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I Have 2 Round Small Bald Places On My Scalp

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Posted on Tue, 9 Jul 2019
Question: I have 2 round small bald places on my scalp that are driving me crazy and I want to have them surgically cut out of my scalp and removed and I want to find out just what they are. They are firm, dry and scaly and feel like a scab and they have stiff hair growing out of them and I cant stop touching my head and picking and digging at them with my fingernails to get them loose so I can pick them out of my head and get rid of them. I have even been using a sharp knife point to try to dig and gouge them loose and it is very painful and sometimes I dig at them for hours nonstop due to severe anxiety and feeling desperate to get them out of my scalp to the point of leaving bloody and very sore spots on my head that are miserable for days. They will not come loose or come out and seem like a tree stump with deep roots imbedded into my scalp and no matter how long I dig at them, they will not come loose and I have no relief and people stare at me because I even pick at my head in public and cannot stop myself so they think I must have lice or something contagious. My family has noticed my nonstop picking and touching my head and they think I must be high on drugs because I cannot stop and I do it all the time now. What are these spots and will I be able to have them surgically removed by a dermatologist permanently or wiil they grow back? I am miserable and desperate for relief because it is a very embarrassing problem and I prefer to stay home alone so I can pick at my head as long as I want and not be harassed about it by anybody.
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Follow up: Dr. AJEET SINGH (10 minutes later)
Also it is very soothing to just feel them with my fingertips and feel the firm dry and hard skin that is sticking up around them. I pick at them nonstop with the edge of my fingernails and after hours nonstop of trying to dig them loose enough I feel a spot that if I can just get a hold of it I could pull it loose or I try to use fingernail clippers to try to cut or clip the loose hard skin that is sticking up and remove it so I can get some relief and stop picking at it but I always end up going too far and causing myself injury to my scalp and leaving bloody sores that are still going to be there later and I will just start over again later and repeat the digging and picking all over again.
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Answered by Dr. AJEET SINGH (3 hours later)
Brief Answer:
?OCD with Alopecia areata

Detailed Answer:
Hi.
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX

I have gone through your details and here is my opinion.

As per your symptoms, my first diagnosis would be Alopecia areata.
This is an autoimmune disease where antibodies get formed in the body against own hair follicles and destroy them.
There are typical round,shiny bald patches with thick skin.
This can involve the hair of any body part.
Treatment includes oral steroids,minerals and vitamin supplements and intralesional injection of steroids (by microthin insulin syringe).
Over a period of time,it usually gets reversed.
Kindly visit a dermatologist for management.

I also think that your thought process is abnormal and you need to visit a psychiatrist for further work up.
Once he rule out thyroid abnormality,he would manage the neurotic symptoms by psychotherapy and relaxation techniques and you would be able to adjust with your symptoms in a better way.
You may need drug treatment (usually Benzodiazepines) to tide over your obsession and compulsion.

Hope that I have answered your query.
If you have any doubts,please let me know.

Stay healthy and stay blessed.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. AJEET SINGH

General & Family Physician

Practicing since :1994

Answered : 2151 Questions

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I Have 2 Round Small Bald Places On My Scalp

Also it is very soothing to just feel them with my fingertips and feel the firm dry and hard skin that is sticking up around them. I pick at them nonstop with the edge of my fingernails and after hours nonstop of trying to dig them loose enough I feel a spot that if I can just get a hold of it I could pull it loose or I try to use fingernail clippers to try to cut or clip the loose hard skin that is sticking up and remove it so I can get some relief and stop picking at it but I always end up going too far and causing myself injury to my scalp and leaving bloody sores that are still going to be there later and I will just start over again later and repeat the digging and picking all over again.