Headgear-induced temporary pressure alopecia

Abstract

The development of hair loss associated with headgear use is a rare phenomenon. Pressure alopecia is a condition characterised by localised, non-scarring hair loss attributed to a mechanical cause. Factors such as prolonged periods of peri- and postoperative immobility have been implicated, as well as immunological and genetic predisposing factors. If the mechanical trauma is very prolonged, there is a risk of permanent follicle damage due to tissue hypoxia. A 13-year-old boy wore high-pull headgear as part of his orthodontic management. Within four weeks of headgear wear, localised areas of hair loss were seen corresponding with the areas of contact with the force delivery modules of the headgear. The patient experienced bullying at school as a result of this hair loss. Hair regrowth resumed after headgear use was discontinued, therefore confirming the diagnosis of temporary pressure alopecia. Temporary pressure alopecia is a rare side effect of orthodontic headgear. Alopecia can negatively impact an individual’s psychosocial wellbeing; therefore, caution should be taken to avoid prolonged or excessive pressure in susceptible individuals and headgear patients should be regularly monitored.