Spots on a shaved head with alopecia

Shaving can reveal lesions previously hidden by hair and can also irritate the follicle openings. Alopecia and spots may occur at the same time without one necessarily causing the other.

Folliculitis often presents with tender or itchy bumps centred on hairs, sometimes with a small amount of pus. Razor bumps develop when cut hairs curve into or irritate nearby skin. Acne can present with clogged pores, inflamed pimples or deeper tender lesions, including on an oily scalp.

Note whether the marks appeared immediately after a close shave, whether they follow the direction of hair growth, and whether there is itch, scale, drainage or increasing pain. Smooth areas of hair loss without surface bumps call for a different assessment from inflamed spots around follicles.

Pause close shaving while the skin is inflamed. Clean the scalp gently, avoid squeezing lesions, and keep hats, pillowcases and clipper heads clean. When shaving resumes, soften the hair first, use a clean sharp blade or guarded electric clipper, shave with hair growth and avoid repeated passes over one area.

Skip heavy oils or fragranced aftershaves if they sting or seem to block follicles. A clinician or pharmacist can help select a wash or treatment after examining whether the problem is acne, folliculitis, ingrown hairs or another eruption; these conditions do not all respond to the same products.

Seek prompt medical care if redness spreads, pain or swelling worsens, pus is extensive, fever develops, or the scalp feels hot. Book a routine assessment when spots keep returning, leave scars or dark marks, occur with scaling or broken hairs, or accompany a new pattern of hair loss.

Ask whether the bumps arise from the hair follicles, whether infection or ingrown hairs are visible, and whether a sample is needed if drainage is present. Bring the products and shaving tools you use, and explain how closely you shave and how soon the spots appear afterward.