Braids or Pony-Tail-Associated Traction Alopecia in Female Children

Abstract

Backgrounds: Traction Alopecia (TA) is a type of traumatic hair loss caused by prolonged tension on the scalp hair. And it is not sparse to see TA in girl children with their hairs braided or pony-tailed in Korea. This Braids or Ponytail associated Traction Alopecia (BPTA) could be difficult to differentiate from early Alopecia Areata (AA). Objectives: We intended to propose a new subtype of TA, that is BPTA, and to suggest the diagnostic flow chart for BPTA based on its characteristic clinical and dermoscopic findings through the present study. Methods: We investigated the clinical features and dermoscopic findings of BPTA in 24 patients. Dermoscopic findings of alopecia areata (AA) in 65 patients were also investigated to compare with. Results: The mean age of 24 girls was 5.92 year-old. BPTA showed clinical features such as lesional location being predominant near the parting lines of the scalp (83.87%), short duration of disease (1.2 months), quite a few lesions (1.48 lesions), small size of patch and spontaneous regrowth (1.5 months) after causative hairstyle change. In dermoscopic findings, black dots (p-value < 0.001), broken hairs (p-value < 0.001) and split end of broken hair shaft (p-value < 0.001) got to the features of BPTA, and tapering hairs (p-value < 0.001) and yellow dots (p-value < 0.001) were the characteristics of AA. Conclusions: In the cases of small hairless patches in girl, our proporal for BPTA and its diagnostic flow chart could be very useful for dermatologists, especially who are dealing hair disorders.

A 9‐year‐old girl with frontotemporal hair thinning and peripilar hair casts

“…It is more frequent in black women, although it has been described in all races and is likely underdiagnosed in children. TA has been associated with the use of ponytails, tight braids (such as cornrows and dreadlocks), and hair extensions, but if it persists over time, the alopecia tends to become cicatricial and irreversible 2,3 …”

Pediatric androgenetic alopecia: an updated review

“…In traction alopecia, the constant tension of the scalp hair caused by the mechanical forces initially induces a transitory hair loss that may later result in a scarring alopecia 26 . It commonly affects the frontotemporal hairline, but depending on the type of hair style, other areas may be affected 27 .…”

Aktuelle Übersicht zur androgenetischen Alopezie bei Kindern und Jugendlichen

“…Bei der Traktionsalopezie führt die ständige Spannung der Kopfhaare, verursacht durch die mechanischen Kräfte, zunächst zu einem vorübergehenden Haarausfall, der später zu einer narbigen Alopezie führen kann 26 . Häufig ist der frontotemporale Haaransatz befallen, aber je nach Art der Frisur können auch andere Bereiche betroffen sein 27 .…”

“…25 Bei der Traktionsalopezie führt die ständige Spannung der Kopfhaare, verursacht durch die mechanischen Kräfte, zunächst zu einem vorübergehenden Haarausfall, der später zu einer narbigen Alopezie führen kann. 26 Häufig ist der frontotemporale Haaransatz befallen, aber je nach Art der Frisur können auch andere Bereiche betroffen sein. 27 Bei der Trichoskopie können eine verringerte Dichte der Terminalhaare mit erhaltenen Vellushaaren sowie weiße Haarbüschel und weiße Punkte (leere Follikel) beobachtet werden.…”