What type of alopecia is caused primarily by excessive pulling force being applied to the hair?

• A. Alopecia areata
• B. Traction alopecia
• C. Alopecia totalis
• D. Alopecia universalis

Answer: (B)

Traction alopecia is caused by excessive pulling force on the hair, which over time puts mechanical stress on the follicles. This stress leads to thinning and shedding, especially along the hairline or temples where styles tighten and pull the most. It’s commonly seen with tight ponytails, braids, extensions, or other hairstyles that continuously tension the hair. If you catch it early and stop the pulling, hair can regrow and the condition is often reversible; however, prolonged tension can cause permanent, scar-like damage.

Alopecia areata, in contrast, is an autoimmune condition where the immune system attacks hair follicles, causing sudden, patchy bald spots. Alopecia totalis means all scalp hair is lost, and alopecia universalis means hair loss on the entire body. These are not caused by pulling and behave differently in onset, pattern, and often in treatment response.