Dreadlocks, ‘locs,’ or ‘dreads’ is an amazing, iconic hairstyle that women and men, particularly African Americans, enjoy. Growing and maintaining locs takes consistency, commitment, and TLC. When you follow these steps, you’ll have fantastic, thick, shiny locs that can last for years. However, it’s not uncommon to see dreads thinning and falling out.
If you’ve had one lock of hair fall out in a year, you probably won’t worry about it. However, consistent thinning, shedding, receding hairlines, and even balding is a serious concern. The first thing you will notice is one or more signs that your locks are thinning, receding, or shedding. Your dermatologist can take a detailed look at your hair and scalp. The doctor will also assess your general health, family history, medical history and request a blood test or hair biopsy.
1. Traction alopecia: the most common reason for thinning dreadlocks
Traction alopecia is a form of hair loss and the most common reason for thinning dreadlocks. The repeated tension and pulling on your hair is the main reason for traction alopecia. Twisting your locs tightly, placing them in high buns, and pulling your hair back in ponytails are common reasons. As your hair grows, the weight of the hair can cause thinning and breakage. The strain on the hair follicles causes inflammation, soreness, and itching. Eventually, the hair begins to fall out at the hairline and sides.
Traction alopecia happens over time, so older African-Americans with dreads are more likely to have the condition. If you have tight, thinner dreadlocks, you are more likely to have traction alopecia in the future. If you catch the symptoms and signs early, you can reverse traction alopecia. However, for most people, the damage can be more severe and need medical intervention. See your dermatologist if you suspect you’re losing your locs due to tight styles. Your dermatologist will review your health history, examine your hair, and provide medical treatments. These can include steroids, antibiotics, or minoxidil to regrow your hair.
2. Central centrifugal cicatricial alopecia (CCCA)
Central centrifugal cicatricial alopecia or CCCA is another common reason for thinning dreadlocks and hair loss. It’s particularly common in Black women but can happen to men and other races as well. CCCA occurs when hair loss starts at the crown of the scalp and moves outwards, almost in a circular direction. The hair follicles are severely damaged and replaced with scar tissue, preventing new hair growth. You will start to notice thinning at the crown, itching, and discomfort.
Dreadlocks, braids, sew-ins, hair relaxers, hot combs, and other tight hairstyle practices can cause CCCA. The symptoms can take several years before being noticed, so older women with dreadlocks and braids are more likely to be diagnosed with the condition. There may be some genetic links as well. CCCA is difficult to treat as it’s a chronic, sometimes irreversible condition. At Eternal Dermatology + Aesthetics, we implement treatment options quickly as the damage will be ongoing. Steroids, antibiotics, and steroid injections are the first steps to reduce scarring. Other treatments include Platelet-Rich Plasma (PRP), where we use your blood’s platelets in the scalp. In between treatments, supplements, minoxidil, and lifestyle changes can help.
3. Scalp infections and other scalp conditions
Scalp infections are a broad term for any skin infection impacting the scalp. Scalp infections can happen to anyone, even those with dreadlocks. Folliculitis is an infection and inflammation of the hair follicles, caused by bacteria like Staphylococcus aureus, yeast, or fungi. Several forms can develop due to behaviors like shaving or hot water exposure. Folliculitis can look like acne, forming red, itchy bumps. Seborrheic dermatitis results from overproduction of sebum, making the scalp scaly, oily, and uncomfortable with yellow or white flakes. Psoriasis can also develop on the scalp, causing inflammation, bleeding, and scarring. Once diagnosed, follow-up treatment is tailored to the condition.
4. Normal range of hair shedding and telogen effluvium
On average, we lose about 50 to 100 strands of hair daily. If you’re losing a lot more, there may be an underlying condition. Telogen effluvium refers to severe yet temporary hair loss, particularly after stressful or traumatic events like childbirth, menopause, severe stress, and extreme weight loss. Hormonal changes can slow the growth phase, moving more follicles into the resting (telogen) phase. Your dermatologist will perform tests to determine if you have telogen effluvium. It can correct itself within a few months with proper management, lifestyle changes, and possibly supplements.
5. Medications and hair loss
Some medications, while helpful in other contexts, can cause hair loss as a side effect. Some antibiotics, antifungal drugs, and certain acne medications can contribute to hair loss. During a dermatologist visit, disclose all medications you are currently taking. Medication-induced hair loss can be temporary or, in some cases, permanent.
6. Hair products and chemical exposure
Sometimes, what you put into your hair is the reason for hair loss. Popular hair products may damage hair over time and block new follicle growth. Frequent coloring, especially bleaching, can damage existing follicles and prevent new growth. Inform your dermatologist about hair products used with dreadlocks to tailor advice and treatment.
7. Diet and micronutrients
Healthy hair growth requires a balanced diet with vitamins and minerals such as iron, zinc, B12, folic acid, vitamins C, D, and E. Deficiencies can occur due to poor diet or absorption issues. A dermatologist can check for deficiencies with a blood test. Lab results guide dietary changes and supplementation, potentially with a dietician’s help.
8. Hair care practices and timing
Constantly re-twisting your hair can place pressure on the scalp and contribute to traction alopecia. Conversely, leaving dreadlocks unkept for long periods can also be dangerous. If you wait too long between twists, locs can become thinner. New hair follicles need to be twisted into the lock, and neglect can lead to hair loss. Regular scalp care, keeping hair moisturized, trimming ends, and maintaining a reasonable wash schedule helps. If there are no severe medical conditions, improving your hair care routine is essential.
9. Genetics and other forms of hair loss
Sometimes, thinning dreadlocks are driven by genetics. Female-pattern hair loss, male-pattern hair loss, and alopecia areata are genetic-related. About 1 in 2 women experience baldness by age 50, while 4 in 5 men experience the same issue. If thinning occurs with age, consider supplements, lifestyle changes, and other stimulating treatments after identifying the cause. Once causes are identified, medical and lifestyle changes can help save your dreads.
Avoid tight, frequent re-twisting to reduce traction alopecia. Protect locs while sleeping with a satin cap or pillowcase. Keep them shorter if possible. Avoid certain styles to minimize pressure on the head. Washing and conditioning should occur at least weekly to keep scalp health. Limit sun exposure; excessive heat can dry hair, cause breakage, and slow growth. Consider supplements like Ashwagandha and Saw Palmetto to support hair health. If thinning is noticed at the crown, root, or overall, consult a dermatologist promptly, preferably one experienced with locs, to receive sound guidance. At Eternal Dermatology + Aesthetics, Dr. Ife. Rodney is an expert in African American hair conditions and regrowing thinning dreadlocks.
Practical guidance and prevention
Traction alopecia is preventable with proper hair care practices. Give your hair a break from tight hairstyles, avoid chemical relaxers when possible, and seek guidance on protective styling. Regular checkups and early intervention improve outcomes; in early stages, reducing tension and inflammation can reverse hair loss. In longstanding cases, surgical options like hair transplantation may be considered. The condition is largely preventable and manageable with education and proactive care.
Key signs to watch for
- Thinning along the hairline, temples, or crown
- Redness, itching, or scalpel-like tenderness where tension is applied
- Miniaturization of hairs and the fringe sign at the hairline
- Scarring in advanced stages
For those considering extensions or repairs, a careful assessment is essential. Dreadlock extensions or remapping should be discussed with a specialist to determine safety given existing thinning or fragility. Dreadlocks can still be a viable style for many people, but the approach must be individualized and cautious.
Traction Alopecia: Why Pain Is the Warning Sign
Tables and data
| Condition | Typical Location | Reversibility | Primary Management |
|---|---|---|---|
| Traction alopecia | Hairline, temples | Early reversible; chronic may be irreversible | Looser styles, avoid tension, topical steroids, minoxidil |
| CCCA | Crown | Chronic, often irreversible | Steroids, PRP, minoxidil; protect scalp |
| Scalp infections | Scalp surface | Variable | Antibiotics/antifungals as indicated; hygiene |
Note: This article consolidates information on traction alopecia related to dreadlocks and related scalp conditions. Always consult a dermatologist for diagnosis and tailored treatment.