Minoxidil For Traction Alopecia: Why Shouldn't You?

Medically reviewedby Dr. Ahmad Chaudhry M.B.B.S.
WrittenbyLuat Duong
Last updated

Have you ever wondered if you can use minoxidil for traction alopecia? We'll explain how minoxidil works and why you shouldn't use it to treat traction alopecia.

By the end of this article, you'll have a better understanding whether minoxidil will work for your traction alopecia, and other treatment options you have!

What is traction alopecia?

women traction alopecia

Traction alopecia is a type of pattern hair loss that is caused by repetitive stress on the hair follicle. This is not to be confused with telogen effluvium - which is a diffuse hair thinning caused by stress.

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Why does it happen?

The most common form of traction alopecia occurs in people who wear their hair in a tight hairstyle like a tight ponytail or cornrows.

It's most commonly found in the African American community.

When the hair is pulled tight against the scalp, it can cause repeated trauma to the hair follicles, which may lead to inflammation. Over time, this can cause the follicles to shrink making it harder for the hair to grow.

Traction alopecia can also occur in people who use heated hair styling tools, such as curling irons or flat irons. High temperatures can damage the hair follicles and lead to inflammation.

woman with tight braids

How to prevent traction alopecia?

You can prevent traction alopecia from happening by wearing loose hairstyles and easing off the heat.

How does hair loss happen in traction alopecia?

The onset of hair loss in traction alopecia occurs in the temporal regions of the scalp, which is the usual site of corn rows. The pattern of hair loss in traction alopecia reflects traction distribution. The hair loss occurs along the marginal hairline that may be present in the temporal, occipital, or frontal baldness regions.

The characteristic "fringe sign" in traction alopecia demarcates miniaturized hair and decreased retained follicular findings. The fringe sign is also associated with the vellus hairs. Unlike other forms of alopecia, the body hair and eyebrows remain unaffected in traction alopecia. Hair casts represent persistent or ongoing traction alopecia.

Can you use minoxidil for traction alopecia?

man with traction alopecia

Luckily, traction alopecia is usually reversible if caught early enough. This reversible and non-scarring form of hair loss (early in the course) might benefit from the topical application of minoxidil. Minoxidil is a medication that is typically used to treat male pattern baldness. Still, it can also be effective in treating traction alopecia.

Minoxidil stimulates blood flow to the hair follicles and promotes new hair growth. In most cases, Minoxidil will need to be used for several months before minoxidil results are visible. However, if started early enough, Minoxidil can often reverse the effects of traction alopecia and help restore healthy hair growth.

Why shouldn't you use minoxidil?

man with traction alopecia

You might want to think again if you're considering using minoxidil for your traction alopecia.

Although Minoxidil is an effective treatment for male pattern baldness and female pattern hair loss, it's not likely helpful for traction alopecia.

This condition is caused by repeated pulling or tension on the hair follicles, damaging the hair roots and leading to baldness.

Minoxidil works by promoting hair growth, but it can't repair damaged hair follicles.

So, unless you're planning to give up your ponytail or stop wearing tight braids, you might see that minoxidil's not working.

It might even make the problem worse in the form of permanent hair loss. If you're concerned about traction alopecia, talk to your doctor or a dermatologist about other alternative treatment options to minoxidil such as nanoxidil.

How do I grow my hair back faster?

Here are some ways to grow hair back faster even in bald spots after traction alopecia:

Hair growth product

Hair growth products are effective in regrowing hair safely and naturally. But finding them is very difficult with so many options out there.

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Hair extension

While not technically growing hair, hair extensions will allow you to use your desired hairstyle without damaging your real hair. Plus, it can also be used as your hair when you're dealing with traction alopecia.

Hair growth foods

Some foods provide essential nutrients to grow hair, and heal broken hair to beat your hair loss:

Other foods have DHT-blocking properties that are the cause of male pattern hair loss.

hair growth foods

How to use minoxidil on traction alopecia?

If you're concerned about traction alopecia, you may wonder if Minoxidil is an effective treatment. Minoxidil is a topical medication often used to treat hair loss. It is effective in some cases of traction alopecia, particularly during the early stages of non-scarring and reversible hair loss in traction alopecia.

However, following the instructions carefully when using Minoxidil is essential, as it can cause side effects such as scalp irritation.

Here are simplified steps how to apply minoxidil:

  1. Wash your hair with a mild shampoo and allow it to air dry.
  2. Apply a small amount of minoxidil solution to the affected areas of your scalp.
  3. Massage the solution into your scalp for two minutes.
  4. Allow the solution to dry completely before applying anything else to your hair.
  5. Repeat this process twice per day (or once a day)
  6. (Optional) Add a dermaroller with minoxidil for better results.

Note: Minoxidil shedding might happen, which is completely normal.

If you experience any deleterious side effects, such as scalp irritation, redness, or itchiness, discontinue use and consult your doctor. With proper use, Minoxidil can help to stop the progression of traction alopecia and potentially reverse hair loss.

When used correctly, minoxidil can be an effective treatment for traction alopecia. However, it is essential to consult a registered medical professional before using any medication for hair loss.

The basics of minoxidil

man applying minoxidil

Minoxidil was initially developed as an oral anti-hypertensive medication for the treatment of recalcitrant hypertension. The doctors observed hair regrowth and hypertrichosis. This resulted in the development of a topical formulation of minoxidil for the treatment of androgenetic alopecia and alopecia areata.

Minoxidil is available in two topical formulations, minoxidil solution, and propylene glycol-free minoxidil foam. In contrast to the solution, minoxidil foam causes less scalp irritation and delivers the active ingredients to the target site more effectively.

5% formulation of minoxidil has been approved by FDA for hair loss treatment.

How does minoxidil work?

how minoxidil works

Minoxidil causes vasodilation of the arteries by opening the potassium channels found on the arterial smooth muscles. The potassium channel activity is also linked to the cell cycle. Therefore, minoxidil is considered to promote cellular DNA synthesis and cell proliferation in the early stages.

The action of topical and oral minoxidil for hair growth is attributed to its active metabolite called minoxidil sulfate. The enzyme that catalyzes this conversion is called sulfotransferase. Minoxidil stimulates a rapid shift of the hair follicles to the anagen phase of the hair growth cycle and stimulates the secondary hair germ cells present in the telogen follicles.

Side effects of minoxidil you should know

man with tight braids

Common side effects of minoxidil include headaches, dizziness, and individual hairs falling out in clumps.

This is usually temporary and will resolve once you stop using the medication.

However, in rare cases, severe minoxidl side effects sexually, mentally and physically can happen.

If you experience these side effects, you should stop using minoxidil and see your doctor immediately.


Randolph, M., & Tosti, A. (2021). Oral minoxidil treatment for hair loss: A review of efficacy and safety. Journal of the American Academy of Dermatology84(3), 737-746. https://doi.org/10.1016/j.jaad.2020.06.1009

Gupta, A. K., Talukder, M., Venkataraman, M., & Bamimore, M. A. (2021). Minoxidil: a comprehensive review. Journal of Dermatological Treatment33(4), 1896-1906. https://doi.org/10.1080/09546634.2021.1945527

Pulickal JK, Kaliyadan F. Traction Alopecia. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470434/

Suchonwanit, P., Thammarucha, S., & Leerunyakul, K. (2019). Minoxidil and its use in hair disorders: a review. Drug design, development and therapy13, 2777-2786. https://doi.org/10.2147/DDDT.S214907

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Luat Duong

Luat Duong is a Copenhagen-based writer and content strategist specializing in hair loss and health. His work has been featured in MyHealthGuide, The Right Hairstyles, and Woman's Era. He is a graduate of Vaasa University. You can connect with him on LinkedIn.