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Dr. Andrew Rynne

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Have flaky scabs on scalp and bald spot. Is this permanent?

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Dr. Sudarshan

Dermatologist

Practicing since :2005

Answered : 1391 Questions

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Posted on Tue, 29 Jan 2013 in Skin Hair and Nails
Question: A shallow laceration across my scalp resulted in a a large scab. Now that the scab has begun to flake and come away, it appears to be taking the follicles with it leaving behind a bald spot of remarkably smooth and pale skin. It has been a couple of weeks and there is no sign of any whiskers or stubble beginning to grow.

So my question is: Is this bald spot permanent?
doctor
Answered by Dr. Sudarshan 2 hours later
Hi XXXXXXX
Thanks for writing in .
The spot will most likely grow hair back.The process may take some weeks(3-5) before it grows back hair.You can apply neomycin ointment once a day and hydrocortisone 1%cream over the area .It will decrease the chances of scar formation.If the laceration is XXXXXXX and wide ,there is possibility of scar formation.If there is scar formation the hair growth over the area is unlikely.If you can upload a better close up image of the area I would be in a better position to comment on it. XXXXXXX I would like to know
How many days have elapsed after the injury?
Was it sutured?
Is there any skin loss?
Answer the question and we can continue the discussion here.
Regards
Dr Sudarshan
MD
Dermatologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudarshan 19 minutes later
Dr. XXXXXXX
Thank you for your prompt reply. The injury occurred 17 days ago. It was more of an abrasion then a laceration I suppose, and no sutures were used. I'm not entirely sure how to determine if there was any skin loss, but there is not a depression in the scalp or any pitting... so other than the abraded tissue and subsequent scab formation, I don't believe that any significant loss of tissue occurred.
I am uploading a couple of images which may help, showing the area from a couple of angles.

Grateful for the loan of your expertise,
XXXXXXX
doctor
Answered by Dr. Sudarshan 9 hours later
Hi XXXXXXX
Thanks for the details and images.
Whether or not hair will grow back depends on amount of skin loss.If there is dermis of the skin involved then there is chance of scarring and subsequent loss of hair at the site of scar.However if the skin loss is minimal and wound heals properly without scarring there should be hair growth.Out of three prominent injury sites on your scalp the frontal 2 are more likely to get normal hair growth.The one on the back of head can cause localised area of hair loss.
Keep the site clean and dry.Use antiseptic liquid for cleaning.
Apply good quality topical antibiotic like mupirocin 2% oint daily.
Follow up with your doctor if there is any discharge or excess of granulation tissue.
If the wound heals properly without complications there will be regrowth of hair.

Hope this helps.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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