Treating traction alopecia for men who wear turbans

Dr. Renée A. Beach notes that a minority of men, particularly men who wear turbans, report symptoms of the condition (600 words, 2.5 min)

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Traction alopecia is a scalp disorder that occurs commonly in women. But as Dr. Renée A. Beach discussed during her presentation on hair and scalp disorders at Skin Spectrum Summit in Vancouver, a minority of men, particularly men who wear turbans, report symptoms of the condition. 

“As a dermatologist, we often look before we ask, and when we look, we see that there is loss of the frontal hairline, with a fringe pattern [of hair] remaining at the edge of the front,” Dr. Beach said, describing the symptoms of traction alopecia. 

Signs of traction alopecia include fringe hair loss along the edge of the frontal scalp. There is retained vellus or small terminal hairs that simply do not get swept up into the style. A trichoscopy can show specific features, but this is a clinical, bedside diagnosis that doesn’t require further investigation. 

Male patients, who are observing Sikhs wearing turbans, are at a greater risk for traction alopecia. During her talk, Dr. Beach showed examples of a dermatologist based in India using the process of inserting hair grafts and hair plugs in an attempt to cure a case of traction alopecia in male patients. 

To avoid further hair loss, patients need to undergo significant modification to the way they wear the turban so that the condition does not recur. 

“Patients who are wearing turbans or hijabs are encouraged not to pull them tightly along the hair,” said Dr. Beach. “Hairstyle modification is paramount, but there is off- label use of minoxidil 5 per cent foam, which can certainly help in a subacute situation.” 

The takeaway: Traction alopecia is a reversible form of hair loss; however, at later stages, a hair transplant may be the only option for patients. 

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FROM THE LITERATURE ON TRACTION ALOPECIA

Intralesional Triamcinolone Acetonide in the Treatment of Traction Alopecia

  • Intralesional triamcinolone acetonide administered to the hairline of patients with traction alopecia resulted in a visible increase in hair density after six to eight weeks of treatment, according to a recent study. The investigators emphasized that the best way to avoid traction alopecia is to avoid grooming practices that may irritate or pressure the hairline.

    From “J Drugs Dermatol.”

Clinical recognition and management of alopecia in women of colour

  • Traction alopecia occurs at higher rates in women with Afro-textured hair, according to a recent study. This is due to both to physical qualities of the hair itself—baseline tensile strength, hair density, and growth rates differ compared to Caucasian hair—and typical hair care practices, according to researchers.

    From “Int. J. Women’s Dermatology”

Effect of Oral Minoxidil for Alopecia: Systematic Review

  • Low dose oral minoxidil may be a safe treatment for traction alopecia, according to a recent systematic review of nine research articles published in a number of databases. The researchers said that high-quality clinical trials are still necessary to definitively determine factors such as dose size and treatment duration.

    From “Int. J Trichology”

VIDEO: Norrin protein may activate hair growth, lead to new therapies

AT THE INTERSECTION OF SKIN AND SOCIETY

  • Young Sikh volunteers are working with Sikh seniors to ensure that they are properly protected from Covid-19 by helping them with proper mask use and safety tips, according to a report by CBC. As part of the Alberta South Asian Covid-19 Relief project, volunteers in Calgary are assisting Shhk seniors who may have trouble finding properly fitting masks that are compatible with their beards and turbans, according to the report. The volunteers designed special clips that make it easier to wear a mask and turban at once. "Our whole goal is to educate our community because personal protective equipment for minority communities is not always as accessible," said volunteer Isha Kaur (pictured below). Read the full article here.

This Week

Something to think about during the week ahead…

Next Week

Dr. Andrew Alexis on the similarities in presentation between scleroderma and vitiligo in patients with skin of colour.

Thank you to our panellists and delegates for making Skin Spectrum Summit 2020 a great success. Conference highlights will soon be posted to the Skin Spectrum website. As always, we welcome your questions and comments on topics in Ethnodermatology.

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