20 yo F recently diagnosed AA. Think it's cicatricial.Trigger: ripped braid from crown (Photos)

I've always been told i was balding cause my hair wasn't 'good' due to 4b/4c African hair. I've tried a range of products/protective styles but nothing works/worsens situation. Symptoms: tenderness, inflammation, high sensitivity to heat and (recently) painful pustules on the crown. Pimples now spread to nearly everywhere on my scalp with a deeply burning sensation. On antibiotics as GP said it was folliculitus - pustules/pain occur, though few. Blood tests show healthy minerals/hormones.

Doctor Answers 2

Female with alopecia areata

This is a difficult condition to treat and requires a very specialized dermatologist who is familiar with the various modalities for this disease

Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

20 F afro textured hair

Thanks for sharing. It could be any of these (even all three) and you really need an up close exam.The sensitivity is not typical of alopecia areata. The pustules and burning can suggest follicular injury and traction - absolutely. You are a bit young for primary scarring alopecia like central centrifugal cicatricial alopecia (CCCA) - so that is rather unlikely.But with a close up exam, alopecia areata can likely be diagnosed. If there is any doubt, I would advise a scalp biopsy.Regardless, in my patients with similar stories, a trial of steroid injections along with topical steroid ointments for 1 month plus blood tests for iron, thyroid studies (TSH), vitamin D, ANA, ESR, glucose is essential.

Jeff Donovan, MD, PhD
Vancouver Dermatologist

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