Many individuals rely on specific hair accessories daily, whether for work, errands, or bedtime. However, new research indicates that the repeated pressure exerted by these accessories on the same scalp areas may contribute to localised hair loss.
The study examined ten women who developed chronic, localised alopecia precisely where their hair accessories consistently contacted their scalps. Nine of these cases involved patches of hair loss around the crown, linked to items such as hairpins, clips, buns, ponytails, an overnight roller, and a hair prosthesis.
Hairpins were involved in four instances. Biopsies performed on seven patients revealed scarring alopecia in four cases and non-scarring alopecia in three. The researchers concluded that the hair loss was associated with mechanical injury resulting from combined pressure, traction, and friction.
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Dr Emrah Cinik, founder of the Dr Cinik Hair Clinic, explained, “Many people associate traction hair loss with very tight hairstyles like ponytails, braids, or extensions, so a small clip might seem harmless. However, this research highlights that the force does not need to be significant. Continuous pressure, friction, and tension concentrated on one small area over time can irritate hair follicles repeatedly.”
Following the removal or modification of the suspected accessory alongside treatment, four patients experienced partial hair regrowth, while another four remained stable. One patient’s hair loss worsened after continuing to use a hair prosthesis secured with hairpins.
Dr Cinik advises, “If you regularly wear a claw clip, barrette, or hairpin, inspect the exact spot where the accessory usually rests. Look for areas where hair appears thinner, the scalp is more visible, or hair strands are consistently shorter or broken. Check with your hair down and under good overhead lighting, and consider taking photographs to compare changes over several weeks.”
The British Association of Dermatologists notes that hair clips and tight hairstyles can cause traction alopecia, which may become permanent if scalp follicles are repeatedly damaged. They emphasise that ceasing damaging tension early increases the chance for hair regrowth.
Dr Cinik further suggests, “One simple measure is to change the position of your hair accessory. For example, if your clip rests on the crown every day, try moving it lower or alternating its placement to avoid frequently stressing the same follicles. Choose accessories that hold hair securely without excessive tension. If you feel pulling, tenderness, or pressure when applying an accessory, loosen it rather than assuming you will get used to the sensation. Avoid pressing hard accessories against the same scalp area while sleeping, as this prolongs exposure time considerably.”
It is important to note that the study involved a small sample of only ten patients and does not imply that everyone should stop using hairpins or clips altogether. Individuals experiencing unexplained or expanding bald patches should seek professional medical advice rather than assuming their styling habits are the definite cause.