P22 COSMETIC TRACTION ALOPECIA DUE TO HAIR EXTENSION AND SCARRING ALOPECIA FOLLOWING HAIR-COLOR-HIGHLIGHTING
Schauder S1, Schwartz P2
Department of Dermatology1, Department of Anatomy2, University of Göttingen, Germany

A 51-year old Caucasian woman who used to have her hair dyed blonde underwent keratin hair extension. Her hair was attached to 60 natural Indian strands using ultrasound heat. One week later she had her hair dyed blonde. After three weeks she applied 8 jumbo sized flock rollers from an electric hairsetter. The surface temperature of the rollers was 65 ° Celsius. The woman wore the rollers for 3 hours. Two days later 23 strands had loosened. Eight small areas of alopecia had developed beneath the crown and in the parietal region where her extended hair had been put on jumbo rollers. After three weeks 36 strands had fallen off, many of them together with the patients' own hair. Microscopic analysis of the proximal attached natural hair revealed breakage. Another 24 -year old Caucasian woman with fair hair underwent professional color-highlighting. Her strands were treated chemically and wrapped in envelopes of aluminium foil. Then she was placed under a hooded dryer without a sensor that would turn the dryer off in case of overheating. After about 30 minutes she complained of severe burning pain in the vertex area. About 90 minutes later a red, oozing, confined area on the crown was noticed. Seven hours later crusts and a whitish rim around the erythematous region had developed. To avoid pain the patient left the crust until it came off together with tufts of hair four months later. On the crown an atrophic alopecic scar (3.8 x 4.0 cm) with teleangiectasia was noted. Heat development of a hooded dryer is most intense over the crown. Moreover the hot highlighting-color could have leaked out of the envelope. The crown area of the scalp allows hot caustic mixtures to stay there. A combined damage by the dryer and the dye is assumed.