THE ROLE OF TRICHOSCOPY IN THE TREATMENT OF PATIENTS WITH POST-TRAUMATIC SECONDARY CICATRICIAL ALOPECIA AFTER FIRE INJURIES, BURNS OF THE FACE AND SCALP

Abstract

The aim of the study was to identify trichoscopic signs of secondary post-traumatic cicatricial alopecia due to gunshot, mine-explosive injuries, facial and scalp burns to improve surgical techniques for hair transplantation and achieve more predictable treatment outcomes. The study included 19 patients (10 men and 9 women), aged 21 to 40 years with cicatricial alopecia caused by mine-explosive injuries, burns, who were operated on from 2022 to 2025. The causes of cicatricial alopecia included 8 cases after mine-explosive injuries and 11 after deep thermal burns. Hair restoration was performed by follicular unit extraction (FUE) and direct hair implantation (DHI) for beard and eyebrow correction in combination with platelet-rich plasma (PRP) therapy. Trichoscopic examination was performed using a Good Hair trichoscope with built-in Artificial Intelligence with 50-200x magnification in the preoperative period and one year after surgery. Signs of post-traumatic cicatricial secondary alopecia were identified: yellow spots and a large number of porphyrins (80.5%), short vellus hair (76.4%), skin color, its oiliness, texture (70.2%), average hair number (20.0±1.2); proportion of vellus hair (10.0±0.2%); proportion of fine hair (20.0±0.2%); proportion of medium hair (8.9±1.8%); proportion of coarse hair (50.0±1.3%); proportion of single follicles (94.7±1.8%); proportion of double follicle roots (5.2±0.2%); proportion of three or more follicles (0.0±0 %) (p<0.001). The average survival rate of hair after transplantation was 84.1%. 12 months after the operation, the following normalized: porphyrin content - the number of yellow spots is minimal (85.4%); sensitivity of the scalp to external stimuli (75.2%); skin color is bluish-white, which indicated healthy skin (92.5%). Thus, trichoscopy is of great importance for differentiating secondary cicatricial alopecia from other non-cicatricial alopecias, where biopsy is not permissible and requires further study.