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What causes mild pink bald patches on the scalp?

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Posted on Wed, 9 May 2018
Question: Hello Doc,
I am having small to medium bald patches on vertex to front elevated side of scalp and few towards back. This is there since pas 5 months, for sometime they dissapear and now i had close cut and they reappeared back, when closely observed I see couple of white - mild pink/red pacthes where hair isnt there and they progressed all area which I have mentioned earlier. Itcing is sometime mild - severe as something is rolling over.
genetically none has bald XXXXXXX in my family, and I am wash my head daily. I have consulted a doc earlier and this is a second opinion I am going for whosoever addressed me. Kindly suggest, There are lot of names it was told I am confused , some say seborrheic dermatitis, some say some androgenetic alopecia, some say tinea or fungus, and I am lost to figure out whats the exact cause and medicine to it
doctor
Answered by Dr. Kakkar S. (1 hour later)
Brief Answer:
Seborrheic dermatitis and androgenetic alopecia

Detailed Answer:
Hello. Thank you.
I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern and I have viewed the images.
I can see thinning extending from the mid to the vertex of the scalp.b There is relative sparing of the frontal scalp and anterior hair line. This seems like patterned hair loss of males/ androgenetic alopecia.
In addition you seem to have seborrheic dermatitis of the scalp characterized by red to pink patches, scalp scaling and itching.
I suggest you to use a coal tar and salicylic acid based shampoo e.g Protar lotion for seborrheic dermatitis. Lather it well on to wet scalp and allow it to act for 7-10minutes before rinsing it off.
For thinning I suggest you to use Minoxidil 5%solution, 1ml, twice daily.
In addition I would suggest you to take tab finasteride 1mg once a day.
Treatment is long term and response is appreciable after 3-6 months of regular use.
These are prescription medications and I suggest you to use them under the supervision of your local practitioner.

Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Kakkar S. (16 minutes later)
Thanks for your answer,

You have listed couple of medicines and have mentioned about the process of application when and how?
Can coal tar be used in morning while going to office? and minoxidi at night? I am taking fenestiride already and should I continue androangen along with it?

I am also using scalp massager which I brought from XXXXXXX which I am using and should I continue ?

I am also using ACV diluted once in week and should I continue?

also is wearing helmet aggrevate problem?
doctor
Answered by Dr. Kakkar S. (16 hours later)
Brief Answer:
Regarding your alopecia

Detailed Answer:
Hi.

Yes, coal tar shampoo can be used during the day. Minoxidil ideally should be applied, twice daily. You may take either oral finasteride or androanagen. No need to take both of them together. Scalp massager, Apple Cidar Vinegar and wearing a Helmet don't seem to play any role in androgenetic alopecia.

Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Kakkar S. (1 hour later)
Hello Doc,

Thanks for answer

As I've mentioned earlier I am using kenz lotion(shampoo) which is a combination of ketoconazole and salicylic acid should I continue using that? or do you have any specific brand name in coal tar that you can mention. could you also please confirm if itching can be controlled, I have mild to severe itching from past two weeks.
doctor
Answered by Dr. Kakkar S. (18 hours later)
Brief Answer:
Regarding shampoo and itching

Detailed Answer:
Hello.

If you still have pink to red patches and scalp itching after using ketoconazole shampoo then you may switch to a coal tar and salicylic acid based shampoo e.g Protar shampoo or Salytar shampoo.
In addition you may also take a tab Allegra once daily for symptomatic relief from itching.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8962 Questions

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What causes mild pink bald patches on the scalp?

Brief Answer: Seborrheic dermatitis and androgenetic alopecia Detailed Answer: Hello. Thank you. I am Dr kakkar (Dermatologist and Venereologist). I have noted your concern and I have viewed the images. I can see thinning extending from the mid to the vertex of the scalp.b There is relative sparing of the frontal scalp and anterior hair line. This seems like patterned hair loss of males/ androgenetic alopecia. In addition you seem to have seborrheic dermatitis of the scalp characterized by red to pink patches, scalp scaling and itching. I suggest you to use a coal tar and salicylic acid based shampoo e.g Protar lotion for seborrheic dermatitis. Lather it well on to wet scalp and allow it to act for 7-10minutes before rinsing it off. For thinning I suggest you to use Minoxidil 5%solution, 1ml, twice daily. In addition I would suggest you to take tab finasteride 1mg once a day. Treatment is long term and response is appreciable after 3-6 months of regular use. These are prescription medications and I suggest you to use them under the supervision of your local practitioner. Regards