Traction alopecia in London: protective styles and the science of regrowth
Traction alopecia is preventable, reversible if caught early, and one of the most common causes of frontal hair loss in London's Black community.
Dr. Amara Okafor
Consultant Trichologist · Harley Street
In short
- Caused by sustained tension from braids, weaves, ponytails and extensions — not the style itself, but the tension.
- Early stage (fringe of short regrowth hairs visible) is fully reversible.
- Late stage (smooth, shiny scalp) means follicular scarring and requires transplant.
- Treatment combines tension reduction, topical minoxidil and intralesional steroids.
Traction alopecia is the most common preventable hair loss in London's Black and South Asian communities. It begins as a few short hairs at the temples or hairline and, if ignored, progresses to permanent loss within 5–10 years.
The fringe sign
The earliest reliable sign is the 'fringe sign' — a thin line of preserved short hairs at the absolute hairline, with thinning just behind it. If you can still see that fringe, the follicles are alive and the loss is reversible.
Treatment protocol
London trichologists treating traction alopecia in 2026 use a layered approach:
- Immediate tension reduction — looser styles, no daily ponytails, no glued lace fronts.
- Topical minoxidil 5% to the affected hairline, daily for 6–12 months.
- Intralesional triamcinolone for inflammatory phases.
- PRP every 4–6 weeks for 4 sessions to accelerate regrowth.
- Hair transplant only if smooth scarred scalp is present after 12 months of medical treatment.
Frequently asked
Common questions
Can braids cause permanent hair loss?+
Braids themselves do not — sustained tension does. Loose braids changed every 6–8 weeks are safe; tight braids worn continuously for years are not.
Will my edges grow back?+
If you can still see short hairs at the hairline (the fringe sign), yes. If the scalp is smooth and shiny, the follicles are scarred and a transplant is the only option.
Which London clinics specialise in Afro-textured hair?+
Several Harley Street and South London clinics now have trichologists specialising in textured hair. Use the Hair Health Check to match.
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