Traction Alopecia in Sikh Males

To the Editor.— Prolonged traction on the hair due to hairdressing styles or traditional or sophisticated procedures result in a well-delineated form of traumatic alopecia known as traction alopecia.1 In the Sikh religion, males do not cut scalp and beard hair. The beard hairs are straightened with a brush, made into a plait, twisted, and put under the chin in the form of a knot, which is kept there for the whole day. The hairs are pulled and twisted tightly so that the small knot under the chin does not come off. Regular use of this procedure results in traction alopecia along the sides of the mandible (Figure). Unlike the traction alopecia observed in Sikh boys2and adults, the traction alopecia in the submandibular area is seen only in those who adopt the above method of tying the beard. We advise such patients to tie the hair loosely when