In 2024, I wrote a post on the subdermal scalp infusion of drugs by tattooing to induce hair growth. Also known as skin microinfusion of medications (MMP®). One of the main practitioners and developers of this technique is Dr. Pablo Cirino of Brazil. At the time, he called his process “combined regenerative technique” and published a paper on it in September 2025. Cirino Regenerative Technique (CRT): Before and after hair growth. Cirino Regenerative Technique (aka Combined Regenerative Technique) As of 2026, Dr. Cirino now calls his process the Cirino Regenerative Technique (CRTTM). He has made a number of modifications to the original version insofar as what drugs, peptides, growth factors and micronutrients to use. The delivery mechanism via precision microinfusion technology using a tattooing machine type device remains the same. It creates thousands of microscopic channels across the scalp at a controlled depth. This allows the various hair growth customized medications to be delivered directly to the hair follicle at the dermal papilla level. This is superior in comparison to your typical topical gels, serums, liquids, creams and lotions. In addition, this method stimulates natural growth factors and regenerative processes. I think there is a microneedling type effect, but I am not sure. CRT is now becoming especially popular in the hair loss world so I decided to write this post. Moreover, a number of renowned hair transplant surgeons are being trained to use CRT at their clinics (see the end of this post). Also check out Spex’s new interview with Dr. Cirino further below. Cirino Regenerative Technique (CRT): Before and after hair regrowth. In a response to me in 2025, Dr. Cirino told me that he delivers the below combination of topical drugs with a tattoo machine for transcutaneous delivery: Arginine 200 µg. This is an amino acid. Biotin (Vitamin B7) 50 µg. Copper Sulfate 2 µg. Chromium 0.2 µg. Dexpanthenol 20 µg. Riboflavin (Vitamin B2) 10 µg. Vitamin B6 6 µg. In addition, for males with androgenetic alopecia (AGA), he adds the following: Minoxidil 0.5%. Finasteride 0.05%. Dutasteride 0.1% For females with AGA (i.e., female pattern hair loss), he adds the following: CRT scalp microinfusion of drugs via tattooing for thinning hair. This week, Dr. Cirino told me that he now also uses some growth factors from PRP. Moreover, after studying the main hair growth pathways, he has also added some “home treatments” to patients to boost the results. He never prescribes oral finasteride or oral dutasteride, preferring to apply both topically via his scalp microinfusion of drugs via tattooing technique. He does prescribe oral minoxidil. In a January 2026 article, Dr. Cirinho mentions that the combined regenerative technique: “Integrates tattoo machine-assisted infusion of minoxidil sulfate, dutasteride, copper peptides, and platelet-rich plasma with concurrent oral minoxidil and topical finasteride.” Combined regenerative technique for hair growth. Before and after. All of this reminds me of the kitchen skin approach to tackling hair loss that we have discussed numerous times on this blog. Except that in this case, it is via a superior delivery mechanism of topical medications directly to the scalp. And from a doctor who has been experimenting with various regimens for a number of years. On a related note, make sure to read my 2019 post on creating the ultimate hair loss drug cocktail. Most online vendors of topical finasteride these days also offer a mix of molecules in one serum. Dr. Pablo Cirino Interview: Non-Surgical Hair Growth via CRT Earlier this month, Dr. Pablo Cirino gave a lengthy interesting interview to Spencer (“Spex”) Stevenson that I have embedded below. Among the highlights: His CRT method has led to 40% of his patients ultimately not need a hair transplant. The cost is just $500 at his Brazil clinic. He is training many surgeons from around the world via his Tricho Surgery Academy. Most people need one 30-minute treatment session for 6 months. Cirino Regenerative Technique Training Sessions In 2026, Dr. Cirino has started training many other doctors and hair transplant surgeons in regards to his CRT technique. Check out his Tricho Surgery Academy for more information as well as numerous photos and training session videos. A number of globally renowned hair transplant surgeons are now proponents of this unique method of delivering multiple hair loss drugs to the scalp subcutaneously. Source link

Update: July 24, 2026 The StimuField® PEMF Cap to treat Hair Loss Since I published this post in September 2024, there have been a number of new developments. The StimuField® Cap from StimuSIL was launched towards the end of 2025. It requires 30 minutes of daily use and costs $1,590. A pilot study on the results of StimuField pulsed electromagnetic field (PEMF) therapy was published in July 2025 in the “Brazilian Journal of Hair Health.” The positive results of the above study were presented in May 2026 at the 45th Annual Conference of the American Society for Laser Medicine and Surgery (ASLMS). In June 2026, StimuSIL co-founder Pablo Villalba was interviewed by Spencer “Spexhair” Stevenson: September 19, 2024 In my last post on pulsed electromagnetic field therapy, I mentioned a recent August 2024 paper funded by StimuSIL (US). In there, the authors describe in detail a new hair growth technology and device from StimuSIL that combines laser and microneedling. It is supposed to be significantly superior to traditional low-level laser therapy for hair growth. StimuSIL SAGA-001: Combined Laser and Microneedling The new StimuSIL hair growth device is called SAGA-001 and is only meant for in-clinic use. Most hair loss treatments entail daily usage (e.g., pill, topicals or laser caps/helmets/combs). In contrast, SAGA-001 treatments are only required once every two weeks. StimuSIL was co-founded by CEO Ana Villalba and Chairman Pablo Villalba. StimuSIL’s initial SAGA-001 clinical trial was just completed in Turkey on September 1, 2024. The purpose of the 24-week study was to see if the SAGA-001 device is safe and effective at treating male pattern hair loss. The original 2023 trial commencement announcement calls the product a “novel microneedling and laser device for male pattern hair loss”. The SAGA-001 device combines microneedling and laser light delivery for hair growth. The manufacturer calls this patented technology “precision low-level laser therapy (LLLT)”. StimuSIL does not have much on its website regarding the exact nature of this subdermal laser process. StimuSIL SAGA-001 precision LLLT. Combining laser energy and microneedling for hair growth. The device uses lasers that are first inserted into the skin’s dermis in order to avoid loss at the melanin level. According to the new paper’s authors: “Precision LLLT utilizes a novel approach to photobiomodulation delivery, which is intended to reproduce the success of combining minoxidil with microneedling.” The SAGA device pierces through the skin’s epidermis layer using novel optical microneedles. These needles bypass the melanin layer in order to safely and efficiently deliver more energy to the hair follicles. On StimuSIL’s website, they state that when conventional laser hair growth devices shine light over the epidermis, most of it is blocked due to the melanin layer. Per the image above from their study, a staggering 80% of the low-level laser’s light energy is blocked by the skin’s melanin. And another 5% is reflected of the surface. So only 15% gets down to the dermis layer from where the hair follicles arise. Quite hard to believe. The company’s proprietary technology: “Aims to deliver PBM across the melanin layer of the skin in order to enhance this treatment’s biostimulatory effects.” StimuField Also significant, On August 2, 2024 StimuSIL announced plans to launch StimuField, a new wearable product entering their biomedical device pipeline. StimuField uses pulsed electromagnetic field therapy to improve hair and scalp health in men and women. I discussed this development in my earlier mentioned PEMF and hair growth post. Below is a comparison image of the various treatments from the StimuSIL’s new paper: StimuSIL Precision LLLT. Source: Journal of Clinical Medicine, August 2024. Source link

Your Part Looks Wider Than It Used To For women especially, a widening part is one of the earliest and most telling signs of female pattern hair loss (FPHL), a type of hair loss. It happens so gradually that it’s easy to miss in real time. If you look at a photo from a year or two ago and notice a difference in how much scalp is visible along your part, that’s worth paying attention to. You’re Seeing More Hair Than Usual in the Shower or on Your Brush Losing 50 to 100 hairs per day is within the normal range. But if you’re consistently noticing a significant increase in hair in the shower drain, on your pillowcase, or on your brush over several consecutive weeks, that’s a pattern rather than a phase. Context matters here. A burst of shedding for a few weeks following a stressful event, illness, or hormonal shift is normal and usually temporary. Persistent elevated shedding over months is the signal to take seriously. Your Hair Texture Has Changed Hair that was once thick and full starting to feel fine, limp, or flat is a sign that your follicles may be miniaturizing, which means producing progressively thinner strands over time. This is one of the hallmarks of androgenetic alopecia and responds well to treatment when caught before the miniaturization progresses too far. Your Scalp Is More Visible at the Crown Increased scalp visibility at the top of the head, or a growing area of thinning, is one of the more advanced early warning signs. If you’ve started styling your hair differently to cover an area, or if you notice it in photographs, it’s worth having it properly evaluated sooner rather than later. Your Hairline Has Shifted Men typically notice a receding hairline first, with gradual retreat at the temples or the forehead. Women can also experience hairline changes, though they more commonly present as diffuse thinning at the crown. Any shift from where your hairline has historically been is worth noting. Your Scalp Feels Off Chronic scalp itching, flaking, redness, tenderness, or irritation isn’t just uncomfortable, it can be a sign that your scalp environment isn’t supporting healthy hair growth. Conditions like seborrheic dermatitis and scalp inflammation can contribute to shedding and impair follicle function over time. A healthy scalp is the foundation of everything else. Your Skin Is Changing Too The skin and hair follicle share more biology than most people realize. Changes in skin texture, increased breakouts, persistent dryness, or a loss of your natural glow can sometimes point to the same underlying issues affecting your hair, hormonal shifts, nutritional deficiencies, chronic inflammation, or stress. If you’re noticing changes in both your hair and your skin around the same time, that’s worth mentioning at a consultation. Source link

Here is an interesting study of new gene variants in Congenital Hypotrichosis The two key points I’d like you to take from this study are: 1. Two previously unknown (novel) mutations in the LSS gene were identified in children with congenital hypotrichosis, expanding the known genetic causes of this rare hair disorder. 2. This study reminds us that congenital hypotrichosis may not be limited to the hair. Some patients may also have abnormalities involving the teeth, highlighting the importance of looking beyond the scalp during clinical assessment. BACKGROUND AND PURPOSE OF THE STUDY Hypotrichosis simplex is a rare inherited form of hair loss that typically begins in infancy or early childhood. Children usually have sparse, fine, slowly growing hair but otherwise develop normally. Over the past several years, mutations in the LSS (lanosterol synthase) gene have emerged as one of the important genetic causes of this condition. Because relatively few patients have been described worldwide, physicians are still learning how different LSS mutations affect clinical presentation. The purpose of this study was to identify the genetic cause of congenital hypotrichosis in two unrelated Chinese children and determine whether they carried previously unrecognized mutations in the LSS gene. METHODS This was a genetic case report involving two unrelated Chinese pediatric patients with congenital hypotrichosis. The study included one 6-year-old girl and one 6-year-old boy. Both had sparse scalp hair beginning shortly after birth or in infancy. The girl also had delayed shedding of her baby teeth with abnormal eruption of permanent teeth, whereas the boy had isolated hair abnormalities. Neither child had neurological impairment, visual abnormalities, nail abnormalities, or intellectual disability. One patient’s older brother was also affected, while both sets of parents were unaffected, consistent with an autosomal recessive inheritance pattern. Race/ethnicity was Chinese. Because these were newly diagnosed children, no prior hair-loss treatments were reported. The investigators performed whole-exome sequencing on both children and their parents, confirmed the findings with Sanger sequencing, and used computer-based structural protein modeling (AlphaFold2 and PROVEAN) to predict how the newly discovered mutations would affect the function of the LSS protein. RESULTS The investigators identified four disease-causing LSS variants, including two completely novel mutations that had never previously been reported: p.(Glu532Gln) and p.(Pro337Leu). Structural modeling predicted that both mutations significantly destabilize the lanosterol synthase protein and impair its function. The clinical findings supported these genetic discoveries. Both children had congenital hypotrichosis beginning early in life. One child also had dental dysplasia, strengthening the growing evidence that certain LSS mutations can affect structures beyond the hair follicle. Trichoscopy in one patient demonstrated predominantly anagen hairs, occasional twisted hairs, and perifollicular white halos, features that may become useful clues when evaluating patients before genetic testing is performed. Overall, the study expands the known spectrum of LSS mutations and provides additional evidence that genotype may influence whether patients develop isolated hair disease or additional ectodermal abnormalities such as dental involvement. Source link

Protein: The Building Block Your Hair Can’t Do Without Hair is made almost entirely of keratin, a type of protein. If you’re not eating enough protein, your body will deprioritize hair growth to protect more essential functions. The result is diffuse shedding and slower regrowth. Most adults need between 0.7 and 1 gram of protein per pound of body weight per day, and many people, particularly those who eat plant-forward diets or restrict calories, fall short without realizing it. Eggs, fish, chicken, legumes, and Greek yogurt are all strong, accessible sources. Shop our favorite source of protein here, Body Health Perfect Amino Tablets! Iron: The Most Commonly Missed Deficiency Iron deficiency is one of the most prevalent and underdiagnosed causes of hair loss, particularly in women. It affects the hair growth cycle directly, pushing follicles out of their active growth phase prematurely. The tricky part is that standard iron panels often miss the problem. Ferritin, the protein that stores iron in the body, is the more relevant marker for hair loss, and it’s frequently left off routine lab orders. If you’re shedding excessively and also feel fatigued or foggy, requesting a ferritin test specifically is worth doing. Red meat, leafy greens, lentils, and pumpkin seeds are good dietary sources. Pairing iron-rich foods with vitamin C significantly improves absorption. We cover the iron and hair loss connection in depth in a dedicated post if you want to go deeper on this one. Zinc: Quiet but Critical Zinc plays a key role in protein synthesis and cell division, two processes that are essential for healthy hair growth. It also helps regulate androgen production, which matters because elevated androgens are a primary driver of pattern hair loss. Zinc deficiency can cause hair thinning, a dry or flaky scalp, and slow healing. Oysters, pumpkin seeds, beef, and chickpeas are among the best dietary sources. Because zinc and iron compete for absorption, taking them as separate supplements at different times of day is worth knowing. Biotin: The Most Talked About, the Most Misunderstood Biotin (vitamin B7) is one of the most heavily marketed nutrients for hair growth, and the reason is legitimate, a true biotin deficiency does cause hair loss. But true deficiency is actually uncommon in people who eat a reasonably varied diet. For most people with adequate biotin levels, supplementing more won’t produce the dramatic results the packaging suggests. If you are deficient, though, correcting it can make a real difference. Eggs, salmon, sweet potatoes, and nuts are reliable sources. If you’re taking a biotin supplement, it’s worth flagging to your doctor before any lab work, as high biotin levels can interfere with certain thyroid and hormone test results. Vitamin D: Far More Important Than Most People Realize Vitamin D receptors are found directly on hair follicles, and low vitamin D levels are meaningfully associated with hair loss, particularly in women. It’s also one of the most common deficiencies in the general population, especially for people who spend most of their time indoors. If you haven’t had your vitamin D levels tested recently, it’s worth adding to your next panel. Supplementation is simple and can have a genuine impact on hair growth over time. We’ve written a dedicated post on the vitamin D and hair loss connection for anyone who wants the full picture. Shop our go-to Vitamin D3 supplements here! Omega-3 Fatty Acids: For the Scalp Environment You Can’t See Omega-3 fatty acids support scalp health by reducing inflammation and maintaining the skin barrier that your follicles depend on. A dry, inflamed scalp is not a hospitable environment for healthy hair growth, and chronic scalp inflammation is an underappreciated contributor to shedding. Fatty fish such as salmon, sardines, and mackerel are the best sources. Flaxseeds, chia seeds, and walnuts provide plant-based omega-3s. For people who don’t eat much fish, an algae-based omega-3 supplement is a well-absorbed alternative. B Vitamins: The Energy Your Follicles Run On The B vitamin family, particularly B12, folate, and niacin, supports the energy production that hair follicles depend on to function. B12 deficiency is especially common among people who eat primarily plant-based diets, since B12 is found almost exclusively in animal products. Hair loss, persistent fatigue, and neurological changes are all potential signs. If you’ve been plant-based for a while and haven’t checked your B12 recently, adding it to your next lab panel is a good idea. Shop our favorite B12 supplements here! Source link

Rhamsydil from LG AI Research. The number of novel AI-developed hair loss products keeps proliferating. The latest one is South Korea based LG AI Research and its AI-developed Rhamsydil. It seems like this will be a cosmeceutical type product, so there will be no need for it to go through any clinical trials. Rhamsydil: LG’s AI-Driven Hair Loss Solution Set to Launch in 2026 LG (a multinational conglomerate) via LG AI Research has used artificial intelligence (AI) to develop a novel compound called Rhamsydil to treat hair loss. The key ingredient activates a key estrogen receptor on the scalp. The company presented its new AI-developed products at last week’s International Conference on Machine Learning (ICML) in Seoul (video at the bottom). ICML is one of the world’s three most prominent AI and machine learning conferences per Korea Herald. LG created Rhamsydil using its flagship AI model EXAONE. Their EXAONE Discovery platform is designed to accelerate the discovery of advanced materials and drug candidates. Rhamsydil was discovered by LG Household & Health Care in collaboration with LG AI Research. The latter used AI to screen more than 420,000 candidate compounds in just one day. Per the company: “The ingredient has demonstrated hair-loss prevention efficacy without steroid-derived compounds.” The research behind this product was presented at the 14th World Congress for Hair Research that was held in South Korea in May 2026. Rhamsydil is being prepared for commercialization in 2026. Estrogen Receptor Activation On Linkedin, LG Household & Healthcare makes the following claim: “Using AI-powered screening on around 420,000 candidate molecules, LG H&H identified a vitamin A–derived, non-steroidal ingredient that can activate a key estrogen receptor linked to women’s hair health. In testing, this ingredient helped create a more favorable environment for hair growth, supporting both hair follicles and their stem cells, and showed visible improvements in hair thickness in clinical evaluation. Rhamsydil has been shown in lab studies to help reduce signals that push hair into the shedding phase, pointing to its potential as a next-generation “scalp longevity” ingredient.” Make sure to read my past post on estrogen and hair growth. LG AI Research and EXAONE Since its inception in December 2020, LG AI Research has published 363 papers at the world’s leading AI conferences. The institute has also to date filed 838 patent applications (371 domestic patents, 243 international patents and 224 PCT applications), Per Lim Woo-hyung (the co-director of LG AI Research), EXAONE has evolved into an expert AI system that delivers real-world solutions. It is poised to claim global AI leadership through a first mover strategy and a pioneering approach to solving complex industrial challenges. Source link

I read an interesting paper from the journal Clinical and Experimental Dermatology showing a nice case of the hair shaft color changes and calibre changes that can take place in alopecia areata. Two key points of this report were: 1. Segmental heterochromia with calibre change can be a subtle sign of active alopecia areata—even when there are no obvious patches of hair loss. 2. Alternating lighter and thinner segments within individual hair shafts likely reflect intermittent inflammatory activity in the hair follicle and should alert clinicians to ongoing disease activity. OVERVIEW OF CASE This interesting case report describes a 37-year-old woman with a three-year history of intermittent alopecia areata who presented with persistent diffuse hair shedding but no visible patches of hair loss. She also noticed scattered lighter-colored hairs throughout her otherwise black scalp hair. Careful trichoscopy and light microscopy demonstrated alternating segments of depigmented hair that were simultaneously thinner than adjacent normal hair. Remarkably, the hair shaft returned to its normal diameter exactly where normal pigmentation resumed. The authors propose that these findings represent intermittent inflammatory activity affecting both the pigment-producing melanocytes and the hair matrix in diffuse alopecia areata. Treatment with topical clobetasol applied to the entire scalp together with low-dose oral minoxidil reduced shedding, improved hair density, and prevented further patch formation. Here is the nice figure 1 from their paper Source link

Here is a really interesting study. It suggests that autoimmune diseases are not increased in patients with CCCA. That’s an important finding as researchers worldwide seek to understand what really causes CCCA. The two key points I’d like everyone to take from this study are: 1. Patients with central centrifugal cicatricial alopecia (CCCA) were not more likely to have autoimmune disease than matched controls with androgenetic alopecia. This large multi-institutional study found no evidence that patients with biopsy-confirmed CCCA have an increased prevalence of systemic autoimmune diseases. 2. Routine autoimmune laboratory screening (including ANA testing) is probably unnecessary in patients with CCCA unless clinical symptoms suggest an autoimmune disorder. The findings support a more targeted, clinically driven approach rather than ordering autoimmune blood tests routinely in every patient with CCCA. OVERVIEW OF STUDY Central centrifugal cicatricial alopecia (CCCA) is the most common primary scarring alopecia affecting women of African ancestry, but its underlying cause remains incompletely understood. Previous studies suggested that patients with CCCA might have higher rates of autoimmune disease or positive antinuclear antibodies (ANA), leading some clinicians to wonder whether routine autoimmune screening should become standard practice. In this large cross-sectional study, investigators from the University of Pennsylvania and Weill Cornell Medicine evaluated 291 patients with biopsy-confirmed CCCA and compared them with 291 carefully matched patients with androgenetic alopecia. The investigators examined the prevalence of autoimmune diseases, thyroid disease, ANA positivity, and thyroid-stimulating hormone (TSH) levels to determine whether routine autoimmune screening is justified. STUDY FINDINGS This study found no increased prevalence of autoimmune disease among patients with biopsy-confirmed CCCA compared with matched controls. Interestingly, patients with CCCA actually had lower odds of thyroid disease than controls. ANA positivity and thyroid function (TSH) were similar between groups, providing little evidence that autoimmune laboratory abnormalities are more common in CCCA. Overall, the results suggest that routine autoimmune laboratory screening is unlikely to provide clinical benefit in patients with CCCA who have no signs or symptoms suggesting an autoimmune disease. AUTOIMMUNE DISEASE STUDIED Source link

I enjoyed reading an interesting study from the Journal of the American Academy of Dermatology addressing whether or not oral steroids are helpful when added with JAK inhibitors. The focus here was on the JAK inhibitor baricititinib. The two key points to take from this study are: 1. Adding short-course systemic corticosteroids before or alongside baricitinib did not improve 24-week treatment outcomes in patients with moderate-to-severe alopecia areata. Despite common clinical practice, patients receiving prior or concurrent corticosteroids achieved similar rates of hair regrowth compared with those treated with baricitinib alone. 2. Baricitinib monotherapy was just as well tolerated as combination therapy, suggesting that routine addition of systemic corticosteroids may not provide meaningful long-term benefit. Both strategies had comparable adverse event rates, although pneumonia occurred only in the corticosteroid combination group. OVERVIEW OF STUDY Alopecia areata is a common autoimmune disease in which systemic corticosteroids are often prescribed at treatment initiation to rapidly suppress disease activity while waiting for Janus kinase (JAK) inhibitors such as baricitinib to take effect. However, it has remained unclear whether this approach actually improves long-term outcomes. In this retrospective cohort study, investigators compared 35 patients treated with baricitinib alone with 32 patients who received short-course systemic corticosteroids before or alongside baricitinib. After 24 weeks of treatment, patients in both groups achieved remarkably similar rates of hair regrowth, including comparable improvements in Severity of Alopecia Tool (SALT) scores, similar times to response, and nearly identical safety profiles. These findings suggest that routine corticosteroid “bridging” therapy may not provide additional long-term benefit beyond baricitinib alone. CONCLUSIONS This study suggests that prior or concurrent short-course systemic corticosteroids do not significantly enhance the effectiveness of baricitinib in patients with moderate-to-severe alopecia areata. Patients receiving baricitinib alone achieved similar rates of meaningful hair regrowth, including SALT30, SALT50, SALT90, SALT ≤20, and SALT ≤10 outcomes. The safety profiles of the two treatment strategies were also comparable, although pneumonia occurred only in the combination therapy group. Overall, these findings support the use of baricitinib as an effective standalone systemic treatment for many patients with moderate-to-severe alopecia areata, while emphasizing that larger prospective studies are still needed to determine whether certain patient subgroups may benefit from combination therapy. Source link

I enjoyed reading a nice paper by Paudyal et al in Clinical Case Reports of a 17 year old male presenting with a scalp abscess that turned out to be a diagnosis of tinea capitis. Key Lessons from the paper: 1. Kerion can closely mimic a bacterial scalp abscess, leading to unnecessary incision and drainage, antibiotic treatment, and delays in appropriate care. A painful, swollen, purulent scalp lesion with hair loss should always raise suspicion for kerion (inflammatory tinea capitis). Early recognition can prevent unnecessary surgery and reduce the risk of permanent scarring alopecia. 2. Dermoscopy and a simple KOH examination are invaluable bedside tools for making the diagnosis. Characteristic dermoscopic findings—including comma hairs, broken hairs of varying lengths, black dots, and perifollicular scaling—combined with a positive KOH preparation can rapidly establish the diagnosis and allow prompt initiation of oral antifungal therapy. OVERVIEW OF CASE Kerion is a severe inflammatory form of tinea capitis that can closely resemble bacterial infections such as scalp abscesses or cellulitis. This case report describes a 17-year-old male who presented with a one-month history of a swollen, hairless occipital scalp lesion. He was initially treated by surgeons with incision and drainage followed by two weeks of systemic antibiotics, but failed to improve. After referral to dermatology, dermoscopy revealed classic features of tinea capitis—including comma hairs, black dots, broken hairs, and perifollicular scaling—and a potassium hydroxide (KOH) preparation confirmed dermatophyte infection. The patient was treated with oral griseofulvin, topical clotrimazole, and ketoconazole shampoo, resulting in complete clinical resolution within four weeks and substantial hair regrowth by eight weeks, leaving only minimal residual scarring. This case highlights the importance of considering fungal infection whenever inflammatory scalp lesions are accompanied by alopecia. Source link