What is a Black Dot on Scalp a Sign of?

Say you’ve just gotten out of the shower, and you notice it —  black dots 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? Is it just rogue chocolate from dessert last night?

There are plenty of common scalp conditions, from seborrheic dermatitis to male pattern baldness (also known as androgenetic alopecia), and it’s not always obvious which one can cause changes — like a black dot (or dots) on your scalp.

So, what do black dots on the scalp mean? We’ll discuss several possibilities and explain what you can do about them.

What if you find dark spots on the scalp or tiny black dots on the scalp that scratch off? Don’t panic — there could be several reasons for that dark spot on your scalp.

Possible explanations include:

• Tinea Capitis

• Scalp Melanoma

• Alopecia Areata 

• Traction Alopecia

Let’s dig into them.

Tinea Capitis

A fungal infection of the scalp, tinea capitis penetrates the hair follicle (the structure which 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. 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 your 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 by other people, animals, or objects such as hairbrushes, hats, combs, and towels.

You can learn more about scalp fungus in our complete guide.

Scalp Melanoma

According to the American Academy of Dermatology (AAD), a black dot on the scalp could be scalp melanoma, a type of skin cancer that most often appears on the head, neck, upper back, or torso.

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 the 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. This is because of the high concentration of blood vessels and lymph nodes on the head and scalp.

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

Alopecia areata is another type of patchy hair loss that develops when your immune system attacks your hair follicles.

Dermoscopy, a noninvasive technique that examines the skin closely, may find a black dot on the 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.

Traction Alopecia

A black dot on scalp may also be a sign of traction alopecia. This hair loss is caused by tight 

hairstyles pulling on the hair, causing broken hair that may appear as a black dot on the scalp.

What should you do if you have a black dot on your scalp? After searching for “black dot on scalp”  (which you probably did to find us), you should consult with a healthcare provider to determine the cause.

Fungal infections are typically treated with antifungal medications and — to prevent spread — 

antifungal shampoos and other topical products:

• 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, such as those undergoing chemotherapy and those with milder medical conditions.

• 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 the stage of the melanoma, 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. 

We offer minoxidil along with several other hair loss medications, such as finasteride, as part of our range of men’s hair loss treatments.

Finding a black spot on your scalp may raise alarms or be cause for concern (or it may be no biggie — but always best to get it checked). Several conditions could cause black specks on your scalp.

A black dot could result from 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, seeing a dermatologist or other healthcare provider is an important first step to figuring out the cause. From there, they can provide a treatment plan best suited for the condition.