Hair casts are a dermoscopic clue for the diagnosis of traction alopecia

Conflicts of interest: none declared. Madam, Prolonged hair traction may cause cicatricial alopecia, which is more commonly localized at hair margins behind the frontal hairline or along the temporoparietal margin (marginal alopecia) but may involve any scalp area depending on the cause of traction. Traction alopecia is clinically characterized by loss and thinning of hair in the affected area. Traction alopecia due to traumatic hair care practice is a very common problem in African‐American women and children. Hairstyling associated with considerable traction includes braids, twists, dreadlocks, braiding and weaving with extensions, and the use of overnight rollers. According to a large epidemiological study, traction alopecia is more common when traction is applied to relaxed hair and in subjects using combined hairstyles.1, 2 However, marginal traction alopecia due to hairstyle can also occur in straight‐haired individuals, particularly in girls wearing a tight ponytail. Occipital loss has been reported in women wearing a chignon or a bun, in nurses who used to fix their cap with a pin and recently in African‐American girls wearing sculptured hairstyles requiring multiple pins.3