Scalp Lesions: Causes and Treatment Options - Dermatology

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Understanding scalp lesions can be quite complex, as they can arise from a variety of causes and may present in different forms. Based on your description of having 3-5 hard lesions on your scalp that have become painful over time, it is essential to consider several potential diagnoses and treatment options.

Firstly, the term "瘡" (which translates to "sore" or "ulcer") may not accurately describe the lesions you are experiencing. In dermatology, scalp lesions can include a range of conditions such as cysts, folliculitis, psoriasis, seborrheic dermatitis, or even more serious conditions like infections or tumors. The hardness of the lesions, along with their increasing pain and number, suggests that a thorough evaluation is necessary.

1. Possible Causes:
- Folliculitis: This is an inflammation of the hair follicles, often caused by bacterial or fungal infections. It can present as red, itchy bumps that may become painful.

- Seborrheic Dermatitis: This common skin condition can cause flaky, red patches on the scalp. It may not always be painful but can lead to discomfort.

- Cysts: These are closed pockets of tissue that can be filled with fluid, pus, or other material. They can become inflamed or infected, leading to pain.

- Psoriasis: This chronic autoimmune condition can cause thick, red patches covered with silvery scales. It can be itchy and painful.

- Infections: Bacterial or fungal infections can lead to painful lesions on the scalp. Conditions like impetigo or tinea capitis (ringworm of the scalp) may present in this way.

- Tumors: While less common, benign or malignant tumors can also manifest as hard lesions on the scalp.

2. Diagnosis:
To accurately diagnose the cause of your scalp lesions, a visit to a dermatologist is recommended. The dermatologist may perform a physical examination and, if necessary, conduct a biopsy or other tests to determine the exact nature of the lesions. This is crucial, especially since the lesions have become painful and increased in number.

3. Treatment Options:
Treatment will depend on the underlying cause of the lesions:
- Topical Treatments: For conditions like folliculitis or seborrheic dermatitis, topical antibiotics or antifungal creams may be prescribed. Corticosteroids can help reduce inflammation and itching.

- Oral Medications: If the lesions are due to a bacterial infection, oral antibiotics may be necessary. For fungal infections, antifungal medications may be prescribed.

- Surgical Intervention: If cysts or tumors are present, surgical removal may be required, especially if they are painful or causing other complications.

- Lifestyle Modifications: Maintaining a healthy scalp through regular washing with appropriate shampoos and avoiding irritants can help manage some conditions.

4. When to Seek Help:
Given that your lesions have become painful and have increased in number, it is advisable to seek medical attention promptly. Early diagnosis and treatment can prevent complications and provide relief from discomfort.

In conclusion, scalp lesions can arise from various causes, and their treatment depends on the underlying condition. A thorough evaluation by a healthcare professional is essential to determine the appropriate course of action. Please do not hesitate to reach out to a dermatologist for an accurate diagnosis and tailored treatment plan.