Comprehensive Dermatology Care for a 24-Year-Old Woman: Ear Bumps, Acne, Hair Loss & Seborrheic Dermatitis in Houston & Katy, Texas
Skin, hair, and scalp concerns often overlap—and addressing them together ensures patients receive the full care they need. A 24-year-old woman recently visited Dr. Reena Jogi, board-certified dermatologist serving Houston and Katy, Texas, for evaluation of ear bumps, acne, diffuse hair loss, and scalp flaking.
Case Overview
1. Ear Bumps After Piercing
The patient reported a one-month history of swollen bumps on her left ear that appeared after a piercing. The area was consistent with a hypertrophic scar—a thickened, raised, pink lesion that commonly forms after trauma or piercings.
2. Diffuse Hair Loss
She also described 5 years of gradual hair thinning, without itching or burning. Her recent bloodwork, including thyroid function and iron status, was normal except for mild vitamin D deficiency, which she is already supplementing.
3. Acne
She has mild-to-moderate comedonal and inflammatory acne, with papules and pustules.
4. Seborrheic Dermatitis
Exam of the scalp revealed pink-orange scaly plaques, consistent with seborrheic dermatitis, a chronic inflammatory scalp condition.
Diagnosis & Assessment
Hypertrophic Scar (Left Ear)
The lesion appeared as a firm, telangiectatic plaque, typical of scar overgrowth after piercing.
Treatment options reviewed:
Intralesional Kenalog injections
High-potency topical steroids
Shave removal
Pulse dye laser for redness
The patient elected no treatment at this time.
Acne Vulgaris
Findings included comedonal papules, inflammatory papules, and pustules.
Management Plan:
Tretinoin 0.025% cream nightly (pea-sized amount)
Non-comedogenic cleansers & moisturizers
Benzoyl peroxide washes
Education on expected 2–3 months for improvement
Hair Loss: AGA vs. Telogen Effluvium
Her diffuse thinning appeared most consistent with androgenetic alopecia (female pattern hair loss) with a component of telogen effluvium triggered by stress or vitamin D deficiency.
Contributing factors discussed:
Genetics (mother with hair thinning)
Vitamin D deficiency
Longstanding shedding pattern
Seborrheic Dermatitis (Scalp)
Pink-orange scaly plaques indicated active seborrheic dermatitis.
Management Plan:
Ketoconazole 2% shampoo (leave 5–10 min, 1–3x/week)
Fluocinonide 0.05% solution for flares only
Education on chronic, relapsing nature of condition
Treatment Plan
⭐ Hypertrophic Scar (Ear)
Observation for now
Consider ILK, topical steroid, shave removal, or vascular laser later
⭐ Acne
Prescription:
Tretinoin 0.025% cream QHS
6 refills provided
⭐ Hair Loss (AGA + TE)
Conservative regimen selected:
Over-the-counter treatments:
Rogaine 5% solution twice daily for 6 months
Gradual reduction to once daily thereafter
Supplements:
Nutrafol
Votesse
Procedural options (patient may consider later):
PRP therapy
Low-level laser therapy
Alma TED treatments
Counseling included:
Side effects of spironolactone & oral minoxidil (if pursued later)
Need for potassium monitoring with spironolactone
Pregnancy avoidance for anti-androgen medications
⭐ Seborrheic Dermatitis
Prescriptions:
Ketoconazole 2% shampoo
Fluocinonide 0.05% solution (PRN flares)
Follow-Up
4 weeks for seborrheic dermatitis
3–6 months for acne and hair loss response
Expert Dermatology Care in Houston & Katy, Texas
From acne and hair loss to scarring and scalp conditions, Dr. Reena Jogi provides comprehensive, evidence-based care for patients of all ages. Whether addressing a single concern or multiple skin and hair issues at once, our goal is to restore confidence and long-term skin health.
If you are experiencing hair thinning, acne, or ear bumps from piercings, schedule a consultation with Dr. Jogi today at our Houston or Katy offices.
