bubble_chart Concept

White scalp, refers to the symptom of white scabs growing on the scalp, which over time can lead to hair breakage or loss.

Historical documents have referred to it as "white scalp," "fat sore (tinea favosa)," and "white mange."

bubble_chart Pattern Analysis

1. Wind-heat with Toxin︰Initially, gray-white scaly patches appear on the scalp, small as beans or large as coins. Over time, they spread and merge into larger patches. The hair becomes dry, brittle, and uneven, easily plucked without pain, with white sheaths around the roots. Itching is common, mostly affecting children, who may recover spontaneously in adulthood with new hair growth and no scarring. The condition is primarily caused by wind-heat, often due to striae and interstice opening and discharging, leading to infection by wind-heat toxins that accumulate and disrupt qi and blood circulation, depriving the skin and hair of nourishment. The rash presents as gray-white scaly patches that eventually merge, lacking dish-shaped yellow crusts, with dry, broken hair and white sheaths around the roots, healing without scars. Treatment focuses on dispersing wind and clearing heat, internally with Saposhnikovia Root Tong Sheng Pills and externally with Realgar Ointment or Xiong Liu Ointment.
2. Dampness-heat with Toxin︰Initially, small papules or pustules appear at the hair roots, oozing yellow fluid and forming dish-shaped yellow crusts with raised edges and a central depression, through which hair passes, emitting a mousy odor. After the yellow crusts fall off, small scars remain, leading to permanent alopecia areata on the scars. This condition is common in children but can also occur in adults. It is primarily caused by dampness-heat, often due to fetal toxin dampness-heat attacking upward or dampness-heat of the spleen and stomach steaming upward to the scalp. The rash presents with dish-shaped yellow crusts, a central depression, hair penetration, and a mousy odor. After the crusts fall off, hair loss occurs, leaving a shiny scalp with permanent scarring. Generally, oral medication is unnecessary, and topical application of Realgar ointment or Xiong Liu ointment can cure the condition.

Although both are caused by heat toxin, wind-heat with toxin results in white bald patches that are odorless, with hair that only breaks off and does not lead to alopecia areata, and generally tends to heal on its own by adulthood. Dampness-heat with toxin causes yellow bald patches with a foul odor, leaving permanent scars after healing, and can also occur in adults.

bubble_chart Documentation

1. Waike Dacheng．Bald sores: "Bald sores produce white scabs that form individually and are not connected. If [疒斂] sores, they produce yellow scabs in patches with pus, which is different. The head is the leader of all yang, and sores also belong to fire, caused by the burning of two yang."