Pressure Alopecia

August 2004 in “ International Journal of Dermatology ”

José D. Domínguez‐Auñón, Mónica García‐Arpa, Beatriz Pérez‐Suárez, Esther Castaño, José Luis Rodríguez‐Peralto, Aurora Guerra, Luis Iglesias

cicatricial alopecia pressure alopecia hair follicles granulomatous reaction tissue ischemia hypoxia topical corticosteroids minoxidil Rogaine

TLDR Prolonged pressure on the scalp can cause permanent hair loss.

A 23-year-old man developed a cicatricial alopecic lesion on his scalp after being immobilized in an intensive care unit due to a motorcycle accident. The lesion, characterized by destroyed hair follicles and a granulomatous reaction, was attributed to pressure alopecia, a condition caused by prolonged pressure leading to tissue ischemia and hypoxia. This condition has been observed in surgical and comatose patients, with the severity of alopecia depending on the duration of pressure. While some cases resolve with hair regrowth, others, like this patient's, result in permanent cicatricial alopecia. Treatment with topical corticosteroids and minoxidil was ineffective. Prevention involves frequent repositioning to avoid prolonged pressure on the scalp.

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