Prevalence and Associated Factors of Traction Alopecia in Women in North Sudan: A Community-Based, Cross-Sectional Study

Abstract

Background and Objectives: Traction alopecia is a common type of hair loss that primarily results from prolonged tension in hair follicles. This condition is often associated with certain hairstyles and hair care practices that are prevalent in various cultures, especially in Africa. There have been few studies on this issue in Africa, and none have been conducted in Sudan. Therefore, we aimed to examine the prevalence and associated factors of traction alopecia in women in north Sudan. Materials and Methods: A community-based, cross-sectional study was conducted in north Sudan in December 2022. Women's sociodemographic characteristics were assessed using a questionnaire, and hair and scalp examinations were performed. A multivariate binary analysis was performed. Results: A total of 192 women participated in the study, and 48 (25.0%) had traction alopecia. The median age of the women was 42.0 years (interquartile range: 32.0-52.0 years). In a multivariate binary analysis, a family history of women with male pattern baldness or thinning (adjusted odds ratio [AOR] = 2.96, 95% confidence interval [CI] = 1.05-8.37) and the use of hair color or chemicals (AOR = 2.98, 95% CI = 1.30-6.83) were positively associated with traction alopecia. In contrast, increasing age was inversely associated with traction alopecia (AOR = 0.96, 95% CI = 0.93-0.99). The women with traction alopecia showed characteristics such as hair breakage, hair loss with the root attached, scalp tenderness, and trichodynia. Conclusions: In north Sudan, one in four women is affected by traction alopecia. Increasing awareness of this condition, providing education on proper hair care methods, and conducting large-scale research are essential steps to prevent its occurrence.

Keywords: age; chemicals; hair care practice; hairstyle; traction alopecia.

Figure 1

Illustration of the study process.