Pain, Inflammation, then Hair Loss

About a year ago I noticed I had some pain in my vertex. No itching. I went to my dermatologist who said it was seborrheic dermatitis – as my vertex was red and inflamed. It is uncomfortable to the touch, and touching the hairs there hurts. Since then it has come and gone, but I have started to thin quickly on the vertex, and see scalp now even when dry. I have no hairloss in my father or older brother, and I am 33. I know you’ll say get mapped for miniaturization, but my derm said the loss wasn’t bad, saw no MPB and would not prescribe propecia yet. He said MPB is not associated with pain. Still it is thinning quickly, and only in the spot it hurts – the vertex. So, 2 questions. Is it normal just to have pain on the vertex and be thinning there from just from SD? And in your practice, have you ever seen pain associated with MPB? I just want my hair back and the pain to go away so I can touch my scalp.

Thanks!

Your dermatologist is correct in stating male pattern baldness (MPB) is not associated with pain. It seems you have some sort of inflammation on your scalp and I would follow up with your dermatologist to treat the underlying problem. You may have some hair loss and have seborrheic dermatitis (SD) at the same time, though if you do, the SD may not be the cause of the thinning hair. If it is not related to the MPB, your hair should grow back. The mapping of your scalp tells the health of the hair in the crown, something that you should want to know.