Misc. question

[sopr81]

Are there dermatologists that specialize in scalp issues? If so, I would really appreciate if you could you give me the name of one of your colleages. I have 3 issues as a result of wearing my hair in a very tight pony tail for 8 years since I was twelve. The sides of my hair line are extreamly thin of course. The skin on of my scalp in sort of ridged or wavy. What is going on? Did the skin adapt to my hair being up so tight? The ridges use to be worse it seems some of the "waves" have disappeared however some still remain. The very top of my scalp hurts sometimes. This part is going to sound crazy to you - I even have to laugh at myself about this part. The reason I continued to leave my hair in such a tight ponytail (at first it was just becasue I liked the style and way it looked) but after awhile I noticed that if I didnt have my hair in that tight pony my face looked a little different. It's like I stretched the skin or something. My skin - esp. my eyes sort of sagged. I have very loose skin on the sides of my scalp. I went to a surgeon and told him my the issues. I thought the solution was simple - just remove that excces skin on the sides of my head-bring the side with hair to the other side with hair and discard the middle. This would get rid of the bald spot on the side of my head AND get rid of this excess skin that is making me look sad. He told me it was not that simple and somehow I ended up having a brow lift. Sorry for the length and lack of clarity of my post but as you can see I'm confused about it myself. So may be if you could just explain what could be going on with my scalp - teh characterists of skin etc and I would be so thankful if you had a name or something of a dermatologist that specializes on the scalp. This case is so strange (for lack of a better word) I dont feel like going to my primary care physician to ask her. It hard even typing this on a public forum - but I am sick of searching the interent for answers. Thank you Dr!

[Alan Rockoff, MD]

Although I understand your question, it is not easy to answer.  I can't tell from your description whether the changes you describe are just normal variants.  Permanent scalp changes from a hair style seem most unlikely.

Whatever the case, it remains a question as to whether anything can or even should be done about it.  Before undergoing any further plastic surgery, I suggest you consult a dermatologist.  If you learn--as I believe you will--that there is nothing inherently wrong with your physical characteristics, you are going to have to deal with your unhappiness about the way you look.  This may involves psychological counnseling, but may also involve consultation with hairdressers and cosmetologists to learn if you can modify your "look" to your satisfaction (or your satisfaction to your look.)

Basically, you need help to come to terms with yourself.  Surgery seems unlikely to be the answer.

Best.

Dr. Rockoff

[sopr81]

Dr Rockoff thanks for the prompt reply. I know permanent scalp changes seem unlikely to result from a hairstyle however I am positive these changes are not just normal variants. Regardless of what caused the changes (lets just throw that out) I am telling you my scalp is undergoing some recognizable changes.

My intentions are not to DO something about about this but rather to understand and inquire about what is going on with my scalp. You are right about coming to terms with myself, etc and I am happy to say I have succesfully dealt with THAT aspect of this. I want to know is my scalp in a healing process? Is the pain on the top of my head when I brush my hair eventually going to go away? Are there dermatologists that specialize in the scalp (rather than just a general dermatologist) and what are they called? What would really what would help me if you could answer this specific question:

What happens (scientifically and technically speaking - forget about the scalp story) to the skin if for a prolonged period of time the skin is under forced tension. Like being pulled up one direction. What does the dermis do? Can the connections with the underlying areolar tissue etc be shifted. Given the characteristics of skin (which I am not extreamly familiar with) what would likely happen if the skin was stress like that?

Just give me the best answer/description you can - I'll go look words up in the anatomy & physiology book if I dont understand them. Thank you so much.

[Alan Rockoff, MD]

Chronic pulling on the scalp can damage hair follicles, but it doesn't permanently change the skin anatomy there.  Any dermatologist should be able to help with this evaluation.

Dr. Rockoff