Hair Extensions Hair Loss

Traction Alopecia associated with Hair Extensions, Braids, Cornrows


Hair-extensions
The ‘hair extensions’ procedure may involve the attachment of donor tails containing up to approximately 250 human or artificial hair-shafts (from an external  source) to groups of naturally growing hair-shafts using metal rings, knots, or methods of ‘welding’ at any given point along the shaft, but more usually at just above scalp level. The objective being to provide extra hair length or volume instantly.
Many such units may be installed.
Whereas the procedure can enhance appropriately it can also have disastrous consequences. The points of attachment usually manifest as small hard lumps often sited very close to the scalp. These are capable of causing headaches, real discomfort especially during pillow contact, and sleep deprivation.
During sleep, natural body movement can create stresses on the natural scalp hair-shafts processed in this way resulting in epilation (the forced removal) of growing (anagen) hair-shafts – verifiable by the presence of their epithelial sheaths at the proximal ends. Hair-follicles suffering such tractional effects are not guaranteed to regenerate their lost hair-shafts.

Braids & Cornrows
Braiding and Cornrowing are procedures in which hair-shafts are plaited together into rows. Tractional forces created may and often do cause the development of traction alopecia. This hair may or may not re-grow.

Hair follicles were not designed to withstand such processes or support the weight of added natural or artificial hair shafts – especially when wet.
Each of the procedures should therefore be regarded as potentially damaging to hair-follicles.

The author has seen many cases of permanent baldness resulting from Traction Alopecia associated with hair extensions.

If temporary long hair is a necessity and extensions are seen as the only option, they should be removed after the shortest possible period of time.

Hair extensions The ‘hair extensions’ procedure involves the attachment of tails of up to 250 human or artificial hair-shafts (from an external donor source) to groups of naturally growing hair-shafts using metal rings, knots, or methods of ‘welding’ at any given point along the shaft, but more usually at just above scalp level. The objective being to provide extra hair length or volume instantly. Many such units may be installed.
Whereas the procedure can enhance appropriately it can also have disastrous consequences (and end in tears). The points of attachment usually manifest as small hard lumps often sited very close to the scalp are capable of causing headaches, real discomfort especially during pillow contact, and sleep deprivation.
During sleep, body movement can create stresses on the natural scalp hair-shafts processed in this way resulting in epilation (the forced removal) of growing (anagen) hair-shafts from their host follicles – verifiable by the presence of their epithelial sheaths (short light-coloured ‘socks’ at their proximal ends). Hair follicles suffering such tractional effects are not guaranteed to regenerate their lost hair-shafts.
Braids, Cornrows & Weaves are procedures in which hair-shafts are plaited into rows at close proximity to the scalp. Tractional forces on these during pillow contact have the potential (either immediately or eventually) to cause actual pain / discomfort, scalp distress / damage (occasionally with bleeding) and the more frequently witnessed traction alopecia from which the follicle may or may not recover to reproduce hairs.
Hair shafts and their individual host follicles were not designed to withstand such processes or support the weight of added natural or artificial hair-shafts – especially when wet or during the sometimes-traumatic ritual of routine grooming.
Each of the said procedures should therefore be regarded as potentially damaging to hair follicles and destructive to incumbent hairs.
I have seen many cases of permanent baldness resulting from Traction Alopecia associated with hair extensions.
I have also seen many thousands of women with Afroid hair which has undergone permanent length reduction to that of short fuzz – the direct result of insidious corn-rowing, braiding, weaving or plaiting damage inflicted on hair-bearing follicles during or since childhood.
If temporary long hair is a necessity and extensions are seen as the only option (even although wigs are safer), they should be removed after the shortest possible period of time. 
All permanently attached extension units should in my opinion be banned (or at the very least carry a risk of serious damage warning!). If however humans must be allowed the right to choose – Clip on tracks which can be removed before sleeping are a safer option.

DAMAGE LIMITATION

Damage limitation exercises (with no guarantee of success) are to attend a hairdresser who is aware of the risks caused by:  

i) attaching extension tails close to the scalp.

ii) attaching extension tails which are significantly heavier and much greater (numerically) than the naturally growing hairs to which they are attached.

iii) attaching extension tails composed of poor quality hair or hair-shafts which have not been cuticle matched (Cuticle cells form the hard protective outer layer of the hair-shaft. The cells (up to 6 layers deep) overlap and are seen under scanning electron microscopy to be imbricated (like the tiles on a roof) with the free margin of the overlap pointing toward the distal end.
It is important during the assembly of groups of donor hair-shafts to ensure that the cuticle cell imbrication of each donor hair lays in the same direction.  Tangling may be caused or exacerbated if this is not achieved. Any such tangling will create difficulties with routine grooming leading to follicular distress and possible epilation.

 

© Prof. B Stevens FTTS 

London Office:
97 Gray's Inn Road
Holborn
London
WC1X 8TX
The Trichological Society
The Registrar:
19 Balgores Square
Gidea Park
Essex
RM2 6AU