tender scalp/hair problems

what could cause dry tender scalp(no obvious redness or flakiness), small pimples come & go; when it first presented had a burning sensation down part area, hairshafts seemed to become thinner all over head. Have not had excessive hairfall but hair texture became very dry,frizzy,more curly/kinky, darker in hat area(My hair was wavy to soft curly before, quite thick),developed sort of  twisted clumps containing both shorter & longer hairs, seem to have less hair coverage on vertex & front and what looks like miniaturisation of hair. Almost appears as if new hair coming thru after loss of end of cycle telegon hairs is not growing properly. Some hair has weird twists/bends/kinks, rough feeling, some twisted (pili torti) looking hairs & most of these are  much shorter than, some interspersed with more normal looking, longer hairs. Hair recession at temples & frontotemporal at same time this all started a few months ago. Derm diagnosed seborrheic derm & telegon effluvium, but overall not impressed with her; she really made no bother to look at unusual hairshafts or at my scalp properly; just said to use Head & Shoulders which has been useless. Trying a more natural product (Moo Goo shamp/condit/scalp cream) from Australia. Helping condition of hair, not so dry, & scalp feel a little less dry, but still tender at times. Could it be hormonal or discoid lupus or what?

[Bhupinder Kaur, MD]

Hello,
It can be seborrheic dermatitis and telogen effluvium but the possibility of perifolliculitis also needs to be evaluated. It is characterised by small, very itchy pustules within the scalp, often most troublesome on the frontal hairline. The scalp should be washed with a mild normal shampoo as often as desired. Antidandruff shampoos containing antifungal agents such as ketoconazole or ciclopirox are sometimes helpful. Apart from that you need topical and oral antibiotics, antihistamines, oral steroids and topical tretinoin.

My sincere advice is to get it examined from a dermatologist. 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 doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.