Evaluation of clinical signs and early and late trichoscopy findings in traction alopecia patients with Fitzpatrick skin type II and III: a single-center, clinical study

Abstract

Background: Traction alopecia refers to (often permanent) hair loss caused by prolonged physical damage. No study has yet described the unique trichoscopic findings of the condition. We describe the trichoscopic findings of traction alopecia and its relationships with the duration of traction.

Methods: We studied 25 patients who were clinically diagnosed with traction alopecia. The patients were divided into two groups in terms of traction duration. Trichoscopy was performed at a minimum of two scalp locations in each patient.

Results: Reduction in hair density, hair diameter diversity, empty follicles, and vellus hairs were observed in all patients. In addition, the following were observed: loss of follicular openings in 19 (76%) patients, yellow dots and broken hairs in 17 (68%), black dots in 12 (48%), hair casts in 7 (28%), circular hairs in 5 (20%), and arborizing red lines in 3 (12%). The trichoscopic findings varied with the duration of traction.

Conclusions: Traction alopecia is a chronic condition that is difficult to treat. Trichoscopy can be used for diagnosis. Our study is the first to identify the early and late trichoscopic features of traction alopecia. The limitation of the study is the lack of histologic diagnosis.