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QUESTION OF THE WEEK


Frozen Pea Bag Sign

Frozen peas are a versatile treatment in many aspects of medicine. Frozen peas wrapped in a towel are used for treatment of musculoskeletal injures, bug bites and so much more. The cooling reduces swelling and also reduces pain.

Frozen peas often provide a short term solution to debilitating scalp symptoms. All patients who require frozen peas to suppress scalp symptoms need to see an expert fo proper diagnosis. In  some cases,  a biopsy is needed to confirm the diagnosis.

Frozen peas often provide a short term solution to debilitating scalp symptoms. All patients who require frozen peas to suppress scalp symptoms need to see an expert fo proper diagnosis. In some cases, a biopsy is needed to confirm the diagnosis.


Some hair & scalp conditions are associated with significant scalp itching, burning and tenderness. Some patients with severe symptoms can’t sleep, can’t think... and can barely function. Many patients find that a bag of frozen peas wrapped in a towel reduces these symptoms and brings some degree of relief. I refer to this as the “frozen pea bag sign.” Bags of peas are versatile and can be shaped to fit anyone’s scalp.

Many patients come to learn about the benefits of frozen peas on their own through trial and error. They don’t read about it anywhere. They don’t hear about it anywhere. Many are surprised to hear when I tell them about the “frozen pea bag sign” and how many others have also discovered this strategy on their own.

There are several hair & scalp conditions associated with the frozen pea bag sign. A really good history together with a scalp examination often helps the clinician reach the diagnosis. But not always. Sometimes the patient needs a biopsy if the diagnosis is not clear after the history and examination steps are completed.

The 3 most common conditions associated with the “frozen pea sign” include scarring alopecias, scalp dysesthesias, and allergic contact dermatitis. Other conditions are also possible (ie infections, autoimmune and neurological issues issues) too but these first 3 I mentioned are the most common. Some causes show up in biopsies. However, not all reasons show up in the biopsy. In situations where biopsy seems unhelpful, the biopsy helps eliminate some of the potential reasons but the answer lies in the history and examination.

Frozen peas are safe to use and don’t damage hairs or the scalp when used appropriately and for short periods. They are not an ideal long term option - as getting to the actual cause of the scalp symptoms is where all efforts should be focused.

Frozen peas have allowed countless of my own patients get through some pretty tough times.


This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.



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