Hair loss and red spots on scalp? (Photo)

Question

I have always had thick hair until I realised I was shedding heavily in Nov 2023. It stabilised sometime in Feb/March, but now the heavy shedding is back. Initial shed coincided with creatine and whey use, which made me think they are the culprit. I have not used creatine since Nov. I noticed my heavy sheds are not limited to scalp hair, but also eyebrow and pubic hair. Recently I purchased a microscope to zoom into my hair, and found miniaturised regrowth and red spots - can this be reversible?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing these details. From what you describe, it sounds like you are experiencing diffuse hair shedding that is affecting not only your scalp but also eyebrows and body hair, along with some red spots and miniaturized regrowth.

Several things can contribute to this pattern:

Telogen effluvium – often triggered by stress, illness, nutritional changes, or supplements (like creatine/whey, though you stopped them). This type of shedding is usually temporary, and hair often regrows over months once the trigger is resolved.

Androgenetic changes or miniaturization – the small, thin hairs you’re noticing suggest some degree of miniaturization, which may indicate early genetic hair thinning, though it can still be stabilized.

Inflammatory scalp conditions – the red spots could reflect mild inflammation, irritation, or folliculitis, which may contribute to shedding if persistent.

The good news is that much of this can be reversible, especially if we identify and address any triggers, manage scalp inflammation, and support regrowth. Treatments may include topical therapies, gentle hair care, and nutritional support, sometimes combined with in-office procedures if needed. Monitoring the pattern and possibly getting lab work can also help clarify contributing factors.

Early attention improves outcomes, so continuing to track shedding and regrowth is key. With the right approach, many patients see stabilization and gradual improvement over a few months.

Marco Barusco, MD · Answer

Hello,

The shedding you’re experiencing, along with miniaturized regrowth and red spots, could be due to a combination of factors such as telogen effluvium (TE) triggered by creatine or whey use, stress, or other underlying causes. The presence of miniaturized hairs suggests there may also be androgenetic alopecia (AGA) involved.

Many cases of TE are reversible once the trigger is addressed, and early treatment for AGA can stabilize and improve hair regrowth. I recommend consulting with a hair specialist for a full evaluation to determine the best course of action to restore and maintain your hair health.

Best regards,
Dr. Marco Barusco

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, I recommend treatment with exosome injections in the area of concern. I hope this helps and best of luck!

Matt Tahsini, MD · Answer

Hello and thank you for your question. I suggest a trip to see your primary care doctor and have some bloodwork done to see if there is anything going on. If everything is ok then see a dermatologist for a diagnosis. Best of luck to you.

Dr. T

Dr. T

Jeffrey Rawnsley, MD - Account Suspended · Answer

This is a common, and non-serous issue. Some grafts may get red and look like a pimple. The technical reason for this is some of the small bit of skin on the graft has been pushed below the level of the skin. these will open up without intervention. There is no need to do anything. No antibiotics are needed. Just re-assure yourself of this.

Hair loss and red spots on scalp? (Photo)

Answers (5)

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