The Trichoscopic Hallmarks of Pressure Alopecia: A Case-based Study

Abstract

Pressure alopecia is a rare and often underrecognized form of hair loss caused by prolonged ischemia of the scalp. Frequently misdiagnosed, it requires a high index of suspicion  and a careful clinical and dermoscopic assessment. Trichoscopy plays a pivotal role in its diagnosis. In this case-based study, we highlight the distinctive trichoscopic hallmarks that can aid in the timely diagnosis of this condition. Through an illustrative clinical scenario following prolonged immobilisation, we demonstrate how trichoscopy—combined with histopathology, can be instrumental in distinguishing pressure alopecia from other alopecic disorders. This report emphasises the diagnostic value of trichoscopy and the importance of simple preventive strategies to mitigate this avoidable complication. The case sheds light on a condition that remains underreported, urging clinicians to be aware of its subtle but telling signs. Early recognition—facilitated by trichoscopy, especially through identifying comedone-like black dots—can optimise management. Close monitoring and preventive measures can mitigate its impact and improve outcomes.