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Pus-filled pimples on Scalp. Need help!!!

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Hi HRN Members/experts,

> Need your help treating pus-filled, painful, itchy pimples/bumps on my scalp
> Using Minoxidil 10 once daily (can't apply minoxidil 5 twice due to odd office working hours that's why using 10 instead once daily with Finestride 1 mg tablet
> Applying coconut oil 2-3 times weekly

*Upon doctor's recommendation, used T-bact 2% Ointment (Mupirocin 2%), but didn't get result
*Also, used Ketoconazole 2% shampoo twice weekly but didn't help

Need your help treating my scalp pimples as it has increased my hair loss. I tried reducing minoxidil application from daily to alterate days, but that has increased hair loss.

Request your help treating my scalp pimples.

Regards,
akc

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Hello

1. Using 5% minoxidil once a day is almost as effective as twice a day treatment according to Dr Bernstein as topical minoxidil has a 22 hour half life.

 

2. If you are getting pimples on your scalp I would avoid applying any type of oil on it as that can’t be good. Can you imagine someone with acne/whiteheads applying oil on their face? Just seems like a bad idea to help bacteria grow. I assume you’re indian as many of my Indian friends love using oil/coconut oil on their hair and claim it does everything from stopping hair loss to curing dandruff.

 

3. Have you tried a salicylic acid shampoo such as tsal? Salicylic acid has been proven to help with acne.

 

4. Did you have a hair transplant? I’ve heard it’s somewhat common get folliculitis after surgery for some people.

 

5. I’d follow up with your doctor again to let them know the cream didn’t work.

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2 hours ago, jj51702 said:

Hello

1. Using 5% minoxidil once a day is almost as effective as twice a day treatment according to Dr Bernstein as topical minoxidil has a 22 hour half life.

 

2. If you are getting pimples on your scalp I would avoid applying any type of oil on it as that can’t be good. Can you imagine someone with acne/whiteheads applying oil on their face? Just seems like a bad idea to help bacteria grow. I assume you’re indian as many of my Indian friends love using oil/coconut oil on their hair and claim it does everything from stopping hair loss to curing dandruff.

 

3. Have you tried a salicylic acid shampoo such as tsal? Salicylic acid has been proven to help with acne.

 

4. Did you have a hair transplant? I’ve heard it’s somewhat common get folliculitis after surgery for some people.

 

5. I’d follow up with your doctor again to let them know the cream didn’t work.

Hello,

Thank you for your quick reply, I truly appreciate your suggestions & help. Below are some of the details to my scalp acne problem:

> I'll try switching to minoxidil 5% once a day (any suggestion if I could switch back to minoxidil 10% once my scalp pimples goes away, is minoxidil 10% effective/better than 5%, what's the use of minoxidil 10%)

> Yes, I'm Indian & my doctor has suggested coconut oil daily before shower for 20 minutes

> I tried Ducracy Anaphase & Ketoconazole 2% shampoo, surely will try salicylic acid shampoo as well

> Yes, had hair transplant, consulted surgeon, explain scalp problem, post which he suggested Mupirocin 2% Ointment. Sure I will consult him again & mention Ointment isn't effective


While, I'll follow the mentioned suggestions for scalp acne, just want to know that in order to reduce future hair loss, what are some regular hair care lotions, medicines or any other thing like shampoos/oils. As mentioned, I am relying on minoxidil, Fenestride, cocunut oil massage, & shampoos, it'll be helpful if you could suggest something to reduce hair fall. Lately my hair loss/fall problem has increased a bit. 

Thank you for all your help. 

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34 minutes ago, akc said:

Hello,

Thank you for your quick reply, I truly appreciate your suggestions & help. Below are some of the details to my scalp acne problem:

> I'll try switching to minoxidil 5% once a day (any suggestion if I could switch back to minoxidil 10% once my scalp pimples goes away, is minoxidil 10% effective/better than 5%, what's the use of minoxidil 10%)

> Yes, I'm Indian & my doctor has suggested coconut oil daily before shower for 20 minutes

> I tried Ducracy Anaphase & Ketoconazole 2% shampoo, surely will try salicylic acid shampoo as well

> Yes, had hair transplant, consulted surgeon, explain scalp problem, post which he suggested Mupirocin 2% Ointment. Sure I will consult him again & mention Ointment isn't effective


While, I'll follow the mentioned suggestions for scalp acne, just want to know that in order to reduce future hair loss, what are some regular hair care lotions, medicines or any other thing like shampoos/oils. As mentioned, I am relying on minoxidil, Fenestride, cocunut oil massage, & shampoos, it'll be helpful if you could suggest something to reduce hair fall. Lately my hair loss/fall problem has increased a bit. 

Thank you for all your help. 

1. Honestly I don’t know much about 10% minoxidil as the fda has only ever approved 5% here and anything higher needs an rx here. I would ask your doctor or whoever prescribed u the 10%. Sorry wish I could be more helpful

2. Def follow up with your surgeon again as any type of folliculitis needs to be treated 

3. Honestly you are currently on the best treatments medically. Finasteride and minoxidil are the gold standard. There aren’t really any other lotions or topicals worth using (would you want to add more hassle to your lifelong regimen; I assume not since you got a transplant). Make sure to eat well, sleep well, take care of yourself emotionally, and get some exercise. If you want, you can also add in some vitamins that can potentially help your hair healthier and grow faster (they don’t stop hair loss however). These include biotin, msm, silica, etc. No standard dosages so just read up about them. However, many report acne increase with biotin so be careful.

 

good luck

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6 minutes ago, jj51702 said:

1. Honestly I don’t know much about 10% minoxidil as the fda has only ever approved 5% here and anything higher needs an rx here. I would ask your doctor or whoever prescribed u the 10%. Sorry wish I could be more helpful

2. Def follow up with your surgeon again as any type of folliculitis needs to be treated 

3. Honestly you are currently on the best treatments medically. Finasteride and minoxidil are the gold standard. There aren’t really any other lotions or topicals worth using (would you want to add more hassle to your lifelong regimen; I assume not since you got a transplant). Make sure to eat well, sleep well, take care of yourself emotionally, and get some exercise. If you want, you can also add in some vitamins that can potentially help your hair healthier and grow faster (they don’t stop hair loss however). These include biotin, msm, silica, etc. No standard dosages so just read up about them. However, many report acne increase with biotin so be careful.

 

good luck

Thank you so much for the detailed suggestions. I really appreciate your help and insight. Thank you. 

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13 hours ago, akc said:

 

Hi HRN Members/experts,

> Need your help treating pus-filled, painful, itchy pimples/bumps on my scalp
> Using Minoxidil 10 once daily (can't apply minoxidil 5 twice due to odd office working hours that's why using 10 instead once daily with Finestride 1 mg tablet
> Applying coconut oil 2-3 times weekly

*Upon doctor's recommendation, used T-bact 2% Ointment (Mupirocin 2%), but didn't get result
*Also, used Ketoconazole 2% shampoo twice weekly but didn't help

Need your help treating my scalp pimples as it has increased my hair loss. I tried reducing minoxidil application from daily to alterate days, but that has increased hair loss.

Request your help treating my scalp pimples.

Regards,
akc

 

Have a look at HIBISCRUB it has incredible reviews for lots of skin conditions, you just have to get the right dilution for whatever your using it for. From acne, to athletes foot, to folliculitis.  look at the reviews on Amazon, hope you get it sorted.

18EA97C7-7842-4F6C-836A-1FFC96CA7773.thumb.jpeg.c03e96c7316c845df69d14188dd38d1e.jpeg

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I am guessing you are 3-4 months post procedure? 6-7 of these is common.  The follicle comes with a gland.  The glad doesn't know what to do...a pimple forms.  Once all resolved, the hair will grow normally.  Best thing, use a warm compress and then just treat it like a zit.

Because of the alcohol content, I would check with your doctor....Postpone Rorgaine until this is resolved.  Or use Rogaine away from the bumps.  Rogaine is systemic.  No need to put it everywhere.  Just pick one spot and massage in.  The next day you can put it in another area.  It is working your entire head.

By using Rogaine twice a day you are getting 100% of the medication. Using it once a day, you're still getting 90%. Cut down to once a day and put it on before you go to bed.

If none of these things help, go to your dermatologist.  The can prescribe a number of steroids.

Cleanliness is important.  Wash daily.

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6 hours ago, Anthonyd said:

Have a look at HIBISCRUB it has incredible reviews for lots of skin conditions, you just have to get the right dilution for whatever your using it for. From acne, to athletes foot, to folliculitis.  look at the reviews on Amazon, hope you get it sorted.

18EA97C7-7842-4F6C-836A-1FFC96CA7773.thumb.jpeg.c03e96c7316c845df69d14188dd38d1e.jpeg

Thank you so much. I will check more on this.

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4 hours ago, LaserCap said:

I am guessing you are 3-4 months post procedure? 6-7 of these is common.  The follicle comes with a gland.  The glad doesn't know what to do...a pimple forms.  Once all resolved, the hair will grow normally.  Best thing, use a warm compress and then just treat it like a zit.

Because of the alcohol content, I would check with your doctor....Postpone Rorgaine until this is resolved.  Or use Rogaine away from the bumps.  Rogaine is systemic.  No need to put it everywhere.  Just pick one spot and massage in.  The next day you can put it in another area.  It is working your entire head.

By using Rogaine twice a day you are getting 100% of the medication. Using it once a day, you're still getting 90%. Cut down to once a day and put it on before you go to bed.

If none of these things help, go to your dermatologist.  The can prescribe a number of steroids.

Cleanliness is important.  Wash daily.

Hello!

Thank you for such a detailed suggestion. I truly appreciate your help. I'll definitely follow some of the suggested points. I'm sure it'll help me. Thanks again for all your help!!

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Hi!

Thanks for your suggestions & help thus far. To provide more clarity about my scalp pimples, I've clicked few pictures.
Request to please check & suggest remedial treatment.

Thank you in advance for your help.

WhatsApp Image 2019-08-27 at 08.16.14.jpeg

WhatsApp Image 2019-08-27 at 08.16.44.jpeg

WhatsApp Image 2019-08-27 at 08.16.55.jpeg

WhatsApp Image 2019-08-27 at 08.17.32.jpeg

WhatsApp Image 2019-08-27 at 08.17.41.jpeg

Edited by akc

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From the pics it definitely looks like an infection...you need to see the doctor in person...if that's not possible, go in and see a dermatologist immediately and get treated.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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That doesn’t look good, let’s see what our resident physicians think @Dr. Glenn Charles @Dr Blake Bloxham


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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@akc this needs to be treated by your doctor or a dermatologist. There is definitely an infection based on the photos and I do believe it warrants a proper swab to culture what type of infection it is and also some oral antibiotic medication in addition to some topical treatment.  You have to see someone locally. 

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The "tagging" feature is neat. Thank you for bringing this thread to my attention, Melvin! 

AKC, 

I think you have received good advice thus far. Pustules like this seem to indicate some type of infection. The level of involvement (multiple follicles, skin, deeper tissues, etc) and proper course of treatment is difficult to estimate based on images alone. One question I do have, however, is how long ago you had the hair transplant? I was not clear on this. 

If I had to fathom a guess, I would say that you had the transplant within the last 3-4 months and the pustules are related to "ingrown" hairs penetrating through the scalp. If these were manipulated enough or things like oil were placed around them and created a nice environment for bacteria to grow, infectious agents absolutely could have infiltrated through the surface of the scalp and settled in various layers of the tissue. Depending on how deep the bacteria penetrated and how wide it spread, oral antibiotics may be a good option. 

This will all need to be determined by a knowledgeable doctor in person. It would be nice to get your HT doctor's input, but I would probably see your GP as well. 

Hope this helps. 

 

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Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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On 8/28/2019 at 4:29 AM, gillenator said:

From the pics it definitely looks like an infection...you need to see the doctor in person...if that's not possible, go in and see a dermatologist immediately and get treated.

Thanks for your suggestion!!! I'll consult the doctor & take remedial steps. Thanks for your concern.
 

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13 hours ago, DrTBarghouthi said:

@akc this needs to be treated by your doctor or a dermatologist. There is definitely an infection based on the photos and I do believe it warrants a proper swab to culture what type of infection it is and also some oral antibiotic medication in addition to some topical treatment.  You have to see someone locally. 

Thank you DrTBarghouthi for your suggestion & help. I will visit get this treated soon.

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11 hours ago, Dr Blake Bloxham said:

The "tagging" feature is neat. Thank you for bringing this thread to my attention, Melvin! 

AKC, 

I think you have received good advice thus far. Pustules like this seem to indicate some type of infection. The level of involvement (multiple follicles, skin, deeper tissues, etc) and proper course of treatment is difficult to estimate based on images alone. One question I do have, however, is how long ago you had the hair transplant? I was not clear on this. 

If I had to fathom a guess, I would say that you had the transplant within the last 3-4 months and the pustules are related to "ingrown" hairs penetrating through the scalp. If these were manipulated enough or things like oil were placed around them and created a nice environment for bacteria to grow, infectious agents absolutely could have infiltrated through the surface of the scalp and settled in various layers of the tissue. Depending on how deep the bacteria penetrated and how wide it spread, oral antibiotics may be a good option. 

This will all need to be determined by a knowledgeable doctor in person. It would be nice to get your HT doctor's input, but I would probably see your GP as well. 

Hope this helps. 

 


Thank you Dr Blake Bloxham for your detailed suggestion & help. Below are some of my HT surgery details for your diagnosis:

I had two surgeries in the recent past - 

> Dec 2017 - Crown/Vertex & Frontotemporal
> Dec 2018 - Frontotemporal

While I didn't feel any scalp pimples during first surgery, it's been 8 months post second surgery, and I have these painful pimples all over my scalp. I've clicked few more pictures for your reference, could you please diagnose this further & provide suggestions before I take this up/consult with my surgeon.

Thanks for all your help.

WhatsApp Image 2019-08-27 at 08.17.41.jpeg

WhatsApp Image 2019-08-29 at 08.27.52 (1).jpeg

WhatsApp Image 2019-08-29 at 08.27.53.jpeg

WhatsApp Image 2019-08-29 at 08.27.55.jpeg

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You're welcome akc and please let us know how things turn out for you.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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 Sure Gillenator, I will keep you posted about my improvement.

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