
Having Severe Abscess Formation On Scalp. Treated With Topical Steroids And Antibiotics. What Is The Treatment?



hair loss is not related to thread lift
Detailed Answer:
Hi,
Thanks for writing to us.
I can understand your concern.
Firstly i would like to summaries your problem. You have irreversible hair loss or scarring alopecia associated with development of abscess and crust formation and tufted hair.
I agree that tufted hair folliculitis can rarely occur with any surgery or trauma( in your case thread lift) but presence of abscess, crusting, inflammation till date cant be associated with thread lift done 7 years ago. So, you need to understand that any suture can get infected after surgery but the persistence of infection even after seven years of surgery is rare. So like other doctors you have consulted earlier, I too believe its not related with thread lift.
Now having said this I would like to concentrate on possible causes of your present condition. Lichen planus can lead to tufted hair but again its not associated with abscess, crusting, swelling etc.
In my opinion, two possibilities should be ruled out dissecting cellulitis of scalp and folliculitis decalvans. This can be done by skin biopsy. In hair loss, two biopsies are sent one is horizontal section biopsy and another one is vertical section biopsy to ascertain the cause of scarring hair loss( cicatricial alopecia). Also pus culture sensitivity is necessary. Usually it is positive for staph aureus.
The treatment plan in your case should be using a good antibacterial shampoo, application of topical antibiotic cream like clindamycin along with antibiotics like rifampicin and minocycline( given for prolonged period) to control infection and inflammation. Once infection is controlled, tufting should improve as it occurs due to matting of hair infundibuli of hair follicles. Unfortunately hair that has gone cant be grown back as its a scarring alopecia.
Kindly reach out incase of further queries.
Regards

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