I just want to know what is causing the hair loss and if the brown marks are something concerning? (Photo)

Question

I have been experiencing hair loss on the crown of my head I am a 37 year old female. I saw one dermatologist who barely looked at it and said it is pattern baldness. It itches and burns and has one or more brown spots and a scab. It is not smooth it is like stubble the hair is broken off just above the scalp.

Jae Pak, MD · Answer

If you have brown irregular marks on your skin or scalp it can be a mole or even a sign of skin cancer.  Since you are concerned you should see a dermatologist or your primary doctor for an exam.

Jason Emer, MD · Answer

Thinning Hair -- Rogaine, Propecia, Viviscal, Progesterone, PRPIf you have thinning hair you really need an evaluation to see if it is genetic or from another cause like stress or autoimmune.  If it is determined to be genetic there are many options and traditional treatments like rogaine foam and propecia pills can be used.  I have great success in my practice using injectable progesterone and prp to the scalp.  Postmenopausal women also benefit from spironolactone.  I suggest seeing a dermatologist with expertise in hair loss.  Best, Dr. Emer.

George Abrahamian, MD · Answer

Hello, Dr. George Abrahamian here from LA FUE Hair Clinic in Pasadena, CA. First and foremost, moles that are new, asymmetrical, with irregularly defined borders, more than one color, with a diameter more than 5mm, and has changed over time should be evaluated for melanoma. Melanoma does not cause any pattern of balding, but skin cancer in and of itself should be evaluated with urgency. 
Regarding the hair loss itself, if you are unsatisfied with your dermatologists approach, it is always advisable to get a second opinion. Having irritation, burning and itching to the area that is experiencing hair loss sounds indicative of something other than male/female pattern balding. It could be autoimmune, there can be a fungal infection, inflammation to the area, seborrheic dermatitis/keratosis, just to name a few. 
Once autoimmune, infectious or malignant causes are ruled out, intervention for the hair loss can be considered. Platelet rich plasma injections, stem cell/exosome therapy, as well as topical minoxidil are all considerations to see if the hair loss can be stabilized or reversed to some extent. I hope this helps.

Jacquelline Leva, DO · Answer

I would suggest looking at the mole To make sure that there is nothing else concerning with an in office evaluation. I also suggest for youthinning hair to be evaluated... May be due to stressful event that is causing hair, shedding or even fungal. Infections or just female pattern balding. If it's a non scarring alopecia, then there are different modalities did I use, such as minoxdil, prp, low light laser therapy, if menopause add spironolactone, viviscal pro neutraceutical is an option too. I do combination therapy, most of the time, and get great results.

Larissa Miller, MD · Answer

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Please, remember it's always safer to see your doctor for concerns.

Ryan Welter, MD · Answer

There are generally 2 types of hair loss in women - focal and diffuse.   Female pattern baldness can appear focal at first, but then tends to involve a larger diffuse area.  However, your pattern seems more focal.  Also the symptom of broken hair shafts also leans towards a focal pattern.  Focal hair loss conditions which include alopecia areata, fungal infections and others, are sometimes best diagnosed with a biopsy.  Generally at least 2 sites for a biopsy are chosen and sent to a dermatopathologist for evaluation.  Treatment would depend on the condition, but it is clear you need a more comprehensive evaluation. The brown spot on your scalp looks like a typical macular nevus and this is likely due to sun exposure through your hair, an indication you may have had this condition for a while.

Jeff Donovan, MD, PhD · Answer

The brown spots are a separate issue from your hair loss. One is a hair loss issue and one is a skin issue. They are not directly related except that sun exposure could have helped the brown spot to develop. However, without seeing both "up close" and knowing a bit more about your medical history, it's not possible to give a diagnosis.

William Rassman, MD (retired) · Answer

I would need to examine you, but I would treat the two conditions separately. I would get Bulk Measurements of
your hair to determine if you have balding and where your present balding is now. This is a very accurate way to determine if you are losing hair.

I just want to know what is causing the hair loss and if the brown marks are something concerning? (Photo)

Answers (8)

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