Traction Alopecia
Normally the hairs are firmly attached to the skin by means of the hair roots. It is therefore not easy to pull a hair out of the skin without applying an adequate amount of force. Pulling a strand of hair out of the skin causes pain. The amount of force required to pull a hair out of the skin can be judged from the fact that some strong-willed individuals have at public demonstrations pulled a truck or some other similar heavy vehicle with their hair, although in such instances it is the collective strength of the hair roots which comes into action. A hair which comes out of the skin easily and without pain is most likely to be the hair which is in the resting phase and would have fallen off even otherwise within the next few days.
Under certain circumstances however, if the hairs are kept under constant and prolonged traction, the hairs can loosen out of the skin. This is called traction alopecia.This is commonly seen on the front or the sides of the scalp in ‘women who tie their hair into a very tight knot or a ponytail. Women who have a heavy growth of hair and tie their hair into a large bun which loosely hangs on their back can also produce sufficient traction on the hair roots, leading to traction alopecia in the corresponding areas. Sikh boys and some adults, who tie their hair into a tight knot on the top of their head or tie their beard in a manner which causes excessive tension, can suffer from the same type of alopecia. It is usually seen on the front and the sides of the scalp or the beard respectively.
Since the hairs in this disease are not abnormal and the alopecia is caused merely by the traction, for treatment it is sufficient to prevent further traction to curb further loss of hair. The hairs start regrowing in due course, even without any medicinal treatment, but take due time to regrow.
Some people are likely to develop a psychiatric disease called trichotillomania, in which the patient develops a tendency to pull the hairs out from the scalp (and occasionally from the eyebrows, the moustache or the beard), whenever under psychological stress. The scalp and the hair in all such cases are completely normal and the hairs in these areas start regrowing almost immediately, but the process is often repeated in other areas. Thus, the areas of the loss of hair usually keep shifting from one region to the other. For treatment, it is advisable to assure the patient that the hairs on the scalp are normal and explain the mechanism of the hair loss. Psychiatric help may be obtained, if necessary, to bring out the cause of the psychological stress.
Filed under: Diseases & Conditions