PRESSURE ALOPECIA

By Gary M. White, MD


Pressure alopecia is the loss of scalp hair after after prolonged pressure, e.g. after a surgical procedure. Tissue hypoxia is the cause.

Clinical

A patch of non-scarring alopecia is seen usually on the occiput within a few weeks of surgery. A prodrome of local tenderness, erythema and swelling may occur. Necrosis may rarely occur. It may also occur in those in the intensive care unit. In one study of 27 patients, the means duration from pressure to alopecia was 3.6 weeks. Permanent alopecia occurred in 18.5%. The main risk factor was a long surgery time, e.g. > 10 hours [JAAD 2015;72;188].

Treatment

Regrowth usually occurs within a few months.

Prevention

Turning the patient's head at regular intervals during a long surgical procedure is recommended as prophylaxis.

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