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Read articleTraction Alopecia: Hair Loss from Hijab and Tight Hairstyles
Traction alopecia is hair loss that happens when hair is pulled continuously for long periods, gradually tiring and weakening the follicles. It usually appears along the hairline, at the temples and above the ears. The hijab itself is not the cause; the problem is excessive tension from tight ties, under-scarves or pins. Importantly, in its early stages it can improve considerably once the source of tension is removed.
What are the early signs of traction alopecia?
The problem develops slowly, so many people only notice it once a gap has become obvious. Look out for these signs:
Spotting these signs early is the most important step, because years of constant pulling can scar the follicles and make the loss permanent.
- Thinning at the temples, along the front hairline or at the back of the neck.
- Short broken hairs at the edges of the hairline.
- Small red bumps around the hair roots where the pull is strongest.
- Soreness, a pulling sensation or headache after tying your hair or wearing a tight covering.
- Immediate relief when you loosen the tie or remove the covering.
What are the common causes?
Any hairstyle or covering that pulls the hair firmly for many hours a day can cause the problem over time, especially when repeated in the same place. Common causes include:
Combining tension with chemicals such as hair relaxers, or with high heat from styling tools, makes things worse.
- A tight ponytail or bun, especially if tied in the same place every day.
- A tight under-scarf beneath the hijab, or one tied firmly across the forehead and temples.
- Pins and clips fixed into the hair itself.
- Tight small braids and hair extensions.
- Tying hair while it is wet, when it is weaker and more likely to stretch and break.
How can I wear hijab without straining my hair?
You do not need to give up your style of dress, just make small changes that reduce tension and friction. The hot, humid weather in the Eastern Province increases sweating under the covering, which makes the hair and scalp more sensitive to pulling and friction.
- Choose a comfortable, non-tight under-scarf in cotton or a soft, breathable fabric.
- Change where you tie your hair and how you wear the covering from day to day, so the same spot is not pulled repeatedly.
- Pin the fabric, not the hair.
- Dry your hair well before tying or covering it.
- Use soft ties without metal parts and leave the hair a little loose.
- Give your hair and scalp a rest at home by untying your hair and removing the under-scarf.
Does hair grow back after traction alopecia?
In the early stage, hair usually grows back within months once the pulling stops, because the follicles are still alive. If tension continues for years, however, some follicles can scar and the scalp in that area may look shiny, and then regrowth becomes unlikely.
That is why changing the habit early is the most important treatment. Patience is essential, as hair grows slowly and it may take several months to see a clear difference.
What treatments might a doctor suggest?
Your doctor will first confirm the diagnosis, because other conditions can cause thinning in the same places, such as alopecia areata, pattern hair loss, iron deficiency or thyroid problems. They may request blood tests or examine the scalp with a dermatoscope.
Depending on your case, they may prescribe treatment to calm follicle inflammation, such as topical or injected corticosteroids, an antibiotic if there are inflamed bumps, or minoxidil solution to stimulate growth, all used under medical guidance. For long-standing, stable cases that have not improved, hair transplantation may be an option after careful assessment. Pregnant and breastfeeding women should consult their doctor before any hair treatment.
Frequently asked questions
Can men get traction alopecia too?
Yes, it can affect men who tie long hair tightly or wear a very tight cap for many hours a day, although it is more common in women.
Can children get it?
Yes, especially girls whose hair is tied in tight braids or ponytails every day. Use soft, loose ties and see a doctor if you notice thinning at the temples.
Can home oils make the hair grow back?
Gentle scalp massage may feel soothing, but no oil has been shown to treat this type of hair loss. What matters most is stopping the pulling and seeing a doctor if the hair does not improve.
When will I see improvement after changing the habit?
New growth usually takes 3 to 6 months to become clearly visible, because the hair growth cycle is slow.
When to see a doctor
See a dermatologist if you notice increasing thinning at the temples or hairline, painful bumps around the hair roots, no improvement after several months of reducing tension, or if hair loss comes with severe itching, scaling or shiny bald patches. Early diagnosis distinguishes hair loss that can improve from a condition that needs different treatment. You can book a consultation at Medical Care Clinics in Al-Shati Al-Gharbi, Dammam, close to Al-Khobar and Dhahran, where our dermatology team will examine your scalp and agree a suitable plan with you.
This article is general health education and does not replace a medical examination. Every case needs its own assessment by a doctor.
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