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What Causes Burning Sensation On Scalp Followed By Hair Fall?
Question: Hi Dr,
I am a 29 yr old male and I have been experiencing scalp issues since XXXXXXX of last year. At first I started feeling mild burning out of no where and it lead to a small patch of hair on the top of my scalp falling out. After that, I started to notice that every time I took a shower and would wash my hair, I would see lots of hair on my hands that was falling out. I thought that it might have been the shampoo I was using but then I proceeded to try another brand which caused bad burning on my scalp as well. At that point I stopped washing my hair because my scalp would burn with any shampoo that I tried. Over time more patches started forming. I've been to multiple dermatologists and they say it is alopecia areata. Steroid shots didn't work, every shampoo they prescribed burned including those that contained nizorol. They have no idea why my head is burning, they say that It's not a normal symptom that comes with alopecia areata. Aside from that, my hair is rapidly falling out all over the top of my head and recently I have noticed disgusting flaky yellow chunks on my scalp. When I try to remove them, it pulls hair out with it. My scalp literally feels like it is sick. I have a fungal infection on the tip of my penis that I have been trying to get rid of and I have always wondered if the 2 could be related. Any advise you can offer is much appreciated, after seeing all these doctors, they make me feel like I'm the only person on the planet with this issue. I am now using an organic shampoo that contains tea tree oil and urea, although it doesn't burn my scalp, it does not help at all with my condition. I've been tested for hyperthyroidism and I've had hairs cultured for fungal infection which came back negative. Please help.
I am a 29 yr old male and I have been experiencing scalp issues since XXXXXXX of last year. At first I started feeling mild burning out of no where and it lead to a small patch of hair on the top of my scalp falling out. After that, I started to notice that every time I took a shower and would wash my hair, I would see lots of hair on my hands that was falling out. I thought that it might have been the shampoo I was using but then I proceeded to try another brand which caused bad burning on my scalp as well. At that point I stopped washing my hair because my scalp would burn with any shampoo that I tried. Over time more patches started forming. I've been to multiple dermatologists and they say it is alopecia areata. Steroid shots didn't work, every shampoo they prescribed burned including those that contained nizorol. They have no idea why my head is burning, they say that It's not a normal symptom that comes with alopecia areata. Aside from that, my hair is rapidly falling out all over the top of my head and recently I have noticed disgusting flaky yellow chunks on my scalp. When I try to remove them, it pulls hair out with it. My scalp literally feels like it is sick. I have a fungal infection on the tip of my penis that I have been trying to get rid of and I have always wondered if the 2 could be related. Any advise you can offer is much appreciated, after seeing all these doctors, they make me feel like I'm the only person on the planet with this issue. I am now using an organic shampoo that contains tea tree oil and urea, although it doesn't burn my scalp, it does not help at all with my condition. I've been tested for hyperthyroidism and I've had hairs cultured for fungal infection which came back negative. Please help.
Brief Answer:
Burning sensation seen in 14% of cases
Detailed Answer:
Hi, welcome to HCM,
14% of the patient of alopecia areata experience burning sensation or pruritus in the affected area.
Your hair culture for fungal infection is negative, there is no need of antifungal shampoo. application of Ketoconazole lotion for more than 5 minutes itself lead to burning, due to irritant contact dermatitis.
Flaky yellow chunks on scalp appeared after fungal culture or it was there before this? This is not alopecia areata. There is a feature to upload the image by yourself on the right side of this query page. You may utilize that. I shall review images and give my opinion.
Your alopecia areata is progressive one and I usually prescribe following -
Oral XXXXXXX pulse of betamethasone ( 5 mg for two consecutive days in a week)
Rinse your hair with shampoo containing ciclopirox olamine, although it is antifungal but has inherited anti inflammatory property.
Intralesional injection of triamcinolone acetonide at very low dose 5 mg/ml (make sure that injection is given by dermatologist inadequate technique may lead to atrophy and permanent hair follicle loss).
Potent steroid (Halobetasol) lotion for local application.
Tab Biotin+PABA once daily.
All these suggested treatment options need close monitoring by a qualified doctor, please consult your dermatologist and discuss the same.
Hope this is helpful.
Thanks
Burning sensation seen in 14% of cases
Detailed Answer:
Hi, welcome to HCM,
14% of the patient of alopecia areata experience burning sensation or pruritus in the affected area.
Your hair culture for fungal infection is negative, there is no need of antifungal shampoo. application of Ketoconazole lotion for more than 5 minutes itself lead to burning, due to irritant contact dermatitis.
Flaky yellow chunks on scalp appeared after fungal culture or it was there before this? This is not alopecia areata. There is a feature to upload the image by yourself on the right side of this query page. You may utilize that. I shall review images and give my opinion.
Your alopecia areata is progressive one and I usually prescribe following -
Oral XXXXXXX pulse of betamethasone ( 5 mg for two consecutive days in a week)
Rinse your hair with shampoo containing ciclopirox olamine, although it is antifungal but has inherited anti inflammatory property.
Intralesional injection of triamcinolone acetonide at very low dose 5 mg/ml (make sure that injection is given by dermatologist inadequate technique may lead to atrophy and permanent hair follicle loss).
Potent steroid (Halobetasol) lotion for local application.
Tab Biotin+PABA once daily.
All these suggested treatment options need close monitoring by a qualified doctor, please consult your dermatologist and discuss the same.
Hope this is helpful.
Thanks
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Dr XXXXXXX
Thank you for your prompt and detailed reply. If you zoom into the first image, you will see a yellowish tint on the top of my head. Those are the chunky flakes that I am talking about. It is disgusting. My scalp is so sensitive that when I run my hand through my hair, chunks will come out and the hairs come with it. Burning and itching happens at random times throughout the day. If this is not alopecia areata, what do you think it could be. Have you ever seen something similiar in a past patient?
Thank you for your prompt and detailed reply. If you zoom into the first image, you will see a yellowish tint on the top of my head. Those are the chunky flakes that I am talking about. It is disgusting. My scalp is so sensitive that when I run my hand through my hair, chunks will come out and the hairs come with it. Burning and itching happens at random times throughout the day. If this is not alopecia areata, what do you think it could be. Have you ever seen something similiar in a past patient?
Brief Answer:
Seborrheic Dermatitis of scalp
Detailed Answer:
Hi, welcome again,
It is seborrheic dermatitis of scalp. It is an inflammatory condition of overactive oil glands. It presents as greasy patches of scaling, which appear as thick, crusty yellow, white or brown. Dandruff is a mild form of seborrheic dermatitis.
Diagnosis is clinical, and I have seen a lot of cases of this.
But i will advise you to go for histopathology of the lesion one from yellow crust and other from bald patch. As from picture it is very difficult to say whether patch is atrophic or not. to visualize hair follicle it needs magnification some time dermatoscopy helps a lot. As i doubt the patch to be alopecia areata, these are more like atrophic patches occurring after secondary bacterial infection.
Hope this will clear your doubts.
Thanks
Seborrheic Dermatitis of scalp
Detailed Answer:
Hi, welcome again,
It is seborrheic dermatitis of scalp. It is an inflammatory condition of overactive oil glands. It presents as greasy patches of scaling, which appear as thick, crusty yellow, white or brown. Dandruff is a mild form of seborrheic dermatitis.
Diagnosis is clinical, and I have seen a lot of cases of this.
But i will advise you to go for histopathology of the lesion one from yellow crust and other from bald patch. As from picture it is very difficult to say whether patch is atrophic or not. to visualize hair follicle it needs magnification some time dermatoscopy helps a lot. As i doubt the patch to be alopecia areata, these are more like atrophic patches occurring after secondary bacterial infection.
Hope this will clear your doubts.
Thanks
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you doctor. I am going to bring this information with me to the dermatologist. What are the normal methods of treatment? Will the hair grow back or does seborric dermatitis permanently damage the folicle? Thank you for all of this information, it will help me out a lot. Cheers
Brief Answer:
Of course Seborrheic dermatitis can be treated
Detailed Answer:
Hi,
Seborrheic dermatitis does not damages the hair follicle. Superimposed secondary bacterial infection damages hair follicle and and cause scarring alopecia.
I used to treatSeborrheic dermatitis with
Ciclopirox olamine shampoo daily,
Beclomethasone + Clotrimazole lotion to be applied once daily,
Cap Isotretinoin 20 mg once daily at night.
If scarring has occurred only hair transplantation can grow hair on that area no medicine will help.
If you have any other query go ahead. In case you have no more questions, please close this discussion and review.
Thanks
Of course Seborrheic dermatitis can be treated
Detailed Answer:
Hi,
Seborrheic dermatitis does not damages the hair follicle. Superimposed secondary bacterial infection damages hair follicle and and cause scarring alopecia.
I used to treatSeborrheic dermatitis with
Ciclopirox olamine shampoo daily,
Beclomethasone + Clotrimazole lotion to be applied once daily,
Cap Isotretinoin 20 mg once daily at night.
If scarring has occurred only hair transplantation can grow hair on that area no medicine will help.
If you have any other query go ahead. In case you have no more questions, please close this discussion and review.
Thanks
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. Yogesh D
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