Maltese has bald spot on head.

Dr. Marie replied:

Hi there Derrick and thanks for your question about Tyche. You can send your picture to drmarie@askavetquestion.com and I'll have a look at it and let you know what I think!

Thanks!

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Dr. Marie replied:

Hi Derrick...just wanted to let you know that I am going offline for the night. I'll keep an eye out for your email and send you a response in the morning!

Dr. Marie.

Dr. Marie replied:

Thanks for the photos Derrick. That's certainly some unusual looking skin!

Is she still itchy? If not, it may be that whatever the problem is, it is gone, but there may be damage to the hair follicles and the hair may not grow back.

However, if she is still itchy there has to be something that we can treat. While allergies can cause skin problems it is quite unusual (but not impossible) for them to just affect the top of the head. We usually see itchiness in the feet and inside of the ears of an allergic dog.

If this were my case, I would be doing the following tests. (Likely some of these have been done by your vet already). I would do a skin scraping to look for parasites such as demodex or sarcoptic mange. I would also do a fungal culture to rule out ringworm. Likely she's already been tried on antibiotics, but that is something I would try as well.

Some little dogs like maltese dogs can get hair loss on their head because of too much use of an elastic. Sometimes this hair loss is permanent. However, it shouldn't really cause her to be itchy.

If all of the tests have been done and there is no answer then the next step is a skin biopsy. This really should tell us what the cause of the problem is. Your regular vet should be able to do a biopsy with a local anesthetic and some sedation (unless Tyche is a very uncooperative dog in which case she may need a general anesthetic).

With all that being said, sometimes it is less expensive to just see the specialist. These vets see all of the "unusual" cases and they may be able to pinpoint the problem with fewer tests.

I hope this information helps! Let me know if you need more clarification at all.

Dr. Marie.