Trichoscopy in folliculitis decalvans

Folliculitis decalvans affects hair follicles and may cause redness, pustules, crusting, tenderness and areas where hairs grow in small tufts from one opening. Ongoing inflammation can damage follicles and leave smooth, shiny areas with reduced hair growth. Trichoscopy lets the dermatologist inspect follicular openings, scale, redness, pustules and hair-shaft changes without relying only on the naked-eye view.

The examination supports a diagnosis but does not replace clinical history. A scalp swab, biopsy or other test may be considered when infection, another scarring alopecia or a non-scarring hair disorder is possible.

Book a dermatology assessment if you notice persistent scalp pustules, crusts, painful areas, expanding patches or tufted hairs. Bring a list of products and medicines, and describe how the scalp has changed over time. Avoid picking crusts, tight hairstyles and harsh chemical treatments while the scalp is inflamed.

Treatment is chosen according to activity, extent, symptoms and test results. A dermatologist may discuss anti-inflammatory treatment, antimicrobial treatment or injections into selected inflamed areas. Follow-up examinations and repeat trichoscopy can help show whether inflammation is settling, but lost scarred follicles may not regrow.

Contact a dermatologist promptly if pustules multiply, pain increases, crusting spreads or a bald area is enlarging. Seek urgent medical help for fever, rapidly spreading redness, severe swelling or feeling acutely unwell. Earlier review matters when scarring hair loss is suspected because active inflammation can continue beneath a small visible patch.

Ask what trichoscopy showed, whether a biopsy or culture is needed, whether the process is scarring, which treatment targets inflammation or infection, how soon progress will be checked and what scalp changes should prompt an earlier visit.