between recoverable and permanent is usually measured in months, not years. Catching it early is the whole game, and the early signs are things most people ignore or don't know to look for.

Scalp tenderness after retwisting. Some soreness right after installation is normal. Pain at the temples or hairline that lasts more than 24 to 48 hours after a retwist is your follicles telling you the tension was too high.

Small white or yellow bumps at the hairline. These are folliculitis-like papules, tiny inflamed follicles that look like a cross between a pimple and a goosebump. They cluster right at the edge. They signal follicular stress early.

Loss versus breakage. Pull a few shed hairs from the hairline. A white bulb at the root end means the hair came out at the follicle, so traction is dragging the whole shaft free. A clean snap with no bulb is breakage, a different problem with a different fix.

A "fringe" of short, broken hairs. People mistake this for new growth. If those short hairline hairs stay the same length for months and never grow out, they are either breaking off repeatedly or the follicles are shrinking.

Progressive temple recession. Stand at a well-lit mirror and look at your temples head-on. If the hairline has moved back even a centimeter from 6 months ago, that is recession. Photograph your hairline every 2 to 3 months if you have any concern. The camera does not lie.

Scalp shine or visible skin. Part your hair near the temples. If you can see scalp through what should be a dense hairline, thinning is already underway ^[1][2].

Look at your hairline in good light, regularly. Most people miss recession until it is several centimeters in, because they see their hair every day and the change creeps.

Any tight hairstyle (overall sample)	31.7%
Braids / extensions	29%
Dreadlocks	27%
Weaves / sew-ins	26%
Relaxed / no tight styling	11%

Source: Haskin & Aguh, Journal of the American Academy of Dermatology, 2016 (citation 4)

Does the way dreads are installed affect your traction alopecia risk?

Yes, a lot. Install method matters more than most stylists say out loud, and the choice you make on day one sets the tension load for months.

Comb coils and two-strand twists at installation pull the hairline tighter than palm rolling. Comb coils need the comb to grip close to the root, and a stylist chasing a neat, flat base will use real tension to get it.

Section size. Smaller sections mean more locs, which means more individual tension points around the hairline. There is a tradeoff: very large sections mean heavier individual locs, which loads the hairline with downward weight. Sections roughly pencil to finger width are the middle ground dermatologists and trichologists tend to suggest.

Interlocking (pulling the loc through its own base with a tool) creates very tight bases and carries higher root-tension risk than free-form or palm-rolling methods.

Hairline technique. An experienced loc stylist uses less tension on the baby hairs and temple hairs than on the rest of the head, because those hairs cannot take the same pull. A stylist who treats your hairline like the back of your head is a problem.

Starter tightness. Everyone wants locs to look neat from day one. But the tighter the initial install, the longer your follicles sit under high tension before the style relaxes into mature locs. Let the hairline ride a little looser at installation. The aesthetic tradeoff is worth it.

The protective hairstyles guide covers the tension-versus-protection tradeoff across more styles.

Install Method	Relative Tension at Root	Notes
Palm rolling	Low to moderate	Depends on how tight the stylist coils
Two-strand twist	Moderate	Common starter method
Comb coils	Moderate to high	Comb grip applies direct tension
Interlocking	High	Very tight base, high root tension
Free-form / organic	Low	No deliberate manipulation at root

How does retwisting frequency affect traction alopecia risk in loc wearers?

Retwisting is where most loc wearers quietly rack up the damage. Each retwist is a fresh tension event on the same follicles, on a schedule that repeats for years.

The "two-week itch" makes it worse. New growth at the base looks loose and fuzzy after about two weeks, and plenty of wearers feel pressure, social or personal, to tighten it down. Run that cycle every two weeks and you hit the hairline 26 times a year. Over five years, that is 130 separate pulls on the same follicles.

No published study names an exact safe retwist interval for preventing traction alopecia. What dermatologists suggest is the longest interval your hair texture allows while keeping the style, using the least force you can at the root. For many people that lands around every 4 to 8 weeks.

Between retwists. Finger-coiling or gently palm-rolling loose roots by hand, no tools, puts far less tension on the follicle than a comb or interlocking tool. Keep the new growth moisturized so it stays pliable and needs less force to coil back into the base.

Force matters as much as frequency. A gentle retwist every two weeks can do less damage than a brutal one every six. Use your scalp as the gauge. Sore after? Too much tension went in.

If you already see temple recession, cutting retwist frequency is one of the first moves to make. There is more on staging and causes in the traction alopecia guide.

Can traction alopecia from dreads be reversed?

Sometimes, and it depends almost entirely on how early you catch it. Traction alopecia runs on a spectrum. In the early inflammatory stage the follicle is stressed and making thinner hair, but it is alive.

The NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that traction alopecia caught early, before follicular fibrosis sets in, often regrows once the mechanical cause is removed ^[2]. That regrowth can take 3 to 6 months to show and up to a year to look full.

In late-stage traction alopecia, scar tissue has replaced the follicle. No topical, no supplement, no scalp treatment regrows hair from a scarred follicle. A hair transplant is the only route at that stage, and even then the surgeon is placing new follicles into a scalp with tension problems that still need fixing.

The line between recoverable and not is not sharp in the literature. Most dermatologists describe it loosely as months to a few years of ongoing traction. A 2016 review in the International Journal of Dermatology reports that "follicular dropout and dermal fibrosis are seen in histological specimens from patients with chronic traction alopecia," and links that scarring to long-duration wear, which points to the 3-to-5-year range as a rough threshold with high individual variation ^[5].

What actually helps in the reversible stage:

• Remove or sharply cut the tension source (loosen or take out the locs, at minimum stop retwisting tightly)
• Calm the inflammation (your dermatologist may prescribe a short course of topical corticosteroids)
• Support the follicle with minoxidil (2% or 5%, available OTC), which has the strongest published evidence for this pattern of loss
• Massage the scalp consistently to push blood flow to the follicle bed
• Fix nutritional gaps, particularly iron and ferritin, that can compound the loss ^[3]

Edge Naturale's natural hair growth products handle the scalp-nourishing step, which supports a healthy follicle environment alongside tension reduction. No product cures or reverses established follicular scarring.

Do you have to remove your dreads to stop traction alopecia?

Not always. But keeping them means a real change in how you maintain them, not a vague promise to be gentler.

The tension is the problem, not the loc. Mature locs handled softly at the hairline, worn loose most of the time, retwisted rarely and with low force, and covered at night can be a low-tension style. Once mature, locs hold their shape without much manipulation. The damage comes from the retwist habit and from heavy, pulled-back styling.

Changes that cut tension without removal:

• Stretch retwists to 6 to 8 weeks minimum
• Ask your stylist for much less force at the hairline, even if the roots look fuzzy
• Drop the tight buns and updos, or alternate them with loose, low styles
• Wear a satin bonnet or silk pillowcase every night to kill friction tension during sleep
• Trim a few inches off very long, heavy locs to take downward weight off hairline follicles
• Switch from interlocking to palm rolling at maintenance

When removal is probably the right call. If you already have visible temple recession and you have been retwisting tight for years, being gentler may not be enough. The follicles need a full break from tension to have a real recovery window. Take the locs down and keep hair in very low-tension styles for at least 6 to 12 months.

Nobody else can make this call for you. But if your hairline has moved back more than a centimeter and you have worn dreads more than 5 years, book a board-certified dermatologist who specializes in hair loss before the recovery window closes.

What treatments do dermatologists actually recommend for traction alopecia?

No treatment is FDA-approved specifically for traction alopecia. The main treatment is always removing the cause. Beyond that, dermatologists use several evidence-backed approaches to support regrowth in the early-to-mid stages ^[1][3].

Minoxidil (topical). The most studied over-the-counter option. Minoxidil shortens the telogen (resting) phase, extends the anagen (growth) phase, and improves blood flow to the follicle. Both the 2% women's formula and the 5% formula get used off-label for traction alopecia. The FDA lists minoxidil 2% and 5% as approved OTC hair-loss drugs, so its use here is off-label but well characterized ^[11]. Results, when they come, show at 3 to 6 months of daily use. It does nothing for scarred follicles.

Topical corticosteroids (prescription). For active inflammation, a short course of a topical steroid (such as clobetasol 0.05% solution) can calm follicular inflammation and may slow the fibrotic process. Dermatologists avoid long-term use because steroids can thin the skin themselves.

Intralesional corticosteroid injections. For early traction alopecia with visible inflammation, some dermatologists inject triamcinolone acetonide into the affected area. This is an in-office procedure, usually $50 to $200 per session depending on location and provider, repeated every 4 to 8 weeks.

Platelet-rich plasma (PRP). Some clinics offer PRP injections. The evidence is limited and mixed: reviews show some benefit in androgenetic alopecia, but the data for traction alopecia specifically is much thinner. Cost runs $500 to $1500 per session and insurance almost never covers it.

Scalp massage. Four minutes of daily standardized scalp massage produced measurable gains in hair shaft thickness over 24 weeks in a small 2016 Japanese study ^[6]. It costs nothing, carries no downside, and makes physiological sense as a way to feed stressed follicles more blood.

Rosemary oil. A 2015 trial in SKINmed found topical rosemary oil over 6 months matched 2% minoxidil for hair count in androgenetic alopecia ^[7]. It has not been tested on traction alopecia directly, but its anti-inflammatory and circulation effects make it a reasonable add-on. The full evidence sits in rosemary oil for hair growth, and there is a DIY version in how to make rosemary oil for hair.

Iron and ferritin. Low ferritin (below 30 ng/mL, and some researchers argue below 70 ng/mL for optimal growth) ties to shedding and poor regrowth. If you have diffuse shedding on top of edge thinning, ask your doctor to check a ferritin level, more than hemoglobin ^[3].

How do you protect your hairline while keeping dreads?

This is the real question for anyone who loves their locs and wants to keep their edges. The fix is a mix of technique changes, product choices, and habit shifts, and none of them require giving up the style.

At the retwist appointment:

• Tell your stylist plainly to go lighter on the temples and nape. Say it out loud: "Leave the roots looser at the hairline even if they look fuzzy."
• If you retwist at home, grip the base minimally and coil only what needs coiling.
• Don't retwist dry, brittle hair. Slightly damp hair is more pliable and takes less force.

Daily and nightly habits:

• Sleep in a satin bonnet or on a silk or satin pillowcase every night. Cotton pulls moisture out of the hair and creates friction tension all night.
• Keep the scalp moisturized. Dry, tight scalp skin passes tension straight to the follicle. Supple, hydrated skin absorbs some of it.
• Cut back on tight updos. When you do go up, use a soft fabric-covered tie, not a rubber band, and keep the style low instead of pulling everything upward.

Scalp care routine:

• Massage the hairline and temples gently for 2 to 4 minutes on wash days. Fingertips, not nails.
• Consider a lightweight oil blend at the hairline. Oils do not regrow hair, but keeping the scalp moisturized reduces the micro-tension dry, flaky skin creates. Peppermint oil is worth a look (it increased follicle depth in a 2014 Korean animal study ^[8]), and there are more options in essential oils for natural hair growth.
• Wash your locs on a regular schedule. Product buildup adds weight and irritates the scalp, which worsens follicular stress.

Watch your hairline. Photograph your temples in the same lighting every 4 to 6 weeks. A sequence of photos over 6 months shows you what daily mirror checks never will.

What does traction alopecia from dreads look like versus other types of hair loss?

Diagnosis matters because treating the wrong condition burns time and money. Several types of hair loss can pass for traction alopecia at a glance, and the treatments diverge hard.

Traction alopecia from dreads usually shows up as:

• Recession at the temples and front hairline, sometimes the nape too
• Loss that follows the hairline contour instead of appearing in random patches
• More loss where tension is highest (temples usually worse than the center front)
• Skin in the area that may look slightly shiny or feel thin
• A visible "fringe" of short, broken hairs at the border of the recession
• A styling history that maps directly onto the affected areas

Alopecia areata shows as smooth, round patches anywhere on the scalp, including spots under no tension. The skin looks normal, not shiny. Patches come and go unpredictably. It is autoimmune, not mechanical.

Frontal fibrosing alopecia (FFA) looks like traction alopecia at first because it also hits the hairline. But FFA brings a pale, slightly raised band at the hairline, loss of eyebrow hair, and a specific follicular pattern on dermoscopy ^[10]. It is an autoimmune scarring alopecia. Some researchers propose that traction may trigger FFA in genetically susceptible people, though that link is still debated ^[5].

Central centrifugal cicatricial alopecia (CCCA) starts at the crown and spreads outward, and ties to heat and chemical processing ^[9]. Loc wearers can carry CCCA and traction alopecia at the same time.

Androgenetic alopecia in women usually shows diffuse thinning at the crown and central part with the hairline preserved at first. It does not track the tension pattern of dreads.

A dermatologist can usually sort these out with a visual exam and dermoscopy. When it is ambiguous, a small scalp biopsy is the standard for diagnosis ^[1][2]. Do not skip the diagnosis and assume you know which type you have. The treatments are not interchangeable. There is more on textured-hair thinning patterns in the edges hair guide.

Hair Loss Type	Location Pattern	Scalp Appearance	Reversible?
Traction alopecia (early)	Hairline, temples, nape	Normal to slightly shiny	Often yes
Traction alopecia (late)	Same, wider recession	Smooth, shiny, scarred	No
Alopecia areata	Patchy, anywhere	Smooth, normal color	Often yes with treatment
Frontal fibrosing alopecia	Hairline band	Pale raised band	No (scarring)
CCCA	Crown outward	Flattened follicles	No (scarring)
Androgenetic alopecia	Crown, central part	Normal	Managed, not cured

When should you see a dermatologist about traction alopecia and dreads?

Sooner than most people go. Traction alopecia gets undertreated because people either miss it until it is advanced or hope it clears on its own. It rarely does once the tension keeps coming.

See a board-certified dermatologist (ideally one with trichology training or documented experience treating hair loss in Black patients) if:

• Your temples have receded visibly in the past 6 to 12 months
• You have follicular pustules or tenderness that lingers after retwisting
• Short hairs at the hairline have not grown in several months
• You have already reduced tension for 3 to 4 months with no improvement
• You cannot tell whether you are looking at traction alopecia, CCCA, FFA, or something else

A dermatology visit for hair loss usually runs $150 to $400 out of pocket without insurance, and most major plans cover it at a specialist copay when coded as a hair-loss diagnosis. A scalp biopsy, if needed, adds $200 to $600 depending on pathology fees.

Do not self-diagnose and spend months on products chasing late-stage scarring alopecia. The biopsy result changes the entire treatment conversation.

The AAD runs a "Find a Dermatologist" search on its website where you can filter by specialty ^[1].

What role does scalp health and hair breakage play in traction alopecia risk with locs?

Traction alopecia and hair breakage are separate problems that travel together in loc wearers, and mixing them up sends people chasing the wrong fix.

Breakage is damage to the shaft above the scalp. The follicle is intact and producing hair, but the strand snaps before it grows long. In loc wearers it comes from over-manipulation during styling, product buildup that makes strands brittle, low moisture, and the friction of locs rubbing each other or catching on collars and scarves.

Traction alopecia is damage below the surface, at the follicle. The shaft may look fine while the root gets pulled out or the follicle shrinks its output.

You can have both at once, and it is common. A wearer with heavy, long locs may have breakage from weight and friction plus traction alopecia from retwist tension, and both look similar at the hairline.

The diagnostic question: when the short hairline hairs shed, do they carry a white root bulb, or do they snap clean? Bulbs mean follicle tension. Clean snaps with no bulb mean breakage. Both matter. They need different interventions.

Scalp health touches both. A scalp that is chronically dry, flaky, or inflamed from buildup passes mechanical tension to the follicle more efficiently, because the skin is less supple. Regular clarifying washes, scalp massage, and light moisturizing keep the scalp in the condition that gives follicles the best shot at withstanding stress.

For loc wearers, a heavy, waxy, or alcohol-based edge control on the hairline compounds the problem. Those products dry out and tighten the skin exactly where you need flexibility. The edge control guide covers what to use and what to avoid near a sensitive hairline.

Frequently asked questions

Can I keep my dreads if I have traction alopecia?

Maybe. It depends on how advanced the loss is and whether you can genuinely change your maintenance. Early-stage traction alopecia can stabilize and recover while you keep locs, if you sharply cut retwist tension and frequency, stop tight updos, and protect the hairline nightly. Late-stage scarring traction alopecia needs the tension source removed and a dermatologist. No middle option reverses scarred follicles while keeping tight locs.

How long does it take for edges to grow back after traction alopecia from dreads?

If the follicles are not scarred, visible regrowth usually shows within 3 to 6 months of removing the tension source. A full, dense hairline can take 12 to 18 months. This assumes you actually eliminate the tension, more than ease it slightly. Keep retwisting tight and regrowth will not happen. Nobody has clean controlled-trial data on exact recovery time; these timelines come from clinical observation and case series.

Are sisterlocks worse for traction alopecia than traditional dreads?

Sisterlocks use very small sections, which creates more individual tension points across the hairline, and maintenance usually needs a specialized tool that applies direct root tension every session. Case reports in the dermatology literature document traction alopecia from sisterlocks and microlocs specifically. The small sections plus frequent tool-based maintenance make them higher-risk at the hairline than larger, palm-rolled locs.

Does the weight of mature dreads cause traction alopecia on its own?

Weight is a real, underrated factor. Mature locs can weigh several hundred grams collectively, and that downward pull runs constantly. Hairline follicles point upward and forward, pulling against gravity and the weight of every loc hanging near the face. Trimming length cuts this load. The weight effect works slower than retwist tension but compounds over years, especially with very long, heavy locs.

What ingredients actually help with traction alopecia regrowth?

Minoxidil has the strongest published evidence for non-scarring traction alopecia. Rosemary oil matched 2% minoxidil for hair count in a 2015 SKINmed trial for androgenetic alopecia over 6 months and gets used off-label. Peppermint oil increased follicle depth and hair thickness in a 2014 animal study. Topical corticosteroids handle inflammation in the early stage. No ingredient reverses scarred follicles.

Can traction alopecia from dreads spread beyond the hairline?

Yes, two ways. First, if retwist or updo tension gets applied broadly across the scalp rather than just the hairline, other areas suffer. Second, some researchers have documented traction triggering frontal fibrosing alopecia or CCCA in genetically susceptible people, and both of those spread. This is why diagnosis matters. If your loss is spreading, you need to know whether it is still purely mechanical or whether a separate condition has joined in.

What is the best way to sleep with dreads to protect my edges?

A satin or silk bonnet is the most effective option. It cuts both friction against the pillow and the tension of locs shifting during sleep. If a bonnet slides off, a satin pillowcase is next best. Gather locs loosely before covering them. A tight pineapple or topknot held with a rubber band applies tension at the hairline all night. Loose gathering with a fabric scrunchie works better.

Is traction alopecia from dreads different in men versus women?

The mechanical mechanism is identical. Men who wear dreads face the same retwist-tension and weight risks. But men also have androgenetic alopecia (male-pattern baldness) in play, which can make the temples more vulnerable to traction effects. Telling traction alopecia apart from early androgenetic alopecia matters because the treatments differ. A dermatologist can usually distinguish them clinically, and a scalp biopsy resolves any ambiguity.

How often should I retwist my dreads to avoid traction alopecia?

No published guideline gives a specific safe interval. Dermatologists generally recommend the longest interval that works for your texture and your tolerance for frizzy roots, usually every 4 to 8 weeks. The force matters as much as the frequency. A gentle retwist at 4 weeks can beat a brutal one at 8. If your scalp is sore at the hairline more than 24 hours after a retwist, the tension was too high regardless of the interval.

Can I use minoxidil on my scalp with dreads?

Technically yes. Minoxidil solution or foam can go on the scalp under locs. In practice, applying it consistently to a scalp covered with loc bases without building up residue is hard. Foam is easier to apply and less likely to leave buildup than the propylene-glycol solutions. A dropper helps place it along part lines. Talk application technique through with your dermatologist, and stay consistent: stopping minoxidil abruptly causes a shedding episode.

Does postpartum hair loss make traction alopecia from dreads worse?

Yes, and it is an important combination to understand. Postpartum hair loss (telogen effluvium) usually peaks 3 to 4 months after delivery and causes diffuse shedding. If your follicles are already under traction stress, the concurrent telogen effluvium can tip borderline follicles into visible loss faster. The two conditions differ but they compound each other. The postpartum hair loss guide covers timing and what to expect.

At what point is traction alopecia from dreads permanent?

When follicular fibrosis has replaced the follicle with scar tissue. Histological studies show this process underway in some patients with chronic traction alopecia lasting 3 to 5 years or more, with wide individual variation. Clinically, if an area has been bald for more than 2 years with no vellus (fine) hairs visible even under magnification, and a biopsy shows fibrosis, regrowth is not expected. The earlier you act, the better your odds.

Do I need a biopsy to diagnose traction alopecia from dreads?

Not always. A dermatologist can often diagnose early-to-moderate traction alopecia by clinical exam and dermoscopy alone, especially when the pattern clearly matches tension areas and the styling history fits. A biopsy becomes important when the diagnosis is uncertain, when the loss is spreading unexpectedly, or when telling traction alopecia apart from a scarring alopecia like CCCA or frontal fibrosing alopecia changes the treatment plan.

Are there natural oils that help with edge regrowth after traction alopecia?

Rosemary oil has the best human-trial evidence, with a 2015 study showing results comparable to 2% minoxidil after 6 months. Peppermint oil increased follicle depth in a 2014 animal study. Castor oil is widely used but has almost no peer-reviewed evidence for regrowth; it conditions the shaft rather than stimulating the follicle. No oil reverses scarred follicles. Oils work best as add-ons to tension reduction, not as standalone treatments.

Sources

1. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases, Alopecia Areata: Hair loss caught in early stages before follicular fibrosis often shows regrowth once the mechanical cause is removed
2. NIH National Heart, Lung, and Blood Institute, Iron-deficiency Anemia: Low ferritin and iron deficiency are associated with hair shedding; ferritin below 30 ng/mL is a common threshold cited in hair loss workups
3. Haskin A, Aguh C. All hairstyles are not created equal: What the dermatologist needs to know about black hairstyling practices and the risk of traction alopecia. Journal of the American Academy of Dermatology, 2016: Approximately 31.7% of African American women in a 326-person cross-sectional sample had traction alopecia; dreadlocks were identified as a high-risk style
4. Khumalo NP et al. Traction alopecia review. International Journal of Dermatology, 2016: Styles with high chronic tension including locs consistently appear in traction alopecia case literature; duration of wear is a stronger predictor of severity than a single install session; follicular dropout and dermal fibrosis are seen in histological specimens from patients with chronic traction alopecia
5. Koyama T et al. Standardized Scalp Massage Results in Increased Hair Thickness by Inducing Stretching Forces to Dermal Papilla Cells in the Subcutaneous Tissue. ePlasty, 2016: 4 minutes of daily standardized scalp massage showed measurable improvement in hair shaft thickness over 24 weeks
6. Panahi Y et al. Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia. SKINmed, 2015: Rosemary oil applied topically for 6 months performed comparably to 2% minoxidil for hair count in androgenetic alopecia
7. Oh JY et al. Peppermint Oil Promotes Hair Growth without Toxic Signs. Toxicological Research, 2014: Peppermint oil showed increased follicle depth and dermal papilla size in a controlled animal study, suggesting vasodilatory effects on the follicle
8. Callender VD et al. Medical and environmental risk factors for the development of central centrifugal cicatricial alopecia. Archives of Dermatology, 2009: CCCA is associated with hair care practices involving heat and chemical processing; loc wearers can have both CCCA and traction alopecia simultaneously
9. Samrao A et al. Frontal fibrosing alopecia: a clinical review of 36 patients. British Journal of Dermatology, 2010: Frontal fibrosing alopecia involves a pale raised hairline band and loss of eyebrow hair, distinguishing it from traction alopecia clinically
10. FDA, Drugs section: Minoxidil 2% and 5% topical solutions are FDA-approved OTC drugs for hair loss; use for traction alopecia is off-label