Black dots correspond to remnants of hair shafts in the follicular ostia and cannot be removed mechanically. They are usually associated with other forms of broken hairs. The second trichoscopic finding is hair dye; if hair is improperly washed, dye can deposit on the scalp and may even penetrate the follicular ostia.
Piedra is a superficial fungal infection of hair shafts, which presents with small nodules stuck-on to the shaft. Black piedra, caused by Piedraia hortae, is characterized by black-colored nodules and is common in the tropics, especially in individuals with long hair and poor scalp hygiene.
Black dots, also called comedo-like cadaver hairs, can be found in almost 50% of alopecia areata patients and indicate disease activity. Trichostasis spinulosa is a follicular disorder resulting from the retention of numerous hairs surrounded by a keratinous sheath in dilated follicles.
"Black dots" represent hair follicles broken off at the level of the skin surface. Black dots are also referred to as cadaverized hairs. Black dots correlate with disease activity in alopecia areata and are a negative prognostic factor.
Some common bugs that can be mistaken for lice are ants, bedbugs, and fleas. A few things all these bugs have in common is they're small in size, can be dark colored, and can give you an itchy head. A few things that can be mistaken for lice nits are dandruff, hair product, or dirt.
Check all areas of your child's scalp, especially at the nape of the neck and around the ears; these are favorite spots for lice. Also look for lice feces, that look like tiny black specks on your child's scalp. If you see black specks, care- fully examine the rest of the head for live lice.
If a person notices bugs or black or brown spots on the scalp or in the hair, this usually means they have lice, not dandruff.
In the scalp, fungal infections often form circular, scaly, inflamed patches. Frequently, there can be temporary hair loss (hair returns when infection clears but if treatment is delayed and scarring results, permanent hair loss can be seen). This is a classical example of ringworm (tinea capitis) in a young child.
Lice eggs (nits).
These look like tiny yellow, tan, or brown dots before they hatch. Lice lay nits on hair shafts close to the scalp, where the temperature is perfect for keeping warm until they hatch. Nits look a bit like dandruff, but aren't removed by brushing or shaking them off.
An unhealthy scalp can show up as skin concerns on the scalp or issues with your hair. "An unhealthy scalp shows hair loss, hair breakage, dandruff, redness, pain, acne, cysts, and itching," says Ayesh.
Dark spots
If you notice them on your scalp, don't be worried. It's time to be overjoyed! These dark spots indicate that your hair follicles are in the active phase of hair regrowth. So, these spots are a sure shot sign of new hair growth.
Scalp folliculitis [2] occurs when a hair follicle gets inflamed due to a bacterial or fungal infection. The condition is characterized by painful, itchy pustules and papules that later form hardened, blackish scabs on the scalp. Extreme cases of scalp folliculitis can cause scars on the skin.
Nits are the empty egg cases attached to hair that head lice hatch from. Head lice are a common problem, particularly in school children aged 4 to 11. They're largely harmless, but can live in the hair for a long time if not treated and can be irritating and frustrating to deal with.
The nodules feel hard. The most commonly affected area of the body is the scalp hair. Black piedra less frequently affects beards, mustaches, and the pubic hair. The fungus grows into the hair shaft; ultimately, it may cause hair breakage because of structural instability.
Piedra is the Spanish word for stone. White piedra appears as white or light brown stones that loosely attach to the tip of a hair shaft and may group to form clusters. The stones, which people sometimes call concretions or nodules, feel gritty and are easy to remove.
Alternaria
Alternaria, an allergenic type of mold, is commonly found under sinks and along tub and shower bases where wetness can linger. Experts can easily identify this mold by its velvet-soft appearance and brown filaments that resemble hairs.
Up close, the scalp can look scaly and silvery with patches of broken hair. You may also see small black dots if the hair has broken off right at the scalp. Ringworm of the scalp (tinea capitis) is a rash caused by a fungal infection. It usually causes itchy, scaly, bald patches on the head.
The head louse (Pediculus humanus capitis) is an insect parasite, spending its entire life on human hair and feeding exclusively on blood, 4-5 times daily. Man is the only known host of this parasite.
About head lice and nits
Brown-black nits are eggs that haven't hatched into lice yet. White nits are eggs that have already hatched.
Scalp buildup occurs when an oily secretion called sebum accumulates alongside sweat, hair products, and dead skin cells on the scalp.
They can be white, brown, or dark gray. You're more likely to find them in the hair at the back of your neck or behind your ears. The nits are round or oval specks that are tightly stuck to hairs near the scalp.
Adult Head Lice: When lice reach adulthood, their color darkens in response to their environment. Those with blonde or light brown hair are more likely to have tan or light brown adult lice. Darker Head Lice: You'll typically find dark gray to black lice for those with black hair or dark skin.
Head lice eggs (nits) are brown or white (empty shells) and attached to the hair.
Horsehair worms are threadlike roundworms that get their name because they resemble the hair of a horse's tail or mane. In fact, people once thought that they arose spontaneously from the hairs of a horse's tail.