Bibbidi Bobbidi Bald: Two Hair-Raising Tales of Princess Package Hairstyles

April 2018 in “ Pediatric dermatology ”

Bree Zimmerman, Marta Ivars, Kelly M. Cordoro

localized alopecia Princess Package erythema scalp necrosis scarring alopecia pressure ischemia acute traction alopecia hair loss redness skin death scarred hair loss blood flow restriction hair pulling

TLDR Elaborate princess hairstyles at a theme park caused hair loss and scalp damage in young girls.

The document described two cases of localized alopecia in young girls following elaborate hairstyling known as the “Princess Package” at a major U.S. theme park. The alopecia was preceded by pain, erythema, and delayed crusting due to scalp necrosis. While most of the affected areas showed regrowth at follow-up, small areas of scarring alopecia persisted. The authors suggested that the alopecia was caused by a combination of pressure ischemia and acute traction alopecia.

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