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Therapeutic Approach

Traction alopecia (TA) is a prevalent form of hair loss caused by excess or prolonged tension placed on the hair follicles, often attributable to the application of high-tension hairstyles such as braiding, weaving, extensions, and tight buns/ponytails. In its early stages, TA is reversible. The fundamental approach to management of TA involves the early identification and cessation of the causative hairstyling practices and counseling on alternative low-risk hairstyling practices. In the authors’ experience, patients presenting with active signs of inflammation or folliculitis can benefit from adjunctive medical therapies, which can also attenuate hair regrowth in early TA. Minoxidil is typically very effective at hair restoration in limited or moderate disease. Without appropriate intervention, TA progresses to advanced stages of disease characterized by irreversible hair loss with the loss of follicular ostia and scarring, and is no longer amenable to medical therapies. Surgical intervention may be an option for restoration of hair growth at this phase of disease. See Table 87-1.

Table 87-1Traction Alopecia Treatment Table

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