Derm Scalp, Head and Facial Skin Infections


Androgenetic alopecia

  • Treatment:
    • Minoxidil (topical) + oral finasteride
      • Best clinical evidence is for topical MINOXIDIL (2%-5%)
        • Prevents further progression
        • Leads to increase hair density & hair thickness
      • In male patients – can add oral finasteride 1mg – not indicated in patients with history of depression or sexual dysfunction
    • Hair Restoration Surgery
    • Hair transplant, scalp reduction surgery, or combo of both
    • Non surgical hair replacement – wigs, sprinkle hair, camouflage techniques, bonding
    • Low level lasers – PRP

Alopecia areata

  • Etiology:
    • Black dot, exclamation mark hairs
    • pitting nails, sandpaper-like
  • Treatment:
    • Intralesional corticosteroids (triamcinolone) usually self-limiting
      • No treatment option is appropriate for some patients, discuss risks vs benefits
      • Intralesional corticosteroid (triamcinolone acetonide or triamcinolone hexacetonide) injection is first-line therapy for adult patients with less than 50% scalp involvement.
      • Triamcinolone acetonide is used at concentrations from 2.5 to 10 mg/mL
    • Platelet-rich plasma (PRP)
    • Systemic corticosteroids
    • Topical minoxidil
    • Camouflage, wigs, and hairpieces

Lice (Pediculosis)

Seborrheic Dermatitis

Telogen effluvium

  • Def:
    • temporary hair loss due to the excessive shedding of resting or telogen hair after some shock to the system.
    • New hair continues to grow. 
    • Telogen hair is also known as club hair due to the shape of the root.
  • Treatment:

Tinea capitis

Head and Face

Actinic keratosis

Basal cell carcinoma

  • Treatment:
    • Mohs surgery: excision with 1-2mm margins



Keratoacanthoma (KA)



Oral candidiasis

  • Etiology:
  • Treatment:
    • First-line Clotrimazole 10-mg troches 5 times daily or miconazole 50-mg buccal tablets for 1 to 2 weeks
    • Alternative nystatin suspension 100,000 units/mL, 4 to 6 mL 4 times daily for 1 to 2 weeks
    • Refractory and resistant cases:
      • Moderate and severe cases may require fluconazole 100 to 200 mg oral daily for 1 to 2 weeks.
      • Itraconazole, posaconazole, voriconazole, and amphotericin B solutions and suspensions are alternatives for refractory or resistant disease.
    • For denture wearers, disinfection of dentures is an important adjunctive step to prevent reinfection

Perioral dermatitis

  • Treatment:
    • Give metronidazole gel 
    • +systemic ABX (cyclines)

Pseudofolliculitis barbae

Seborrheic keratosis 

  • Treatment:
    • -Liquid Nitrogen
    • -curettage 
    • -surgery

Squamous cell carcinoma

Tinea barbae