Friction Alopecia: A Comprehensive Guide

Friction alopecia refers to hair loss that occurs due to the constant rubbing of the hair. It’s a type of traumatic alopecia that stresses the hair follicle. 

More than the scalp, people usually experience this kind of alopecia on the body. In particular, the legs are commonly affected. 

That’s because friction alopecia can develop from everyday clothing. However, it can also be self-inflicted. And some people develop it more quickly than others. 

In this guide, we’ll explore friction alopecia and what you can do to take care of it. 

What Is Friction Alopecia?

Friction alopecia is a type of non-scarring alopecia that results from friction between your hair and an external surface. 

Keep in mind that friction is a resistive force that arises when two things try to move past each other. When that happens with your hair, it can affect the hair follicle and the growth of your hair.

friction alopecia

This friction can come inadvertently from clothing and accessories. But some people also create it themselves by rubbing and/or scratching their heads with their hands. 

The latter is also known as trichoteiromania – a “self-inflicted hair disorder” in which the scalp is rubbed, and the hair shafts are fractured, according to a case report in Skin Appendages Disorders

Friction alopecia has been reported on the following areas of the body: 

  • Ankles 
  • Shin
  • Thighs  
  • Calves 
  • Abdomen 
  • Scalp 
  • Arms 

Depending on the source and direction of the trigger, one or both of your appendages might be affected. Also, it may just affect the front or back.

And if you already have weak hair, it’s possible that it breaks off more easily due to friction.  

What Are The Symptoms of Friction Alopecia? 

You may notice the following signs and symptoms if you have friction alopecia: 

  • Short broken hairs of variable lengths 
  • Hair shafts split at the ends 
  • Mild itchiness 
  • Reduced hair density in the target area
  • Bald spot 
  • Trichorrhexis nodosa (formation of nodes on hair shafts)
Legs fricion alopecia
Patient with friction alopecia on legs due to socks

What Causes Friction Alopecia?

In friction alopecia, repetitive trauma to the hair can come from a variety of sources. Although, tight headgear, socks, and footwear are the most common culprits. That can also explain why frictional alopecia is common in athletes. 

Among different headgear, different researchers have reported friction alopecia due to:: 

  • Band headphones 
  • Helmet 
  • Baseball cap 
  • Turban

Friction alopecia from wearing hats is also suspected. However, there’s no conclusive evidence of that. 

When it comes to footwear and clothing, researchers have reported the following to cause friction alopecia: 

  • Joggers
  • Knee-high boots
  • Socks 
  • Trousers 
  • Robe 

The study on friction alopecia in Iraqi patients, published in The Journal of Dermatology, also reported that sitting cross-legged for a long time can cause hair loss on the thighs. 

Moreover, the researchers noted that hair loss on the abdomen was usually caused by friction from sleeping on the stomach.

Abdomen friction alopecia

Interestingly, a case report published in Cutis described a case in which a waterslide caused friction alopecia on a patient’s calves (back and sides). 

Even gymnasts have developed friction alopecia due to the apparatus they use. In one case report published in the Archives of Dermatology, a patient reported hair loss caused by balance beams. 

According to the author, it could have been due to the rollovers and headstands done on it.

Other than that, research in Skin Appendage Disorders reports a 15-year-old who developed friction alopecia due to repetitive touching and scratching of hair. 

Is Frictional Alopecia Permanent?

Researchers have reported cases in which friction hair loss persisted even after the source of friction was removed. 

Therefore, in more severe cases, it’s possible for friction to cause long-term alopecia. 

Can Friction Alopecia Be Reversed? 

It can be possible to reverse friction alopecia and regrow your hair. However, again, it’s important to not put stress on your hair follicles again. 

And while you’re trying to grow your hair, you should practice gentle hair care. Exposing your hair to a lot of heat and chemicals while wearing tight hairstyles can further weaken it. 

What Is The Treatment For Frictional Alopecia?

Treatment for friction alopecia involves identifying the source of the friction and then eliminating it. 

Depending on the source of friction, the treatment can vary. For instance, if your friction alopecia is self-inflicted due to compulsive hair rubbing, steroids may be prescribed along with cognitive behavioural therapy (CBT).

Patients have also been given amino acid supplements for friction alopecia to promote regrowth. 

However, if you’ve experienced permanent hair loss, hair transplantation can be another treatment option.


Friction alopecia is an underreported type of hair loss. Since they’re usually found on areas of the body that are hidden by clothing, they don’t cause a lot of aesthetic problems. Still, it can be a cause for concern (especially because it can look like alopecia areata). 

This kind of hair loss can be prevented if you eliminate any object (or habit) that rubs against the hair. Although, if you’ve already developed it, reversal is also possible (if it’s not severe). 

If you have any bald patches on your scalp, face, or body, make sure to get in touch with a board-certified medical professional for an accurate diagnosis and treatment plan.

Reviewed and Approved by Dr. Cagla Yuksel.

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