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You’ll want to see a dermatology expert as soon as possible. You might start with your family physician/general practitioner. There are both skin and hair issues that need addressing. I would need the whole story to advise on specific steps. (length of time extensions were in, type of extensions, your age and general health, reason for extensions in the first place. It would appear there s both a local folliculitis (possibly with minor infection but it’s hard to say with these photos) together with a traction alopecia type issue. It’s unlikely this is alopecia areata here together with traction and folliculitis but of course the area need to be examined up close. The overall approach to treatment (see below) wll be similar so at this point it does not matter. I can’t say if there is any scarring component from these photos but an upclose examination and full review of your story can help with that, For patients of mine with similar issues, I typically start out by swabbing the red area if there is any pus or if I felt there was infection. I would usually start with a topical steroid quite widespread on the scalp for 5-10 days and a topical antibiotic only on the red area. If the redness does not settle, I would switch to an oral antibiotic. As things settle over 5-10 days I would then inject some triamcinolone acetonide at 2 mg per mL into the area and surrounding areas and have the patient get started on topical minoxidil for any areas of hair loss. Close follow up is essential meaning frequent check ins with the doctor to ensure this is improving. Controlling infection (if any) and inflammation is goal number 1. Promoting hair growth is goal number 2. These should take place in that order. It may take 6 months to resolve if there is no scarring or permanent hair loss. If extensions were only used for a short time and there and no other hair loss or scalp issues, the odds are good things will improve.
Most likely this is due to "traction alopecia". Treatments include topicals and you should see hair growth once inflammation is resolved.
Well, it depends on the full story and if you have any other diagnoses present like telogen effluvium or androgenetic alopecia. It also depends if bleaching has been recent or over many years and whether it was associated with scarring in the scalp. There is a whole lot more to this question...
Thanks for this question. It is important to realize that we don’t diagnose hair loss from 15 hairs alone. We diagnose hair loss from listening to the full story from birth until now together with full scalp exam. The trichoscopy of the other areas matter. It’s also important to realize tha...
Peripilar brown spots, also known as "peripilar casts," can sometimes be seen in individuals with androgenetic alopecia (AGA) and are often associated with inflammation around the hair follicles. However, these spots are not exclusive to AGA and can sometimes appear in other scalp conditions,...
