A team of researchers from Johns Hopkins School of Medicine in Baltimore reviewed 19 studies and found a "strong association" between scalp-pulling hair styles and traction alopecia, which is gradual hair loss from damage to the hair follicle from tension at the hair root.
Traction alopecia is the most common type of hair loss among black American women, affecting about one out of three, the researchers said.
The study did not prove a definitive cause-and-effect connection. But, styles linked with this type of hair loss include braids, tight ponytails, dreadlocks, weaves and extensions, especially if hair has been chemically straightened, the review 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," Dr. Crystal Aguh, an assistant professor of dermatology at Hopkins, said in a university news release.
The findings show the need for dermatologists to learn more about these potentially damaging forms of hair styles and to advise patients about the risks and alternatives, the researchers suggested.
Traction alopecia is preventable and early intervention can stop or reverse it, the researchers said. Alternating hair styles, and avoiding those that constantly pull at the hair roots may help, they noted.
"We have to do better as care providers to offer our patients proper guidance to keep them healthy from head to toe," Aguh said.
The study was published online April 27 in the Journal of the American Academy of Dermatology.
The American Academy of Family Physicians has more about hair loss.
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