What is a Black Dot on Scalp a Sign of?
Reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Black dot on scalp? Keep reading to find out what it could mean.
Say you’ve just gotten out of the shower and you notice it — a black dot on the scalp. Maybe you can scratch the dark spot off (or maybe not), but you start to wonder what it could be.
Is a black dot on the scalp a sign of a contagious infection or scalp disease? Could it be a type of skin cancer?
Healthy hair is a goal for many guys. But to achieve this, we should be paying attention to our scalps. Underneath your hair follicles, the health and condition of the scalp can affect the health of your hair. Beyond that, there are plenty of common scalp conditions, from seborrheic dermatitis to male pattern baldness (also known as androgenetic alopecia).
So before you go rushing off to search, “What does black dot on scalp mean?” we can give you some possible answers.
What Causes Dark Spots on the Scalp?
What if you find dark spots on scalp or tiny black dots on scalp that scratch off? Don’t panic — there could be several reasons for that dark spot on your scalp.
Here are some possible explanations.
A fungal infection of the scalp, tinea capitis penetrates the hair follicle (the structure hair grows from) and may reach the hair shaft (the visible part of hair). Tinea capitis is also known as black dot tinea capitis or scalp ringworm.
There are two types of tinea capitis infection: inflammatory and non-inflammatory tinea capitis. While the non-inflammatory variety doesn’t usually result in scalp alopecia (round patches of hair loss), inflammatory tinea capitis may lead to patchy alopecia, an itchy scalp that can leave scars.
Besides a dark spot on scalp, other symptoms of tinea capitis can include brittle hair, a painful or itchy scalp, pus-filled sores or a low-grade fever.
Tinea capitis is a contagious infection caused by fungal spores transmitted onto your scalp and hair from other people, animals or objects such as hairbrushes, hats, combs and towels.
You can learn more about scalp fungus in our complete guide.
A black dot on the scalp could be a scalp melanoma, a type of skin cancer that most often appears on the head, neck, upper back or torso, according to the American Academy of Dermatology (AAD).
Scalp melanoma could appear as a black dot (a mole) that changes color or size or itches and bleeds.
Older men with androgenetic alopecia are the most at risk, although hair can cover potential black dots on scalp. This type of skin cancer is also particularly dangerous, as scalp melanoma can spread more quickly on the scalp than on other areas of the body.
To check for signs your black dot may be cancerous, the AAD recommends the ABCDE method:
Asymmetry. Two halves of the same spot don’t match.
Border irregularity. The spot has an irregular or oddly shaped border.
Color. The spot varies in shading and color.
Diameter. The mole is larger than 6 millimeters in diameter (though smaller dots can also be diagnosed).
Evolving. The dot changes in size, shape or color.
While scalp melanoma can spread quickly to other parts of the body, such as the lymph nodes and internal organs, it’s highly treatable when detected early and treated properly.
Make sure to thoroughly check your entire scalp, including underneath your hair. You can even ask to have your scalp checked when you go to the hair salon — a 2018 article in JAMA Dermatology found that educating hair professionals about melanoma risk can be beneficial.
Alopecia areata is another type of patchy hair loss that develops when your immune system attacks your hair follicles.
Dermoscopy, a non-invasive technique that looks closely at the skin, may find a black dot on scalp or several black dots associated with alopecia areata. These black dots are also known as comedo-like cadaver hairs and have been found in half of those with alopecia areata.
You may be at risk of alopecia areata if you’re affected by an autoimmune disease, such as thyroid disease or psoriasis.
Hims has helped thousands of men regrow their hair
What to Do If You See a Black Dot on Your Scalp
What should you do if you have a black dot on your scalp? Rather than searching for “black dot on scalp,” you should consult with a healthcare provider to determine the cause.
Griseofulvin. One of the most common medications used to treat fungal infections of the scalp is griseofulvin, an oral antifungal.
Itraconazole. This antifungal agent can be used as a preventive treatment for people with weakened immune systems, like those undergoing chemotherapy, as well as folks with milder medical situations.
Fluconazole. This antifungal agent is the most reliable treatment for yeast.
If the black spot is scalp melanoma, the condition is highly treatable if detected early. Depending on what stage the melanoma is in, you may need radiation, chemotherapy and/or surgery.
Common treatments for alopecia areata include:
Topical corticosteroids. These medications are applied directly to your skin to control inflammation. Your healthcare provider may prescribe a corticosteroid to suppress your immune system and reduce inflammation in your scalp.
Minoxidil. This medication stimulates hair growth by moving your hair follicles into the anagen (growth) phase of the hair growth cycle.
Intralesional steroids. These medications are injected directly into your skin to reduce the severity of alopecia areata. They’re considered the most effective form of treatment for patchy alopecia areata.
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No matter the treatment plan, the best place to start is somewhere. Early action is the best hair loss prevention.
In Conclusion: Finding Black Dots on Scalp
Finding a black spot on scalp may raise some alarms or be a cause for concern. There are several conditions that could be the cause of the black specks on your scalp.
A black dot could be the result of a fungal infection on the scalp known as tinea capitis or traction alopecia, causing broken hairs from tight hairstyles that look like black specks. Black dots could also be a symptom of alopecia areata, an inflammatory disease, or even a sign of scalp melanoma.
Due to the range of conditions that can cause black dots on the scalp, going to see a healthcare provider is an important first step to figuring out the cause. From there, they can provide a treatment plan best suited for whatever the condition is.