Margaret Fonder, MD

If your hairline is slowly marching backward or the outer halves of your eyebrows are quietly disappearing, this isn’t routine shedding or standard aging.
It is likely Frontal Fibrosing Alopecia (FFA)—a primary cicatricial (scarring) alopecia where targeted inflammation attacks the hair follicle stem cells, permanently replacing active follicles with fibrous scar tissue.
What to look for:
Symmetrical, band-like recession along the front and temples
Outer-eyebrow thinning (frequently the earliest red flag)
“Lonely hairs” left stranded where the old hairline used to sit
Perifollicular erythema, subtle scale, or mild burning/itching at the fringe
Because scarring cannot be undone once a follicular opening is obliterated, our clinical goal isn’t regrowing the original hairline—it is extinguishing the fire to protect every follicle you still have.
Managing FFA requires aggressive, early anti-inflammatory control: dermoscopic mapping, targeted intralesional or high-potency topical corticosteroids, calcineurin inhibitors, and systemic modulators (such as oral 5-AR inhibitors or hydroxychloroquine) tailored to disease activity.
Skip the biotin and viral hair oils—they cannot rescue a scarring follicle. If your hairline is shifting, get in with a board-certified dermatologist immediately to hold the line.

Not every blue-gray mark on your skin is from a pencil injury, particularly if you don’t remember that trauma.

If you have a mark like this with zero origin story, please don’t just chalk it up to forgotten playground accidents. It could actually be:
A Blue Nevus: A completely benign (harmless) type of mole. The pigment-producing cells sit deep in the dermis, and because of how light scatters through the skin, the pigment looks steel-blue or gray instead of typical brown.

Something more serious: Certain atypical moles, melanomas, or pigmented basal cell carcinomas can also present with deep blue, slate, or gray tones.

Generally speaking, a real pencil point puncture is going to be an unmistakable, memorable event, and the graphite mark stays virtually unchanged for decades.

If your spot appeared out of nowhere, is changing in size, shape, or color, or you simply don’t remember the injury that caused it: get it checked by a dermatologist.

There is a vast difference between performative barriers and sound clinical practice. In dermatology, palpation is an indispensable diagnostic tool—for subtle texture shifts, induration, and lesion depth, sometimes we need touch. Beyond the diagnostic necessity, genuine touch remains a cornerstone of the healing art. We are not all robots (yet).

Standard clinical precautions exist to protect against bodily fluids, mucous membranes, and compromised tissue—not benign human contact. Intact skin examined with rigorously washed hands does not carry infection risk. Mandating gloves where they aren’t clinically indicated offers nothing more than a false sense of security while actively degrading sound hand hygiene. (Picture the healthcare worker who wears gloves all day, in and out of rooms, through door handles and drawers, never changing them or washing, but with the illusion of “clean” — I’ve seen this.)

In an increasingly detached world, I refuse to treat the people under my care as biohazards. We are healers, not sterile technicians. Rigorous handwashing protects my patients; unnecessary gloving is performative, wasteful, and strips away the art and humanity of medicine.

How would you counsel this patient?

What’s your diagnosis?

If you have an active cold sore, the rule is simple: no kissing. (Also no sharing drinks or utensils of course.) While there is zero shame in getting cold sores—most of the adult population carries antibodies to HSV-1—it’s still our collective responsibility to prevent spread to others. Once infected, herpes is for life. Newborns and young children are particularly vulnerable, and passing this virus on means gifting someone a lifelong chronic condition with no cure.
Remember: asymptomatic viral shedding can happen, meaning yes, transmission is possible even between outbreaks, but an active, blistered or weeping lesion is particularly high-risk.

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Sometimes it works (usually it doesn’t). Warts are a contagious pain in the rear to eradicate. I’ll often use a combination of approaches that includes liquid nitrogen cryotherapy (cold, not hot, but patients still describe it as “burning”).