Dissecting Cellulitis Treatment in Atlanta, GAControlling Scalp Nodules and Drainage Before Scarring

Prompt medical care that calms painful nodules and protects your hair.

Common In:
Young adult men most often, especially of African descent; women can be affected
Primary Causes:
Blocked, ruptured hair follicles that trigger deep scalp inflammation
Treatment Time:
Visits of 30 to 60 minutes; oral treatment courses of 3 to 6 months or more
Results:
Drainage and pain often ease within 2 to 3 months; scarred areas do not regrow
Man with short dark hair at a scalp exam for dissecting cellulitis treatment with a dermatologist in Atlanta, GA
Close-up of tender nodules on the back of the scalp from dissecting cellulitis at SOCAH Center in Atlanta

What Is Dissecting Cellulitis of the Scalp?

Recognizing the Signs Early

Dissecting cellulitis of the scalp, also called perifolliculitis capitis abscedens et suffodiens, is a chronic inflammatory condition in which blocked hair follicles rupture deep in the scalp. The result is tender nodules and pockets of fluid that connect under the skin through small tunnels called sinus tracts. Despite the name, it is not a typical skin infection, and antibiotics alone rarely cure it. Without treatment, repeated flares leave scarring and permanent bald patches.

The condition most often affects young adult men of African descent, but it can appear in women and in people of any background. It usually starts at the crown or the back of the scalp. On lighter skin, nodules look red; on deeper skin tones they may look skin-colored, purple or dark brown, and they often heal with darker marks or raised, thick scars. Early bumps under short, coarse or curly hair are easy to mistake for razor bumps.

The goal of dissecting cellulitis treatment is to stop new nodules, dry up drainage and limit scarring. Browse our hair and scalp conditions to see related scarring hair loss diagnoses.

Medically reviewed by Dr. Nikki D. Hill, MD, FAAD. Last updated: October 2026.

Why Dissecting Cellulitis Happens

Understanding the Root Causes

01The Science

It begins with follicular occlusion: dead skin cells and keratin plug the opening of the hair follicle. The plugged follicle swells and ruptures beneath the skin, spilling hair and keratin into the dermis. The immune system reacts strongly, forming nodules and abscesses that join into sinus tracts.

Dissecting cellulitis belongs to the follicular occlusion family, along with hidradenitis suppurativa, acne conglobata and pilonidal cysts, and some patients have more than one. Smoking, excess weight and family history appear to raise the risk. The American Academy of Dermatology guide to hair loss types explains why the cause of hair loss should be confirmed by a dermatologist.

At SOCAH Center, treatment for dissecting cellulitis is part of our medical hair loss treatment program, which combines medicines that quiet inflammation with a plan to protect remaining hair. Once flares are controlled, a gentle scalp detox treatment in our medical hair salon can help keep the scalp clean and comfortable between visits.

02Diagnosis and Treatment

How We Diagnose and Treat It

From Scalp Exam to a Long-Term Plan

Diagnosis starts with a full scalp exam and trichoscopy, which can show yellow plugged follicles and dotted openings typical of the condition. When nodules drain, we may send a culture to look for a secondary bacterial infection. If the picture is unclear, a small punch biopsy helps tell dissecting cellulitis apart from folliculitis decalvans, acne keloidalis nuchae or a fungal scalp infection.

Treatment is matched to severity. Mild disease may respond to oral antibiotics such as doxycycline, chosen for their anti-inflammatory effect, plus steroid injections into painful nodules. Moderate to severe disease often responds best to isotretinoin, which helps keep follicles from plugging. When nodules keep returning despite these options, we refer patients for biologic medicines such as TNF inhibitors. Once the scalp is calm, laser hair removal of the affected area may be added to reduce the follicles that fuel new flares, with settings chosen for your skin tone.

Medical visits, cultures and biopsies are often covered by insurance. For self-pay services such as laser sessions, flexible payment plans through CareCredit and Cherry are available.

What Makes Dissecting Cellulitis Worse?

These factors can trigger new nodules or slow healing. See the AAD overview of hair loss diagnosis and treatment for more background.

  1. 01SmokingTobacco use is linked to follicular occlusion disorders and can make flares more frequent and harder to control.
  2. 02Friction and PressureTight caps, helmets and close shaving at the back of the scalp can irritate follicles that are already prone to plugging.
  3. 03Excess WeightHigher body weight is associated with follicular occlusion conditions and with more inflammation overall.
  4. 04Squeezing NodulesPressing or draining nodules at home pushes debris deeper and can extend the tunnels under the skin.
  5. 05Delayed TreatmentEach untreated flare destroys more follicles and adds scar tissue that cannot be reversed.
Clean, modern treatment room at SOCAH Center in Atlanta, Georgia, where dissecting cellulitis patients are seen

Why Choose SOCAH Center for Dissecting Cellulitis Care in Atlanta, GA

Dr. Nikki D. Hill, MD, FAAD, a board-certified dermatologist nationally recognized for treating medical hair loss disorders, leads care for patients from Atlanta, Tucker, Chamblee and Stone Mountain, with a plan built to control flares before more scarring forms.

Scarring Alopecia Focus
Daily work with scarring hair loss means dissecting cellulitis is recognized early and treated firmly.
Full Treatment Range
Antibiotics, isotretinoin, steroid injections and laser support are coordinated in one plan.
Every Hair Type
Care and grooming advice fit short, coarse, curly and coily hair, with scars assessed on every skin tone.
Salon Support
Our dermatologist-supervised medical hair salon offers gentle scalp care once flares are under control.
Comparison chart of dissecting cellulitis treatment options for the scalp at SOCAH Center in Atlanta, GA

Dissecting Cellulitis Treatment Options

Most patients need more than one of these medical options, chosen by how active and widespread the nodules are.

Care ProgramTreatment OptionBest ForResults TimelineMaintenance
Hair Loss TreatmentOral anti-inflammatory antibioticsMild or early diseaseLess drainage in 4 to 8 weeksCourses of several months
Hair Loss TreatmentIsotretinoinModerate to severe or recurring nodulesSteady improvement over 2 to 4 monthsCourse of 5 to 6 months or longer, with lab checks
Hair Loss TreatmentIntralesional steroid injectionsIndividual painful nodulesFlattening within 1 to 3 weeksRepeated as new nodules appear
Hair Loss TreatmentBiologic therapy referralSevere disease that resists other optionsVaries by medicine, often monthsOngoing under specialist care

Signs You May Have Dissecting Cellulitis

If any of these describe your scalp, a dermatology visit now can help prevent permanent hair loss.

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  • Painful Scalp Bumps

    You feel firm or soft, tender lumps on the crown or back of your scalp that come and go but never fully clear.

  • Drainage

    Bumps open and leak pus or blood-tinged fluid onto your pillow, hat or collar.

  • Connected Lumps

    Pressing one bump seems to move fluid into another nearby, a sign of tunnels under the skin.

  • Patchy Hair Loss

    Hair falls out over the bumps, and some areas stay bald even after the swelling goes down.

  • Thick Scars

    Healed areas leave raised, thick or dark scars, and the bumps return despite antibiotics or home care.

Related Treatment

PRP for Hair Loss

Concentrated platelets from your own blood, placed where follicles are thinning, for every hair type.

  1. Your Own Blood
  2. No Surgery
  3. Little Downtime
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Frequently Asked Questions

Is dissecting cellulitis contagious?
No, dissecting cellulitis is not contagious. It starts with blocked hair follicles and the body's own inflammatory response, not with an infection you can catch or spread. Sharing combs, hats or pillows will not give it to someone else.
Can hair grow back after dissecting cellulitis?
Hair can often regrow where nodules were inflamed but did not scar, especially when treatment starts early. Where tunnels and thick scars have formed, follicles are usually destroyed and regrowth is unlikely. That is why controlling flares quickly is the most important step in protecting your hair.
Will antibiotics cure dissecting cellulitis?
Antibiotics alone rarely cure dissecting cellulitis, though they can calm mild flares. They work mainly by reducing inflammation, and nodules often return when the course ends. Many patients do better with isotretinoin, steroid injections or, for stubborn cases, biologic medicines, sometimes combined with laser hair removal.
How long does dissecting cellulitis treatment take?
Treatment usually takes many months. Steroid injections can flatten a painful nodule within a few weeks, while isotretinoin courses typically run 5 to 6 months or longer. Because flares can return, most patients keep regular follow-up visits after the scalp settles, and individual results vary.
Can I still get haircuts and shave my head?
Yes, but gentle grooming matters. Use clean clippers with a guard rather than shaving close to the skin, avoid cutting over open nodules and skip tight caps during flares. Your provider can tell you when the scalp is calm enough for regular cuts or supportive salon care.
Is dissecting cellulitis related to hidradenitis suppurativa?
Yes, the two are closely related. Both belong to the follicular occlusion group of conditions, along with acne conglobata and pilonidal cysts. Some patients have more than one, so we ask about bumps in the armpits, groin or lower back and coordinate care when needed.
Location2296 Henderson Mill Rd, Suite 300Atlanta, GA, 30345
Emailinfo@socahcenter.com
Phone(404) 474-2301

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Scientific References

  1. Scheinfeld, Skinmed. (2015). Dissecting Cellulitis. PMID: 26380513.
  2. Melo et al., An Bras Dermatol. (2019). Trichoscopy findings in dissecting cellulitis. PMID: 31777364.
  3. Macedo et al., J Cutan Med Surg. (2022). Dissecting Cellulitis of the Scalp. PMID: 34761965.
  4. Thomas et al., J Dermatolog Treat. (2021). Approach to treatment of refractory dissecting cellulitis of the scalp: a systematic review. PMID: 31348693.
  5. Wu et al., Dermatol Ther. (2022). Therapeutic options for perifolliculitis capitis abscedens et suffodens: A review. PMID: 35946169.