by AS

I have thinning and some baldness in the crown of my head. I used to get cornrow extensions quite a bit because of previous problems with hair growth.
Before the braids, I used to go the the salon and get perms and and a short hairstyle. At that time, my thinning wasn't as bad, but enough that my beautician had to create a style to cover it. When you begin to use hair color spray to fill in these spots, then you know you've got a scalp issue. Her styles gave me confidence, but I was still acutely aware of my scalp issues.

When I couldn't afford to continue going to the salon, I permed my hair myself. I tried to wait a long time in between to prevent overprocessing, but it was hard to wait as I am very tenderheaded. My hair was extremely kinky and thick. Notice I said "was." This worked for a while, but then my hair began to break off and my scalp would be sore for no reason. One day, I noticed that there was some slight bleeding at the crown, like something had scratched me pretty good. That's when I felt it was time to see a doctor. I stopped going to the salon at that point.

I went to a dermatologist who told me to stop using relaxers on my hair because this was the cause of my thinning and scalp issues. He also said that in alopecia was my problem and that he saw this a lot with African Americans who wore braids too tight. I asked if I could at least press my hair and he told me that was out of the question too. That's when I went to cornrow braid extensions. I thought that getting my hair braided and leaving relaxers alone for a while would help my hair start the growth process back. My hair grew some, but not at the significant rate I was hoping for. Those spots were still thin even with the braids.

To date, my hair is very thin in the crown and the spot to the left is almost slick. I get relaxers, but no that often because of this issue. In between, I press my hair in hopes of abating any further scalp damage from relaxers. I wear the longer part of my hair to the back and pinned up over those spots so it's not noticeable. I don't know what else to do but would really like my hair to grow back healthy and my scalp issue resolved. I don't want to wear extended hair to cover it the rest of my life, but what are my options here? I am considering braids again and my husband thinks this might be good for me, but don't know if this is a good idea again. Any advice?

By the way, here are some pictures of the crown of my head. I am embarrassed by these but need to do something about it as soon as possible. These were taken by a cell phone. The light spots are just a relection of the light I am standing in front of. If you need better pictures, please let me know. Thanks.

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Feb 18, 2011
by: Q-PITT

I have fought with the crown of the head baldness as well and I just thought it to be heritary. My grandmother was slick bald at the top and extending area of her head. My daughter and I both suffer from this thing. No other granddaughter in the family has this issue and I was wondering if it were a curse or something. I do not perm my hair a lot at all. Have not use hair color in years now. I use to do those things,but I stopped for about 8 years now. At the top of my head, I can experience the bleeding without doing anything,but simply washing my hair. I was wearing wigs until I got tired of that. My hair in the back starting from the mid top is a good length and also no baldness. However I do take medication for hypertension and blood thinning meds. I had just started getting my hairdresser to just cover up the top of my head and I like the styles, but I just want my own hair. I am just considering getting braids also because I am one that like to do different hairstyles as well as change my wardrobe often. I need help in getting my hair back in shape. I have use placenta, that was helping a lot, but I thougt it to be taken off the market. Help!!!

Jan 23, 2009
Response About Hair Thinning At The Crown
by: Seymour M. Weaver, III, M.D.

The time line for everything that you have been experiencing with your scalp is not specified in your note, but I will provide a few comments based upon the information I am able to interpret.

First of all, your photo shows areas of thinning with what appears to be areas of balding which may have the onset of scarring, which can lead to permanent baldness. If you are losing hair and started to develop this type of change, you need treatment right away.

Which leads me to the next question. You mention that you saw a dermatologist at a time when your scalp was tender, and there were areas of bleeding and you were told to stop relaxers. No where do you mention that you were given any medications to use.

Bleeding and tenderness are usually signs of bacterial infection and are usually treated with oral or topical antibiotics. So, I don't know what type or if you received medications for this.

Bacterial infections can injure the scalp and when the process goes deeper, it is possible to get hair loss as a complication and sometimes this condition injures the scalp and causes scarring.

So, while the braiding and extensions can cause hair loss due to traction on their own, I am not sure if your initial scalp problem was ever addressed and brought under control. If the original problem is ongoing then the perms may or may not be aggravating the problem.

I see many patients who lose hair for a combination of factors so that there can be 2 or 3 different problems affecting the scalp at the same time. This could be a problem for you as well.

At this point, you mention that you have a spot that is almost slick. If you have never received treatment, then you need to do so to prevent the slick spot from getting bigger and preserve the hair that you have left. It could take up to a year of treatment to see if hair will grow back in the area it has been lost.

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