How to treat the bald spot and pimples in the back of my head?

I have attached a picture in this post for the reader to better understand my situation. I'm a 25 year old male and I have a bald spot on the back of my head. I noticed the spot about 7 months ago after getter a haircut. In addition, I get pimples like those you see in the picture near the bottom hair line. I am not sure if they are even pimples, they keep appearing at different locations near the hairline and even at the bald spot in the past. Could i be getting these so called pimples due to unsanitary clippers at the barber shop? What causes the bald spot? My sister (2 years younger) had a similar looking bald spot right above her forehead but she used some sort of ointment for a few months and had hair grow back at that spot. I'm no longer in touch with her so I can't find out what she used. Please help...


This discussion is related to Bald Spot.

[Bhupinder Kaur, MD]

Hello,
This bald spot is due to tinea capitis. Tinea capitis is contagious and can spread direct contact with someone who has the condition, or if you touch contaminated items such as combs, hats, clothing, or similar surfaces. Treatment includes washing the scalp with shampoo with selenium sulfide (2.5%) or zinc pyrithione (1-2%) used 2-3 times weekly at home. Oral steroids, Griseofulvin and oral antifungals may also be required. I suggest you to get it evaluated from a dermatologist.

The bumps on the back of head can be due to acne keloidalis nuchae. It occurs when hairs on the back of the head and neck grow into the skin, become inflamed, and cause scar tissue. These ingrown hairs usually occur following a short haircut on the back of the head and nape of the neck.

Treatment of AKN includes suppression of the inflammation with antibiotics and steroid gels or intralesional steroid injections. So apply antibiotic cream like Neosporin or bactroban. If the symptoms persist then oral antibiotics and steroids may be needed. Please consult a dermatologist in that case.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.