Hair extensions have been around for a very long time. They are used by women of all ethnicities to broaden the range of styles they can use for their hair. They add volume, colour and texture to hair and they change the wearer’s appearance dramatically.
The earliest hair extensions were used by the ancient Egyptians, where men and women wore hair extension wigs to ward off lice. Back then it was not uncommon for men to shave their heads and wear a wig over their bald scalps.
Hair extensions have come into, and fallen out of fashion many times. In the 1800s, women were encouraged to keep their hair natural, so extensions fell by the wayside. Meanwhile, hair extensions crept back into fashion during the 20th century and women used them to recreate the pompadour; a French hairstyle featuring hair worn high on top of the head and decorated with jewels, beads and flowers.
During this time, the hair extensions were usually attached using beeswax. The hair itself was mostly real hair cut from people with long hair, who would often grow their hair long specifically to sell it. Because of its high cost, only the rich could afford these hair extensions.
Nowadays the cost is far lower and extensions are available in both real hair, synthetic and mixed varieties. The methods of production have evolved as technology progressed, and so have the methods of attachment. Gone are the days of beeswax. Now modern attachment methods include: micro braiding; strand-by-strand “fusion” methods (hot and cold); sewn-in weaves; bonding weaves; Brazilian knots; clip-ins; and drawstring ponytails. The range of options is dizzying!
It is not all good news, however. The increased popularity and affordability of hair extensions has also meant an increased risk of hair loss by traction alopecia. This is the form of hair loss that is caused by applying pressure to the hair follicle.
Pulling hair too tightly, or adding weight to the hair, causes increased pressure on the follicle. Whatever the attachment method used with hair extensions, they all put additional weight on the follicles of your real hair. With constant use of extensions, hair follicles become damaged.
Under normal circumstances, part of the growth cycle for a hair follicle is the telogen (“resting”) phase. The hair will enter this phase once at the end of every growth cycle and, if the follicle has been damaged (such as through prolonged use of hair extensions) it will not leave the rest phase. The hair follicle will become dormant.
When more and more follicles are rendered dormant, patches of hair loss become noticeable. In traction alopecia caused by excessive use of hair extensions, hair loss is found primarily around the hairline, where the roots are often weaker than those on the rest of the head, and on the crown; where the hair is most often pulled tight into a ponytail, and the drawstring ponytail attachment method for hair extensions is commonly applied.
The most notorious attachment method for causing traction alopecia through hair extensions is the sew-in weave. This method features hair tightly braided into “tracks” along the scalp, with the extensions sewn into the braids. The tracks must be braided very tightly if they are to withstand the extra weight of the hair extensions; which puts a lot of pressure on the follicles. As new hair grows in, the extra growth is pulled on by the weight of the hair extension, further damaging the follicle and eventually resulting in traction alopecia.
Excess weight on the follicle is not the only problem. Bonded hair extensions, which use a bonding glue that is, in essence, the modern beeswax, to attach wefts to the scalp require a special glue-removing substance to remove. Once the bonding glue is softened or broken down using the glue remover, the hair extensions can be simply pulled out.
The problem is that the glue is very strong and the remover is not always applied effectively to every single point that the glue is attached to the wearer’s head. As a result, natural hair is pulled out at the roots when bonded hair extensions are removed. This damages the hair follicles and can lead to traction alopecia.
Other attachment methods cause traction alopecia in ways similar to the two methods discussed above. The strand-by-strand method adds excess weight to the follicle, and so causes alopecia in a similar way to the sew-in weave.
Brazilian knots, on the other hand, use a combination of threading and gluing. Because Brazilian knots are attached as close to the scalp as possible, they put a large amount of pressure on the follicle both due to the extensions themselves and through extra weight added when the hair grows out naturally.
Traction alopecia occurs at different rates for different people, but the worst damage occurs when extensions are used continuously. Use should therefore be curtailed, with extensions worn rarely and always followed by a few months “recovery time” to let your follicles repair themselves.
Chemical relaxants for your hair, and also hair colouring, weakens the roots and makes the hair even more likely to fall out under the strain of hair extensions. You should therefore avoid colouring your hair or using hair relaxants if you intend to wear hair extensions.
It is not all bad news though. Traction alopecia can be treated, even after years of hair abuse, but it requires patience and dedication. Treatment is only possible by stimulating follicles, making them grow new hair.
This requires a healthy scalp, so hair transplant surgery should only be used as a last resort. Transplanting hair into an unhealthy scalp only results in uptake failure as the damaged scalp will not be able to nourish the new hairs and sustain growth.