In my first post on hair loss I looked at two genetic types Androgenic Alopecia and Involutional Alopecia (aka aging). In my second post on hair loss I further explored genetic predisposed types; Alopecia Areata, Alopecia Universalis and Telogen Effluvium the latter of which I suffer from myself. My third post on hair loss looked at additional influencing factors such as hormones, chemotherapy and Scarring Alopecia all of which have become more frequently observed and discussed between Beauty Professionals and their clients. In this post unlike the previous posts I am going to cover two types of avoidable hair loss Trichotillomania and Traction Alopecia. If previous posts covered inside-out types of hair loss, this one covers outside-in.
Trichotillomania:
You may also know it as the hair pulling disorder, is a mental health disorder that involves recurrent, irresistible urges to pull out hair from your scalp, eyebrows or other areas of your body, despite trying to stop. Hair pulling from the scalp often leaves patchy bald spots, which causes significant distress and can interfere with social or work life and many people with Trichotillomania may go to great lengths to disguise their loss of hair.
For some, the Trichotillomania may be mild and generally manageable. For others, the compulsive urge to pull hair is overwhelming. There are many reasons why someone starts to pull their hair, those reasons will be specific to the individual so each case needs to be addressed individually by an mental health practitioner.
The reason I felt I should cover this condition in the post is that I have witnessed an increase in Trichotillomania among young adults on both sides of the Atlantic. Many a concerned parent has asked me to ‘check it out’ and for advice. What you are looking for are missing patches of hair on the head or eyebrows, I have never been asked to have a look at anywhere else. It is not exclusive to young adults it can affect all ages.
Treatment: Fortunately there are several different treatments available for Trichotillomania, all of which involve dealing with the root cause, once the pulling stops, the hair will grow back. In many countries there are associations and support groups. Treatments include Cognitive Behavioural Therapy and the best place to start is with your own family doctor or with a mental health practitioner. Click here for NHS advice on Trichotillomania (UK) or click here for help from NAMI National Alliance on Mental Illness (US)
Professional tips: As hairdressers we are great listeners, don’t avoid or belittle the situation, do reassure the client that they are not alone and that help is available. Clients with Trichotillomania generally are very embarrassed by their condition and will find it supportive if you offer tips and tricks for disguising the areas of hair loss.
Traction Alopecia:
I first noticed this on a client of mine who was a professional ballet dancer. Her hairline and crown area appeared to be vanishing and when I looked into it, I found out she was suffering from Traction Alopecia caused by her constant pulling of her long hair into a tight bun at the crown of her head. Traction Alopecia is hair loss caused by the hair being pulled in a certain way repeatedly. Repeated strain on the hair follicles can pull out strands of hair and even damage the follicles. This can cause redness, itching, and even pus-producing ulcers or infections. Children and adults are both affected, but it is more common in adults as the hair follicles naturally weaken over time.
Traction Alopecia is made more likely by certain hairstyles and professions, some examples;
- Certain hairstyles, including dreadlocks, braids, cornrows, and tight ponytails.
- Hair extensions or weaves. Extensions are glued or tightly tied to the base of the hair, which may cause tension at the hair roots.
- Head-wear, such as sports helmets, tight elastic headbands or even glasses, may cause the hair to thin where the head-wear makes contact with the hair.
- Hair accessories, including hair slides or grips that are worn in the same way every day.
- Very long hair can be heavy, pulling on the hair follicles. Very long or tightly tied beards can also result in traction alopecia.
- Hair relaxers and other chemical treatments. These change the structure of the hair shaft in a way that makes hair loss more likely.
Signs of Traction Alopecia include:
- A receding hairline typically around the forehead, temples, or nape
- Small pimples appearing on the scalp or at the base of braids
- Redness, itching, and ulcers on the scalp
- The hair parting widens
- Patches of thin or broken hair in places where the hair has been under strain
- Patches of shiny, scarred skin in more advanced cases
A study in the British Journal of Dermatology found Traction Alopecia in 31.7 percent of African women with relaxed or permed hair
Treatment: Caught early, it is fully reversible and the hair will regrow. Over time, however, hair follicles can become irreversibly damaged so that the hair does not regrow.
Professional tips; recommend clients to avoid tight hairstyles and if they must wear them for various reasons suggest they also wear their hair loose when possible. Try changing the hairstyle every few weeks to prevent staining one particular area.
When working with chemicals and relaxers best practices and avoid overlapping onto previously treated hair.
In some cases using a regrowth product such as Minoxidil can help with the already thinned out areas. In extreme cases where the skin is looking inflamed or if there are a lot of pimples suggest a visit to their doctor who may prescribe a steroid cream to help reduce the inflammation caused by the Traction Alopecia and help reduce damage to the follicles.
In my next post I will return to grey hair and demi-permanent hair colour.
Caroline
