I Got a Cut on My Head — If It Scars Will There Be Hair Loss?

Dr. Rassman,

Long time no chat. Used to browse here everyday, but took some time off.

Question. I was walking in an apartment complex about two weeks ago, turned the corner, and walked into an air conditioner that was clearly too low with my head. I was fiddling with a bag in my hands, my keys, and some other things so I wasn’t looking up. Plus, I was a wearing a baseball cap, although not a typical baseball cap. More like one of those touristy ones that might say “Universal Studios” or “Los Angeles” on it. Not as thick. Also, I have a ponytail and I wear my hat above the ponytail, so it might hang a bit low. Anyhow, I didn’t see the AC as I turned the corner and smacked/walked into the part where the bottom meets the side and hit the top of my head in one particular spot. I took off my hat and checked for blood. Couldn’t find any, and was relieved. However, when I got to a bathroom, I checked again with a paper towel and blotched a little bit of blood — not too much — on the paper towel. Although there could have been more because I do have pretty thick hair in the spot. The spot where I was hit developed into a raised, red bruise about the size of a quarter. I used a handheld mirror to check the bruise. It looked pretty good actually. Couldn’t even spot any open skin amongst my hair. At most, it looked like a shallow scrape with no definite sides. It was pretty red though. I thought I lucked out. That the hat I was wearing actually absorbed some or a lot of the blow.

I kept looking at the sore for a few days, and was resolved to the fact that I lucked out. Then a few days later I checked again with my hand and noticed a raised scab had formed. It was hard to see amongst the hair, even under light and with a handheld mirror. The scab looked white to me, but my brother said it was dark. Not sure if he saw it well. A scab must mean that the scrape was a bit more than I originally thought right? I didn’t wash my hair as much as usual for about the next two week, which brings us to today, but with working out and using the sauna, my hair became pretty itchy sometimes. So I had to wash, using my usual natural oil shampoo, and massaged with the palms of my hand, something I usually do on the top. Further, it seems the hair on my head protects my scalp from the shower water, which is interesting.

So where am I going? Apparently my scab fell off a few days ago because it wasn’t where it was. My hair in the general area looked pretty dandruffy, although it was the scab and remnants. I’m wondering if I should be worried about a permanent scar and damage to the hair follicles? I’ve read that scar tissue does not contain hair follicles. I checked my hair tonight pretty good and I can’t find a scar, but it’s hard to be certain with my back to the mirror and using a handheld mirror to look over my head. I still think I lucked out because of my pretty thick hair and the hat, but I’m still a bit paranoid. Also, I’m wondering if the hair in the area of the bruise is particularly fragile to being pulled out by a comb or fingers or whatever? What do you think? Give me an honest answer. Not an answer that would make me a client. ;-)

So to summarize… you hit your head, which caused a bruise, followed by a scab. After the scab came off, you became worried that it would leave a scar and hair wouldn’t grow in that area again. You can’t see a scar, you don’t have a bald spot in the injury area, but you’re paranoid. You don’t wash your hair for weeks and now your scalp itches. Is that about it?

My honest answer is that it would terrify me if you were my client. By all accounts it’ll be fine. You can’t see a scar so I’m not sure what you’re worried about. Not everyone will see hair loss surrounding a scalp injury. It sounds like you’re borderline OCD about this.