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No hair in a spot on the head - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Skin Hair and Nails
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1358 Questions
User :   I had a very long surgery (double mastectomy with reconstruction) and that is all I can give account to having happened new in my life, and as a 50 year old female, I now have a silver dollar size bald spot on the back of my head. At first it burned and itched and I scratched that spot on my head, and now there is a serious gap of no hair.
Doctor :   Hi
User :   hello
Doctor :   Since when are you having this symptom?
User :   I noticed the itching and buring on my scalp while in the hospital and probably for another week. Then the burning/itching stopped and nothing noticed until this past week when I noticed a bald spot.
User :   I know I scratched it really hard during that period. The surgery was January 11.
Doctor :   Are you able to feel the sensations over those bald spots?
User :   It doesn't seem to have much sensation
Doctor :   May I know the reason why the surgery was performed?
User :   sure. I had a double mastectomy following a lumpectomy. initially diagnosed with atypia hyperplasia, then more cells found in opposite breast testing postitive. had the double mastectomy
Doctor :   Are you on pills now?
User :   no
Doctor :   Is it a single spot/or do you have multiple bald spots?
User :   today was given some alprazolam .25 mg
User :   during hospital stay had two blood transfusions and did have some iv meds. dilaudid
Doctor :   Do you have any other medical illness such as diabetes, thyroid problems, ovarian disorders in the past?
User :   i am wondering if my thyroid is being impacted by the surgery recovery because my body temperature seems to be difficult to regulate. otherwise, no. my prior medical was donating a kidney last November.
Doctor :   Ok
User :   no diabetes.
User :   any ideas?
Doctor :   Can you confirm if it is a single bald spot or multiple bald spots?
User :   it is one bald spot with a small bit of hair in the top center of the spot so that it isn't a "perfect circle"
Doctor :   Do you have symptoms of white patches on your body with similar itching, burning sensation or with reduced sensation else where in the body?
User :   not at all
Doctor :   Ok
Doctor :   Let me explain to you.
User :   ok
User :   ok
Doctor :   Since you report of short history and an isolated spot, this probably may be an infective condition.
Doctor :   it probably may be a folliculitis secondary to either a fungal or viral infection.
Doctor :   Since I am unable to physically examine the spot, I cannot give you a definitive diagnosis of the lesions.
Doctor :   But folliculitis is the only condition that can present with similar symptoms.
User :   treatment?
User :   temporary hair loss or permanent?
Doctor :   Folliculitis is a condition when treated earlier hair can grow back.
User :   what is the recommended treatment and what type of Dr. should I see.
Doctor :   You will need to report to your doctor/dermatologist who after a physical examination and evaluation can confirm the diagnosis.
Doctor :   Treatment can be initiated once the diagnosis is confirmed.
User :   I will contact a dermatologist. I do want to know what treatments are available IF this is folliculitis.
Doctor :   If folliculitis or any other scalp condition is ruled out, then probably it is the systemic factors such as the recent stress exposure and nutritional factor
Doctor :   that are responsible for this bald spots.
Doctor :   which can be treated gradually by diet and lifestyle modifications.
User :   I am a very healthy eater, but have not been eating as much while recovering. I will continue to increase my protein and fresh fruit intake. I do not eat any packaged foods.
Doctor :   The most common infective organism causing scalp infection is fungus.
Doctor :   They respond well with local antifungal creams or ketaconazole creams.
Doctor :   You may be given one such preparation if the infection is proved.
Doctor :   In the mean time while you wait to see your dermatologist, I do suggest that you improve your diet.
User :   o.k. improve in what way? More protein?
Doctor :   Diet should contain good proteinaceous food along with plenty of fruits and vegetables.
Doctor :   Apart from this, since you have history of recent surgery, it may have been stressful too.
User :   I do intake very healthy foods, but not much in quantity until past couple days.
Doctor :   So proper and timely sleep, regular eating habits, relaxation techniques such as deep breathing exercises will be helpful too.
Doctor :   Have you followed what I have suggested?
User :   I have. I am doing relaxation techniques already, but will do them more frequently throughout the day.
User :   I will increase my caloric intake. I already have the quality of foods, just not the quantity.
User :   Anything else?
Doctor :   Get the necessary diet and lifestyle changes done quickly and consult a dermatologist who after physical examination will suggest you more specific treatment options.
Doctor :   Hope it is clear.
Doctor :   Do you have any other query?
User :   No. I am pretty preoccupied with a bald spot...the rest of me is slowly healing from the mastectomy and sentinal node removal.
User :   but I am making forward progress.
Doctor :   I wish you a faster and healthy recovery.
User :   Thank you very much. Take care.
Doctor :   Thanks for consulting me.
User :   Hopefully the hair will grow back.
User :   Good night.
Doctor :   Bye for now.
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