How effective is steroid injection into the skin for folliculitis decalvans?

Folliculitis decalvans is an inflammatory scalp condition that can cause pustules, crusting, soreness, and areas of scarring hair loss. Injecting steroid into selected inflamed lesions may reduce swelling and inflammatory activity for a time. Its effect is local, and the medicine does not bring back follicles that have already been destroyed by scarring.

Because inflammation can involve more than the spots that are easiest to see, injections are often considered alongside a broader plan. The clinician may need to examine the scalp closely and distinguish active disease from quiet, established scarring.

See a dermatologist if you have recurring scalp pustules, crusts, tenderness, or expanding hair loss. Avoid picking lesions and use only cleansing or topical products recommended for your scalp. Ask how injection sites will be selected, whether another treatment is needed between visits, and how progress will be assessed. Early control of active inflammation matters because scarred follicles do not readily regrow hair.

Contact your clinician promptly if redness, pain, drainage, or crusting is spreading, or if you develop fever or feel unwell. Arrange review when hair loss is advancing, new pustules keep appearing, or the scalp becomes increasingly tender. Severe swelling, marked pain, or widespread discharge needs timely assessment for infection or another cause.

Ask whether your scalp shows active inflammation, scarring, or both; what improvement the injection is intended to provide; and how its benefit will be monitored. Ask about possible local skin thinning or colour change and the plan if flares continue.