When your bun pulls too hard

In the evening, you take your bun down and your scalp breathes a sigh of relief. It pulls, it stings, sometimes it aches right up to your forehead. Then one day, in a photo taken with your hair tied back, you notice your temples look thinner than before. Can a hairstyle really be to blame?

Yes. And it’s one of the few kinds of hair loss you can prevent, as long as you spot it early.

When a hairstyle makes hair fall out

A hairstyle that pulls too hard, worn often, can make hair fall out where it pulls¹. Dermatologists call this traction alopecia: the hair doesn’t fall out because it’s unhealthy, but because it’s being pulled, hard and for a long time.

It mostly affects the front and sides of the scalp, where the tension is strongest, but the area depends on how you style your hair². It can affect anyone, whatever their background or age, and becomes more common over the years as styling habits add up².

At first, the skin turns red around the hair roots. Over the years, the condition can damage the follicle, the small pocket the hair grows from, until it leaves a scar³.

The hairstyles that pull the most

The American Academy of Dermatology lists styles worn too tight¹:

• buns, ponytails and updos pulled tight;
• tight braids, cornrows and locs;
• extensions and weaves, especially on relaxed hair;
• rollers worn to bed most nights.

Weight matters too: very long hair or long braids pull harder¹². A headscarf or other covering can add friction, especially if your hair is pulled back tightly underneath¹. Jobs and practices that call for a strict bun play a part as well: a 2018 review describes a dancer who wore an uncomfortably tight bun to class four days a week for 13 years³. Sikh men who knot their hair tightly at the front of the scalp can also be affected³.

Relaxed hair is a special case. Chemically treated hair is more fragile, and the risk goes up when you add a style that pulls³.

This study examined the scalps of 874 adults in the Cape Town area. Traction alopecia affected 31.7% of the women, against 2.2% of the men, most of whom wore their hair natural. It peaked at 48% when the usual hairstyle was extensions attached to relaxed hair⁴. It’s a snapshot at one point in time, in a population with Afro-textured hair where these styles are very common. It doesn’t say that every braid makes hair fall out, but it shows what years of pulling can do.

A further analysis by the same team, covering 574 schoolgirls and 604 women, put a figure on the risk: compared with natural hair, adding a style that pulls to relaxed hair made traction alopecia roughly 3.5 times more likely⁵.

The first signs

The first warning sign is pain. In the South African study, only 18.9% of people with traction alopecia had never had any discomfort from their hairstyles⁵. In other words, the vast majority had felt pain, stinging or spots, often without paying it much attention.

The American Academy of Dermatology advises changing your hairstyle straight away if you notice¹:

• pain when your hair is pulled;
• stinging or scabs on your scalp;
• “tenting”, where the skin is pulled up like a little tent where the hair is tied.

The very first visible sign is often redness around the hair roots, which can turn into small spots³. Then come broken hairs around the forehead, a receding hairline and thinning patches where the style pulls¹.

One detail helps dermatologists: often, a row of fine hairs is left right at the edge of the thinned area. They call it the fringe sign³. It’s a useful clue, because a receding hairline can have other causes, such as female pattern hair loss or other scalp conditions.

Does it grow back?

Early on, it usually does. As long as the follicle is intact, there’s no scarring², and most cases can be reversed if they’re caught early³. The heart of treatment is taking the tension off the hair³.

If the pulling goes on for years, the tension ends up destroying the follicles and the hair loss becomes permanent². At that stage, the hair cannot grow back¹. There’s no set time that marks the line between the two, which is why it all comes down to staying alert³. To understand the difference between a resting follicle and a destroyed one, see what grows back and what doesn’t.

Keeping your styles without losing your temples

Nobody is asking you to give up braids or buns. It’s about controlling the tension. The American Academy of Dermatology’s advice¹:

• loosen your style, especially along your hairline and temples;
• go for thicker braids and locs, and keep them on the short side;
• don’t keep braids in for more than 6 to 8 weeks;
• wear weaves for short periods, choose sewn-in rather than glued, and take them out as soon as they hurt;
• switch styles and give your hair regular breaks from styling;
• under a headscarf or other covering, tie your hair back loosely; silk or satin is gentler.

For relaxed hair, the researchers’ rule fits in one line: no braids or weaves on relaxed hair³. And on an area that’s already thinning, avoid chemicals and heat². Gentle habits with the hairdryer and straighteners point the same way.

When to see a doctor

According to the American Academy of Dermatology, it’s never too early to see a dermatologist¹. Your doctor may offer you a treatment to calm the inflammation or help regrowth, and check that another cause isn’t adding to it. If you’re not sure who to turn to, here’s which doctor to see.

Watching your hairline with photos

Traction alopecia builds up over years, not overnight². In the mirror, you can’t see your hairline move. The Cape Town researchers understood this well: to measure how severe traction alopecia is, they built a scale based on reference photos. In a small group of patients, comparing against photos gave scores that agreed better between examiners than a simple estimate by eye⁶.

At home, the method is the same. One photo of your forehead and one of each temple, hair pulled back the same way, same light, same framing. Once a week is enough. If you’ve just loosened your styles, these photos show you whether the little hairs are coming back along the edges.

Calvap shows your previous photo as a see-through overlay so you can line up in exactly the same spot, and puts your forehead and temple photos on a timeline. You see your hairline move forward or back, month after month, instead of going on a hunch. Your photos stay on your phone.