Clinicians and patients can benefit from better education about traction alopecia

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Disclosures: The authors report no relevant financial information.


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According to a research letter published in the Journal of the American Academy of Dermatology.

“Traction alopecia (TA) is a condition that primarily affects women and children of color and can significantly reduce quality of life,” Gabriella Santa Lucia, MD, MSCR, from the Medical University of South Carolina, and colleagues wrote. “Council modification of the hairstyle remains the cornerstone of prevention.”

To examine the clinical management and outcomes of AT, Santa Lucia and colleagues conducted a retrospective study of patients diagnosed with AT alone or AT associated with androgenetic alopecia (AGA).

The researchers identified 167 patients, 11 of whom had concurrent AGA. Most of the patients were female, black, and had a history of using tight braids. Additionally, most patients had a frontotemporal distribution of hair loss.

While most patients received treatment counseling and were prescribed adjuvant drug therapy, approximately two-thirds of patients did not return for follow-up. Of those who returned, 78% were lost to follow-up within the first 6 months.

Among the patients followed, 96.3% had stabilized or improved disease.

Santa Lucia and her colleagues highlighted the health care gaps they identified during the study.

“The frequent diagnostic delay observed in our study underscores the need to increase recognition of AT in both children and adults and to expedite referral of affected individuals to a dermatologist,” they wrote. “Patient education can also encourage early visits to the dermatologist when the disease is still reversible and treatment is more likely to be beneficial.”

They added that the number of patients with brief or no follow-up may be linked to clinicians’ limited understanding of the disease, cultural norms, societal expectations and economic limitations.

“Practitioners should appreciate the personal value of hairstyles and provide detailed recommendations for low-risk alternatives,” the researchers concluded. “Culture-sensitive practices can lead to lasting and positive results.”

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