Hair styles requiring pulling hair tightly could lead to hair loss in future, according to a review of several studies conducted by a research team at Johns Hopkins School of Medicine in Baltimore. The research team found a strong association between tight hair styles and traction alopecia. The research paper specifically mentioned Black women who tightly pull back their hair.

Traction alopecia has been earlier linked to certain specific hairstyles. When hair are pulled for a longer time, the hair follicles suffer continuous pressure and this leads to permanent damage to hair follicles. Women should adopt hairstyles that do not lead to tension at hair root, the study team suggested.

The team at Johns Hopkins School of Medicine reviewed 19 studies to arrive at their conclusions. Among Black American women, traction alopecia is the most common hair loss reason. The study team noticed that nearly 33 percent Black women suffer from traction alopecia. It leads to gradual hair loss. It is commonly seen with certain hair styles or braiding patterns that pull the hairline forcefully towards the vertex of the scalp. It has also been seen in female ballerinas.

Dr. Crystal Aguh, an assistant professor of dermatology at Hopkins said, "Hair is a cornerstone of self-esteem and identity for many people but ironically, some hair styles meant to improve our self-confidence actually lead to hair and scalp damage."

The study team added that there is an urgent need for dermatologists to learn more about these potentially damaging forms of hair styles. Women should be informed regarding the risks associated with certain hairstyles and some specific types of braiding.

Traction alopecia can be reversed by acting in time. Using alternative hairstyles can also reduce the risk. Hair styles linked with higher risk of traction alopecia can be avoided or to be used for a limited period only.

The study results have been published in the Journal of the American Academy of Dermatology on April 27.

The researchers at Johns Hopkins agree that hair extensions should not be worn tightly. The tighter the hair extension, the more likely the wearer will lose hair. They also agree that going natural may be the best alternative.

Traction alopecia is a substantial risk in hair weaves, which can be worn either to conceal hair loss, or purely for cosmetic purposes. The former involves creating a braid around the head below the existing hairline, to which an extended-wear hairpiece, or wig, is attached.

Dr. Aguh added, We have to do better as care providers to offer our patients proper guidance to keep them healthy from head to toe.