HPI: This 15 yo African-American girl has noted progressive alopecia for the past year or so. Earlier in her life her hair was in corn-rows for one to two years. She has used "relaxers" for many years but stopped ~ a year ago. Her hair was pulled back for many years. Her mother has been applying "fish oil" to the area which they think may be helping.
O/E: There is marked thinning of the hair at the temporal and occipital areas. Much less involvement on frontal and parietal areas. No inflammation, scaling or scarring is appreciated.
Photos:
Diagnosis: This is most likely " Marginal Traction Alopecia"
Questions: What would you offer this young woman as for treatment. I told her to leave her hair natural, avoid relaxers or any tension on hair.
References:
1. eMedicine.com has a good chapter on Traction Alopecia: Here is an excerpt: "Traction alopecia is a common cause of hair loss due to pulling forces exerted on the scalp hair. This excessive tension leads to breakage in the outermost hairs. This condition is seen in children and adults, but it most commonly affects African American women. The 2 types of traction alopecia are marginal and nonmarginal. Unlike trichotillomania, a psychiatric disorder of compulsive hair pulling that leads to patchy hair loss, traction alopecia is unintentionally induced by various hairstyling practices (eg, use of braids, hair rollers, weaves, twists, locks, or "cornrows"). In the initial stages, this hair loss is reversible. With prolonged traction, alopecia can be permanent. Physicians, especially dermatologists, must recognize this condition early to prevent irreversible hair loss."
2. I would recommend renting Chris Rock's documentary "Good Hair" when it is available.
When a patient comes and a diagnosis of traction alopecia is made,usually the insult to hair follicles has been going on for years prior to presentation. I have yet to see a patient where I have made a diagnosis of traction alopecia and where the harmful hair care practices were introduced recently. The more the time passes before seeking medical advice, the more difficult it is to achieve hair regrowth even with advice to stop all elicited harmful hair care practices.
ReplyDeleteMy friend had problem. He was smoking a lot and than he quit and was under lots of pressure and stress and his hair started falling off in patches. Doctor said it is alopecia ... my friend continued to smoke cigaretes and now his hair started to grow back .. I am not saying it is ok to smoke but I think if you feel under stress try to get out of it asap.
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