Hair Loss and Pigmentation Changes

A darker or lighter area may follow irritation, scratching, inflammation, a burn, or another change in the skin. Hair can also appear less dense because pigment contrast makes the scalp more visible, without the skin change causing the loss. Patchy loss can occur with alopecia areata, while scale and broken hairs raise concern for scalp ringworm.

Pattern loss and temporary shedding may occur alongside an unrelated pigmentation concern. The clinician will look for scarring, follicle openings, scale, tenderness and the boundary of the colour change rather than judging from a photograph alone.

Photograph the area in daylight and note whether the colour change appeared before, after or alongside shedding. List new hair dyes, oils, straightening products, topical medicines and sun exposure. Stop any product that clearly burns or irritates the scalp, and avoid scratching or tight styles.

A clinician may recommend treatment for inflammation or infection, or address a separate hair-loss pattern. Avoid applying bleaching agents or unprescribed steroid products over changing skin. Hair restoration procedures should wait until active scalp disease and the cause of loss have been clarified.

Seek prompt review for a painful, spreading, ulcerated, bleeding or crusted area, sudden patchy loss, or a scalp that is hot and swollen. Arrange assessment when colour change persists, scars develop, or eyebrows and eyelashes are also affected. Urgent help is needed for facial swelling or breathing trouble after a product.

Does the scalp show inflammation, scarring or infection? Could a product or procedure have caused the pigment change? Is the hair loss coming from the same process, and should I pause any cosmetic treatment?