Scalp wound not healing

[Anonymous075]

I have had a scalp wound for as long as I can remember. It is red and it is slightly elevated. It does not bleed. It can be picked, but I don't. It just has never gone away. It has caused no real problems for me. I am just curious as to why it has not healed.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
Generally such wounds that do not heal are called non-healing ulcers in medical term. They could be non healing due to underlying infection, low supply of oxygen to the wound that is reducing the healing process, underlying diabetes, or due to underlying dermatitis. Wounds heal slower in smokers or alcoholics who have been drinking for a long time. So these have to be ruled out.
Also diabetes leads peripheral neuropathy, atherosclerosis etc which make wound healing troublesome.You need a culture sensitivity of wound scraping to know what antibiotics will suit the infection. If there is underlying dermatitis, then this needs to be taken care of. If there is severe atherosclerosis preventing blood supply to wound, then this needs to be diagnosed by angiograms. It is better to get this treated at a wound clinic. Wound debridement (cleaning of wound, removing slough, etc) would be required proper dressing at a wound clinic.
Since I cannot examine you and know other related conditions you may be having, nor is a detailed history possible on net, I have listed the various possibilities that should be looked into. Please consult your PCP for primary examination followed by proper referral.
Hope this helps. Take care!

[LivingInHope]

If it is tiny, you might consider if it is a cherry angioma, which is a benign lesion.  I have one of these in my scalp.  I used to pick at it until I asked someone what it looked like.  Now I plan to leave it alone.

  If it is larger than a pencil eraser or has an irregular border, I urge you to see a dermatologist right away to get evaluated for skin cancer.  A red nevus can mean cancer.  I recently met a man who had melanoma (the most deadly form of skin cancer) on his head.  If you spent a lot of time out of doors as a child, the scalp is definitely a place where skin cancer can show up later on.

If your wound is more an angry pink, elevated and is located in the exact place where you had a rock hit your head years ago, you might consider a keloid scar.  

But you want an expert opinion from a dermatologist who can eyeball your scalp and either diagnose you on the spot or biopsy if necessary.  If it turns out it's cancer, the sooner you go in, the better!  There was one guy who had gotten hurt with asphalt in his head and had a sore that wouldn't heal.  I urged him to go in, but he didn't for a long time.  Finally, when he decided to go in, he had to have a pretty big sized skin graft for what turned out to be skin cancer.