Black Spots on the Scalp: Causes and Concerns

Black circular spots on the scalp?

Dear Dr.
Ke,
I recently noticed a black round spot on the scalp at the back of my head (where there is hair), approximately 0.2 to 0.3 centimeters in size.
I would like to ask you the following questions:
1.
Is it common for benign moles to develop on the scalp (where there is hair)? Could the black round spot on the back of my head possibly be a benign mole?
2.
I often experience redness and swelling on my scalp due to folliculitis.
Is it possible that the black round spot on the back of my head is a hyperpigmented lesion resulting from post-inflammatory hyperpigmentation (PIH)?
3.
If the black round spot on the back of my head is indeed a hyperpigmented lesion from post-inflammatory hyperpigmentation (PIH), will it naturally fade over time, or once formed, will it not disappear?
Thank you, Dr.
Ke, and I wish you a Happy New Year.

Axiang, 30~39 year old female. Ask Date: 2020/01/06

Dr. Ke Fangxu reply Surgery

1.
There is a possibility of this.
2.
It is also possible.
3.
If the pigmentation is due to post-inflammatory changes, the color will gradually fade as long as there are no further inflammatory episodes.

Reply Date: 2020/01/06

More Info

Understanding black spots on the scalp can be a source of concern for many individuals, especially when they appear suddenly or change in appearance. Based on your description, let’s address your questions regarding the black round spot on your scalp, its potential causes, and what you should consider moving forward.

1. Are black spots on the scalp typically benign moles?
Yes, it is possible for individuals to develop benign moles, also known as nevi, on the scalp. These can appear as small, round, dark spots and are usually harmless. Moles can be present at birth or develop over time due to factors such as sun exposure or genetic predisposition. However, it is crucial to monitor any changes in size, shape, or color, as these could indicate a need for further evaluation.

2. Could the black spot be post-inflammatory hyperpigmentation (PIH) due to folliculitis?
Given your history of folliculitis, it is plausible that the black spot could be a result of post-inflammatory hyperpigmentation. PIH occurs when the skin darkens in response to inflammation or injury, such as from an infection or irritation. This condition is more common in individuals with darker skin tones but can occur in anyone. If the black spot developed after an episode of folliculitis, it may indeed be a result of this process.

3. Will post-inflammatory hyperpigmentation fade over time?
In many cases, post-inflammatory hyperpigmentation can fade over time, but the duration varies from person to person. Factors such as skin type, the severity of the initial inflammation, and individual healing responses play significant roles. While some spots may lighten within a few months, others can take longer, and in some cases, they may persist for years. Treatment options, such as topical lightening agents or chemical peels, can help expedite the fading process if desired.

Additional Considerations:
- Monitoring Changes: It is essential to keep an eye on the black spot. If you notice any changes in its appearance, such as increased size, irregular borders, or color changes, it is advisable to consult a dermatologist. They can perform a thorough examination and, if necessary, a biopsy to rule out any malignant conditions, such as melanoma.

- Consultation with a Dermatologist: Given your concerns and the history of scalp issues, scheduling an appointment with a dermatologist would be beneficial. They can provide a definitive diagnosis and recommend appropriate treatment options tailored to your specific situation.

- Preventive Measures: To prevent further episodes of folliculitis, consider maintaining good scalp hygiene, avoiding tight hairstyles that may irritate the scalp, and using non-comedogenic hair products. If you frequently experience inflammation, your dermatologist may suggest medicated shampoos or topical treatments to help manage the condition.

In conclusion, while the black spot on your scalp may be benign, it is essential to monitor it closely and consult a healthcare professional for a thorough evaluation. Understanding the nature of skin changes and seeking timely medical advice can help ensure your scalp health and overall well-being.

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