What is traction alopecia?

Résultat greffe sur cheveux afro
There are several causes of hair loss in African patients.
Alopecia can be caused by repeated braiding and brushing (traction alopecia). It can also be caused by scarring, or the use of straightening products (more than two thirds of African women). It can also be hormonal (androgenetic alopecia) and affect both men and women.
Why is this a special case? 
Transplanting afro hair can be challenging technically due to the color of the roots. African patients must take two aspects into account:
  • Afro hair curls under the skin, increasing the risk of transection (damage) when harvesting the grafts with a micro-punch (see FUE technique).
  • Black skin is more prone to hypertrophic scars or keloids (swollen and bulky): this can be avoided with a careful selection of each area of the scalp to be treated.

 

Woman, 38years old, traction alopecia, afro hair transplant, 1500 grafts.
Which technique should be used? 
Afro hair transplants are performed with the same techniques as for other patients, even if the characteristics are different. The curve of the curly hair roots sometimes makes it difficult to use the FUE technique because of the risk of transection. The FUL technique (FUT without shaving) will be preferred in cases where hair extraction presents a high risk of transection. The preparation of the grafts under the microscope prevents the risk of transection. These procedures involve implantating grafts of 1 to 3 hairs and recreating the natural growth of 1 to 3 hairs through each pilosebaceous orifice. The angle of the implanted hair in patients of African origin is more vertical than in Caucasian or Asian individuals.
The surgeon follows the original angle of the hair so that it grows in a natural way. The hair is taken from an area that is not affected by alopecia (the crown of a man’s head or the middle of a woman’s occipital region) and maintains its ability to grow for the rest of the patient’s life. The curly or wavy hair of African patients has a greater covering capacity than straight hair. This allows the surgeon to perform transplants with less hair while maintaining very good coverage of bald areas. Because of the skin’s darker color, the redness that appears after the hair transplant is much less noticeable and disappears faster than in patients with light skin.
The transplanted hair and scabs will fall out after 15 days. The hair will grow back completely after 12 months. The final results will be visible after one year.
Conclusion: 
Hair transplants with different procedures (FUE without shaving, FUE with partial shaving, FUE with total shaving, FUT without shaving, with long hair) are useful solutions for African patients.  It’s also important to stop pulling on the hair or using straightening products. Most types of alopecia can be corrected definitely. The doctor will take many parameters into account (location, extent or evolution, etiology, trichoscopic data) and the patient’s particularities (age, sex, ethnic origin, personal motivation).