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To the Editor.—
Diffuse hair loss is a frequent complaint among patients, especially among women seeking treatment in our dermatology outpatient clinic. Among these women, we have observed several interesting cases in which the use of traditional dress wear by women results in a type of traumatic or traction alopecia.It is common practice among Libyan girls and women to cover the scalp hair with a scarf that is known in Arabic as maharama. This scarf starts at the forehead and is kept in position by a knot at the back of the head. In some cases, the knot is so tight that the scarf exerts a continuous and strong traction all along the anterior hairline of the forehead. This traction results in gradual hair loss and recession of the hairline. The alopecia corresponds precisely with the position of the scarf. The extent of the alopecia increases along with the
Malhotra YK, Kanwar AJ. Tractional Alopecia Among Libyan Women. Arch Dermatol. 1980;116(9):987. doi:10.1001/archderm.1980.01640330025004