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Dissecting Cellulitis of the Scalp: Signs and Treatments

Dissecting cellulitis of the scalp (DCS) is a rare, inflammatory skin condition characterized by pus-filled nodules and abscesses that develop on the scalp. While DCS is more common in black men 20-40 years of age, it affects people of all races, and also women.

At Hines Dermatology Associates, leading dermatologist and dermatopathologist Yvonne Hines, MD, specializes in treating rare skin conditions such as DCS. If you’re dealing with skin problems affecting your scalp, it’s worthwhile to learn about the signs of DCS, as well as how dermatologists help patients manage this rare condition.

What is dissecting cellulitis of the scalp?

DCS is a chronic inflammatory skin condition that often results in scarring and patchy areas of hair. Patients with DCS have painful abscesses, keloids, and nodules that develop on the scalp. The condition usually persists for several years and may recur.

People with DCS tend to have certain other inflammatory conditions, including:

What causes dissecting cellulitis of the scalp?

DCS is also associated with other skin problems, such as acne. The exact cause of DCS remains unknown, but it appears that hair follicles in the scalp become blocked, causing oily substances and skin cell materials to accumulate. 

This build results in an inflammatory response. There is a risk of infection that can lead to folliculitis.

Signs of dissecting cellulitis of the scalp

If you’ve noticed lumps on your scalp, or anything out of the usual, it’s wise to visit a dermatology specialist for a thorough evaluation. Many skin conditions have symptoms that are similar or overlap, so you need the knowledge and expertise of a dermatologist to provide a skilled determination.

Lumps and abscesses that develop on the scalp and ooze pus or bleed are the most common signs of DCS. Many people with DCS have small tracts between the lesions, causing the scalp to appear very lumpy. 

Dr. Hines diagnoses this type of condition after a thorough evaluation of the scalp. To help her confirm a DCS diagnosis, she may take a sample of the tissue (biopsy) to examine more closely under a microscope.

Treating dissecting cellulitis

Seeking treatment as early as possible can help prevent DCS from spreading across the scalp. If you notice signs of DCS or any other skin condition, contact Dr. Hines right away to schedule an evaluation.

It’s crucial to avoid picking and squeezing the lumps; doing so worsens the condition. Dr. Hines  works closely with you to best manage DCS. Dermatologists use topical treatments, local steroid injections, and oral medications to ease the symptoms of DCS. Short courses of antibiotics are also helpful.

Oral medications that help manage DCS are:

Surgery is used to manage large cysts in severe DCS. Dr. Hines can drain or surgically remove large abscesses or cysts. Treatment goals include reducing inflammation and improving the appearance of the scalp as much as possible. 

It may take weeks or months for the scalp to respond to treatment and the condition may recur, requiring long-term management. Permanent hair loss in affected areas is common.

For more information on our expert team of dermatology specialists and how they can help you combat DCS, contact our Attleboro, Massachusetts, office at 508-222-1976 or book online to schedule an appointment. Another option is to send a message to Dr. Hines and the team here on our website.

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