Concern Over Unusual Brown Spot on Scalp
Hello, I’m a 19-year-old female and my health is generally good, with the only medication I take being birth control. Recently, I noticed two brown spots on my scalp that resemble freckles or possibly moles, and I’m curious about what others think. Context: Skin cancer runs in my family, which makes me vigilant about sun protection. I consistently apply sunscreen and wear hats to shield myself from UV rays. I don’t have many moles or freckles and have never tanned indoors. The spots are located under my hair and haven't received much sun exposure. A few months back, I experienced seborrheic dermatitis in this area, resulting in yellowish flakes. After visiting a dermatologist, I was prescribed a medicated shampoo, which effectively resolved the issue. Since then, I’ve monitored the area without any signs of recurrence. I only recently discovered these brown spots, likely having emerged within the last week or two. Initially, I thought they might be seborrheic keratosis, but they don’t have a raised or flaky texture, and I can’t feel them when I touch my scalp. I have experienced occasional mild headaches in that region, though I’m uncertain if these are related to the spots. I understand that diagnosing skin conditions through a photograph can be challenging, but I would greatly appreciate any insights, particularly if this seems like an issue that warrants professional evaluation!
Answers (1)
7/10/2025, 10:30:48 PM
OpenHealth AI
It's completely understandable to feel concerned about any changes in your skin, especially given your family history with skin cancer. Let’s address your worries regarding the brown spots on your scalp and provide some next steps.
Summary of Key Points:
- New brown spots on the scalp can have multiple causes, including benign conditions like freckles or seborrheic keratosis.
- Your vigilant sun protection is excellent and reduces the risk of skin damage.
- Mild headaches in the area could be unrelated, but it's wise to monitor any changes.
Explanation:
Brown spots on the scalp may emerge from various factors, including genetics, sun exposure, hormonal changes, or skin conditions. Since you have a recent history of seborrheic dermatitis and have been proactive about using medicated shampoo, it's possible these spots are related in some way. However, the characteristics you describe (non-raised, non-flaky) seem to differ from typical seborrheic keratosis or dermatitis spots.
The occurrence of mild headaches is worth noting, but they may not necessarily correlate with the brown spots. Monitoring them is key since headaches can stem from a range of minor issues (tension, dehydration) or more significant concerns.
Actionable Next Steps:
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Monitor the Spots: Keep an eye on the brown spots for any changes (size, color, shape, texture) over the next few weeks. Take photos to track these changes accurately.
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Self-Examine Once a Week: Besides the brown spots, check for any new moles or skin changes elsewhere on your body. Look for asymmetry, irregular borders, multiple colors, or diameters greater than 6 mm (the "ABCDE" rule of moles).
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Headache Tracking: Note the frequency, duration, and severity of the mild headaches. Include any potential triggers (stress, screen time, diet). This information can help in understanding if they are significant or not.
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Consult a Dermatologist: If the spots change, persist, or if the headaches become severe or frequent, it's important to see a dermatologist who can examine your scalp directly for a professional evaluation. Given your family history, this is a proactive measure.
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Continue Sun Protection: Maintain your routine of applying sunscreen and wearing hats to protect your skin from UV damage. This is especially important as you monitor these changes.
Conclusion:
It's good that you are attentive to your skin health, especially with your family history. By monitoring these spots and noting any changes or other symptoms, you will help ensure that any necessary action can be taken promptly. If you have any further questions or need support, feel free to reach out.
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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). 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Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.