Scalp Issues: Redness, Itching, and Hair Loss Explained

Hair problems

Doctor, last week I had my hair washed by someone who used their nails very forcefully on my scalp.
At that moment, I felt like my scalp was being pulled off.
When I went to work that day, I noticed that my entire scalp was extremely red.
After work, when I washed my hair, it was very painful.
Two days later, I noticed a lot of dandruff and my scalp was still red.
Now, a week later, I have developed many pimples on my scalp that are very itchy, brushing my hair is painful, and my scalp remains red.
Additionally, I am experiencing more significant hair loss.
My scalp is very sensitive and tends to turn red easily with seasonal changes; it is much whiter than average.
Sometimes, during severe seasonal changes, my hair loss becomes very noticeable, especially at the hairline, which can look almost bald during these times.
Doctor, which specialist should I see for this? I previously had warts on my fingers; could that be contagious to my scalp?

Ya Piao, 20~29 year old female. Ask Date: 2017/06/06

Dr. Wu Yuxin reply Dermatology

Please see a dermatologist.

Reply Date: 2017/06/06

More Info

It sounds like you are experiencing a combination of scalp issues that could be contributing to your hair loss and discomfort. Based on your description, it seems that you may be dealing with several factors, including scalp irritation, possible dermatitis, and hair loss, which can be exacerbated by physical trauma to the scalp.

Understanding Your Symptoms
1. Scalp Redness and Pain: The redness and pain you felt after the vigorous scalp massage could indicate irritation or inflammation. When the scalp is subjected to excessive force, it can lead to microtrauma, which may cause inflammation and redness. This can also make the scalp more sensitive and prone to further irritation.

2. Dandruff and Flaking: The presence of dandruff or flakes could suggest a condition like seborrheic dermatitis, which is characterized by an overproduction of oil and can lead to flaking and itching. This condition can be aggravated by stress, changes in weather, or even physical irritation, such as what you experienced during your wash.

3. Itching and Pimples: The development of itchy bumps on your scalp could be a sign of folliculitis, which is an inflammation of the hair follicles. This can occur due to irritation, infection, or blockage of the follicles, often exacerbated by scratching or irritation.

4. Hair Loss: The increased hair loss you are experiencing could be related to several factors, including the physical stress on your hair follicles from the aggressive scalp treatment, the inflammatory response from your irritated scalp, or even underlying conditions like androgenetic alopecia (male or female pattern baldness), which can be influenced by genetic factors.

Recommendations for Treatment
1. Gentle Scalp Care: Avoid any further aggressive treatments or massages on your scalp. Use a gentle shampoo designed for sensitive skin or one that targets dandruff or seborrheic dermatitis. Look for ingredients like ketoconazole, zinc pyrithione, or salicylic acid, which can help reduce flaking and inflammation.

2. Moisturizing and Soothing Treatments: Consider using a soothing scalp treatment or oil that can help reduce inflammation and hydrate the scalp. Ingredients like aloe vera, tea tree oil, or chamomile can be beneficial.

3. Avoid Irritants: Be cautious with hair products that contain alcohol or strong fragrances, as these can further irritate your scalp. Opt for hypoallergenic and fragrance-free products.

4. Consult a Dermatologist: Given the persistence of your symptoms, it would be wise to consult a dermatologist. They can perform a thorough examination of your scalp and may recommend treatments such as topical corticosteroids for inflammation or medicated shampoos for dandruff. If necessary, they can also perform tests to rule out any underlying conditions.

5. Monitor for Infection: If the bumps on your scalp worsen or if you notice any signs of infection (such as increased redness, warmth, or pus), seek medical attention promptly.

6. Addressing Hair Loss: If hair loss continues, a dermatologist can evaluate your scalp and hair follicles to determine if there are any underlying conditions contributing to the hair loss. They may recommend treatments such as minoxidil or other therapies depending on the diagnosis.

Conclusion
Your symptoms suggest a multifaceted issue involving scalp irritation, possible dermatitis, and hair loss. Taking a gentle approach to scalp care, avoiding irritants, and consulting a dermatologist for a thorough evaluation will be essential steps in addressing your concerns. Remember, early intervention can often lead to better outcomes, especially when it comes to hair loss.

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