Small bumps on the scalp with hair loss

Tender, crusted, or pus-filled bumps may point to inflammation around follicles. Scalp ringworm can cause scaling, broken hairs, and areas of loss. Tight braids, extensions, or repeated pulling can contribute to traction alopecia, often along the hairline.

Smooth patches without much surface change can occur with alopecia areata. Hair thinning may also be male pattern hair loss, female pattern hair loss, or telogen effluvium after a physical or emotional stressor; these patterns can occur alongside an unrelated scalp rash.

Arrange a dermatology assessment, especially when loss is patchy, painful, scaly, or progressing. Use a gentle shampoo, avoid scratching and picking, and pause tight hairstyles, chemical treatments, and heavy scalp products. Do not share combs, hats, or brushes if infection is possible.

Take photographs in consistent lighting and note shedding, itch, pain, scaling, recent illness, medication changes, and hairstyle tension. Treatment may involve addressing inflammation or infection; finasteride treatment is considered only for suitable patients after medical discussion.

Seek prompt review for rapidly expanding bald patches, broken hairs with scaling, pus, severe tenderness, boggy swelling, or scarring. Urgent care is needed for fever with a spreading painful scalp infection or swelling near the eyes.

Are the bumps affecting the follicles, and is the hair loss scarring or non-scarring? Do I need a fungal test or other scalp test? Which hairstyle changes and treatments are appropriate for my pattern of loss?