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Having severe abscess formation on scalp. Treated with topical steroids and antibiotics. What is the treatment?

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Practicing since : 2006
Answered : 2016 Questions
after years of suffering from what i have always believed to be the result of a "tread-lift" cosmetic surgical procedure which became infected (procedure no longer performed). I think the trauma caused what has now over at least 7 years has developed into severe follicular damage with tufted (doll hair) and alopecia with scarring. I have had severe abscess formation crusted over at various sites along the front going to the vertex of scalp. extremely painful. no cure no that i have finally done my own research. i believe i have a superinfection and irreversible alopecia. my hair is kinky, blackened and thick with multiple hairs growing from the shafts. everyone insists i am crazy. one biopsy did conclude lichen planus while the other two "pickers nodules" and abscess from picking. No culture ever performed. been treated with topical steroids, antibiotics, etc. i also think it may be a autoimmune response to the barbs that are still in my head and cannot be located to be removed. it has been so long too much damage has been done. i should of investigaqted myself years ago. i am extremely angry, disappointed in the medical community but mostly in myself. i just began to believe i was crazy and these oozing burning sores were imaginary and everyone insisted it had nothing to do with the trauma to my scalp (and infection). can anyone help me? i am losing my hair and have shaved it again on top this time the area is huge. i just got so frustrated trying to cover the areas where it is falling out in my hands. NOTHING PERSONAL BUT I WANT ONLY AN EXPERT DERMATOLOGIST OR DERM/PATHOLOGIST familiar with chronic folliculiti,doll hair and alopecia. i know the score. i need someone who can provide possible treatments! i have read enough. in a short amount of time. (no need for medical school) what is the matter with doc's they don't know an answer they send you away. NOT EVEN CULTURES. one PAS neg. from poorly performed punch biopsy by new doc (i worked in pathology)
Posted Thu, 5 Dec 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 2 hours later
Brief Answer: hair loss probably not related to thread lift Detailed Answer: Hi, Thanks for writing to us. I can understand your concern. Firstly i would like to summarise your problem. You have irreversible hair loss or scarring alopecia associated with development of abscess and crust formation and tufted hair. I agree that tufted hair folliculitis can rarely occur with any surgery or trauma( in your case thread lift) but presence of abscess, crusting, inflammation till date cant be associated with thread lift done 7 years ago. So, you need to understand that any suture can get infected after surgery but the persistence of infection even after seven years of surgery is rare. So like other doctors you have consulted earlier, I too believe its not related with thread lift. Now having said this I would like to concentrate on possible causes of your present condition. Lichen planus can lead to tufted hair but again its not associated with abscess, crusting, swelling etc. In my opinion, two possibilities should be ruled out dissecting cellulitis of scalp and folliculitis decalvans. This can be done by skin biopsy. In hair loss, two biopsies are sent one is horizontal section biopsy and another one is vertical section biopsy to ascertain the cause of scarring hair loss( cicatricial alopecia). Also pus culture sensitivity is necessary. Usually it is positive for staph aureus. The treatment plan in your case should be using a good antibacterial shampoo, application of topical antibiotic cream like clindamycin along with antibiotics like rifampicin and minocycline( given for prolonged period) to control infection and inflammation. Once infection is controlled, tufting should improve as it occurs due to matting of hair infundibuli of hair follicles. Unfortunately hair that has gone cant be grown back as its a scarring alopecia. Should there be a further query, please write back. Regards
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