A former ballet dancer is speaking out after years of wearing too-tight ballerina buns gave her a receding hairline. Diva Hollands, 22, a former ballerina who trained at the Royal Ballet School in London, says she needed a hair transplant to fix her traction alopecia, gradual hair loss that’s caused when force is applied to the hair.
Hollands started dancing when she was three years old, and she always wore her hair back off her face, according to a press release from The Maitland Clinic, where she eventually sought treatment. Her hairline started receding due to the tension, leading to tons of teasing. “I was bullied for my hairline in primary school and then into secondary school, but it got really serious when I was about 13. Since then, I was completely self-conscious about it and did everything I could to hide the area,” Hollands says in the press release. Even when she met her now-fiancé David Lawson-Brown, she was so embarrassed by her receding hairline that she wouldn’t let him see her with her hair pulled back until they had been dating for six months. “For me, it’s something that is very personal,” she says.
After having two children, Hollands experienced even more hair loss. Finally, she went to The Maitland Clinic and had an eight-hour procedure to replace damaged hair follicles at her hairline with functioning ones from other parts of her scalp. Thrilled with the results, she decided to share her story of balding because of buns. “I really do think there’s a taboo when it comes to women’s hair loss,” she says. “It can happen to anyone, and it’s nothing to be embarrassed about.”
Unfortunately, this isn’t uncommon, Ted Lain, M.D., a dermatologist practicing in the Austin, Texas, area, tells SELF. “I see it frequently,” he says, adding that it can start early. New York City dermatologist Doris Day, M.D., author of the upcoming book Skinfluence, tells SELF that she sees it a lot in women with tight braids and hair extensions, as well as those who wear really tight ponytails and buns. “The hairstyle’s pull creates tension, which can create inflammation that can lead to scarring of the hair follicle and hair loss,” she explains.
And balding because of buns and other hairstyles doesn’t happen overnight: Day says it can take “decades” for traction alopecia to actually show up, and it can surface even when someone hasn’t worn a tight hairstyle for some time. That’s why Day recommends that people try to wear less-tight hairstyles, adding, “the looser you can make your ponytail, the better.”
Doctors will typically recommend nonsurgical treatments first if your hair loss isn’t severe, hair transplant surgeon Ken L. Williams Jr., a fellow of the International Society of Hair Restoration Surgery, founder of Orange County Hair Restoration, and author of Hair Transplant 360, tells SELF. Those include laser light therapy, minoxidil (a medication that promotes hair regrowth), and platelet-rich plasma therapy, a regenerative treatment that stimulates hair follicles. Unfortunately, they don’t always work. “Sometimes we see a good response, and sometimes we’ll just see a partial response,” Williams says.
Day agrees but says she has been able to recover some hair follicles through low-concentration cortisone injections. “Sometimes the hair follicles are inflamed and miniaturized but not scarred,” she says. “There’s no guarantee that it will work, but I have been able to coax hair back into growing.”
If that doesn’t work, or if your hair loss is severe like Hollands’, surgery is an option. “Surgical remedy is close to 100 percent predictable, but obviously it’s more advanced and invasive,” Williams says. Hair transplant surgery can take anywhere from two to six hours, and it’s typically done at your doctor’s office under local anesthesia. Depending on the severity of hair loss and who you see for it, surgeries can cost anywhere from $5,000 to $10,000.
Treatment for traction alopecia can be complicated, costly, and time-consuming, which is why Day says it’s good to avoid it if you can. “It’s easier to prevent it than it is to treat it,” she says.