Traction alopecia: A neglected entity in 2017.

Area of Science:

• Dermatology
• Trichology

Background:

• Traction alopecia, described in 1904, remains a prevalent cause of scarring hair loss, particularly among young women worldwide.
• This condition is characterized by its unique biphasic nature, progressing from reversible to irreversible (scarring) alopecia.
• It is observed across all racial groups and is associated with hairstyles that exert continuous tension on the hair follicles.

Purpose of the Study:

• To review the current understanding of traction alopecia, including its clinical presentation, diagnostic findings, and management strategies.
• To highlight new dermatoscopic findings that may aid in early diagnosis and referral.
• To emphasize the importance of prompt diagnosis and identification of causative hairstyles in clinical practice.

Main Methods:

• Review of existing literature and clinical observations regarding traction alopecia.
• Discussion of diagnostic criteria, including clinical examination and dermatoscopy.
• Analysis of current and potential treatment modalities.

Main Results:

• Traction alopecia commonly affects the frontotemporal hairline, with patterns varying based on the causative hairstyle.
• New dermatoscopic findings, such as traction folliculitis, the fringe sign, and hair casts (pseudonits), are identified as potential indicators for early specialist referral.
• Cessation of the offending hairstyles is the primary treatment; topical preparations and hair transplantation are considered for later stages.

Conclusions:

• Prompt diagnosis and identification of hairstyles causing traction alopecia are crucial in dermatological practice.
• While cessation of tight hairstyles is the mainstay of treatment, further research is needed to clarify the pathogenesis and enhance medical interventions.
• Hair transplantation may be the only effective option for severe, late-stage traction alopecia.