Traction Alopecia — How Tight is Too Tight?

Dr. Rassman,

We are repeatedly warned that traction alopecia results from pulling hair too tightly. What exactly constitutes “too tight?”

I have thick, long hair (to just above mid-back) and I use a hair-tie at about neck-level to keep it in a ponytail. With a hair tie, only the outer portion of the ponytail hair contacts the actual tie and thus supports the weight of the entire ponytail. For example, the hair at the front of my head and base of my neck often feel the brunt of the weight. Could this be this too much weight? I wonder how much of my thinning is due to years of wearing my hair like this in professional settings.

I assume that “too tight” refers to only to VERY tight hairstyles such as braids, dreadlocks and cornrows. Should I have reason to worry?

Are you losing hair along the outer rim of the pony tail area? If not, then don’t worry. It’s all a matter of perspective. I can’t put a number to it. If you feel excessive pulling, then don’t keep the hair that tightly pulled.