Pressure Alopecia

J. Elliot Paulson, MD

,
Yelva Lynfield, MD

A 50-year-old man had been hospitalized for 27 days, 12 of which he spent comatose, lying on his back. A few days after discharge, he noticed a bald spot on the back of his head. The 2.5 × 3-cm area of alopecia was in the occiput, and the affected portion of the scalp was mildly erythematous.

A 50-year-old man had been hospitalized for 27 days, 12 of which he spent comatose, lying on his back. A few days after discharge, he noticed a bald spot on the back of his head. The 2.5 × 3-cm area of alopecia was in the occiput, and the affected portion of the scalp was mildly erythematous.

Drs J. Elliott Paulson and Yelva Lynfield of Brooklyn, NY, made the diagnosis of pressure alopecia, the result of localized ischemia of the scalp from prolonged pressure in an immobile patient. In most such cases, the hair slowly grows back, but more severe ischemia may produce ulceration, scarring, and necrosis of the hair follicles, with no subsequent regrowth.