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Ask Dr. S. Attili Your Own Question
Dr. S. Attili
Dr. S. Attili, Dermatologist & Dermatopathologist
Category: Dermatology
Satisfied Customers: 5175
Experience:  MRCP (Dermatology), Int. Board Certification in Dermatopathology
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Scalp and forehead skin discoloration. Approximately six

Resolved Question:

Scalp and forehead skin discoloration. Approximately six months ago I began to notice a skin discoloration on my scalp and it has now grown to my forehead. What can this be and what can I use to treat it. i will forward a picture as soon as I get a preliminary answer for software will not allow me to do so now.
Submitted: 5 years ago.
Category: Dermatology
Expert:  Dr. S. Attili replied 5 years ago.
Hi. It could be an allergic reaction or a condition called melasma but difficult to be sure without seeing a picture. Please upload when possible and I shall advice
Customer: replied 5 years ago.
I have a "hair system", but I have had it with the same type of adhesive with no problem for over 15 years. What I have noticed is that this discoloration itches at times.
Expert:  Dr. S. Attili replied 5 years ago.
Sorry for the delay.
What you have looks like melasma. This is a difficult condition to treat and will take a few years to slowly fade. However if you use triluma cream twice a day and avoid sunexposure strictly you should start seeing a response in 2-3 months. Please read this link below which will give you more info. There are a number of chemical peels and LASERS that can also help. But it all depends on how much you want to spend. Chemical peels are easy enough but I wouldn't recommend them, while using the triluma cream.
You can read all about the condition here. I don;t think it is caused by the hair piece as the pigmentation extends beyond the area where the hair piece sits.
Do get back if further questions
Customer: replied 5 years ago.

Thank you for your response. I read the information on the link you provided, but it refers to light brown, blueish or dark patches while mine seems to be a "discoloration". I took a picture under a black light to help you confirm or change the diagnosis. let me know what you think.

Thank you, Carl

Expert:  Dr. S. Attili replied 5 years ago.
Sorry I didn't quite understand. What colour is the discoloration?
Customer: replied 5 years ago.
the discoloration is lighter than my skin, not darker.
Expert:  Dr. S. Attili replied 5 years ago.
do you mean that the abnormal areas are the white rather than the dark areas? The dark areas are your normal skin color?
Customer: replied 5 years ago.
Expert:  replied 5 years ago.
Thanks for the clarification which changes my diagnosis completely. I thought you were saying that the darker colour was unnatural for you.
White discoloration of the skin implies a condition called vitiligo. It is a condition where the pigment producing cells in the skin are destroyed due to the body's immune system reacting against them. It generally affects the whole body but if you are lucky, can stay in one place, when we call it focal vitiligo.
In the initial phase it might respond to a strong steroid cream like clobetasol propionate applied once a day for 6-8 weeks. I would also suggest using tacrolimus cream twice daily, in addition and the combination works better. Try and sit out in the sun everyday for 5-10 minutes (being very careful not to get sunburnt) and that should help the pigment come back.
Get back to me in 2 months time and we shall evaluate options, depending on response.
Dr. S. Attili and other Dermatology Specialists are ready to help you
Customer: replied 5 years ago.

Thank you Dr Attili,

You confirmed what I suspected. Not having a family history to support a genetic cause, I believe stress can be the culprit. Are there any other reasons this could have started?

I already ordered both medicines and will post in 8 wks or as soon as I see any change in the condition.



Expert:  Dr. S. Attili replied 5 years ago.
You are welcome. No we don't really know what triggers vitiligo. It just happens. Hopefully in future, further research will shed more light.
Yes, do keep me posted. Best wishes