Scalp Conditions and Problems
There are many types of scalp conditions and related problems that can
cause symptoms such as itching, flaking and hair loss.
There is no known cause and no cure, just methods for controlling
symptoms. Scalp problems such as mild flaking are referred to as
dandruff, with yellowish scaly and greasy scaling or flaking
referred to as seborrhea or seborrheic
In babies the condition is referred to as cradle cap. The
primary cause of skin cell flaking is dry skin or excess sebum
production from the sebaceous glands, which are found on the scalp,
face and armpits. The substance secreted causes the flakes to clump on
the skin, causing them to fall off in larger, more noticeable batches.
It is not a reflection of poor personal hygiene, unless a person
infrequently shampoos. Many cases of seborrheic dermatitis have the
presence of a fungus called Pityrosporon ovale. Silver scales
are a symptom of psoriasis, which is often mistaken for
seborrhea. Seborrheic dermatitis results in the
most intense itching and symptoms. In adults, treatment starts with
over the counter dandruff shampoo. If the condition is unresponsive, a
visit to the Doctor is necessary."
The most common types of scalp conditions and symptoms are
described below. These include:
An itchy scalp
can be caused by any
of the scalp conditions listed below.
In most cases it is caused by a yeast (pityrosporum) found
naturally on the skin that is attracted to the dead skin cells on the
In most cases, itchy scalp conditions can be controlled
anti-dandruff shampoo that contains ketoconazole.
Scalp itch and dandruff can be treated by washing the hair
2x during the morning shower. The first lather and rinse is
to remove dead skin and the second will help to kill any yeast buildup.
One recommended product is Nizoral
A-D Anti dandruff shampoo.
A mild case of dandruff is the natural way the scalp eliminates dead
skin cells. For some unknown reason, in some people or in
others at some particular time, the skin cells die off faster, causing
dandruff. When the sebaceous glands produce excess
sebum or oil, the flakes build up on the scalp before
falling, and then fall off in a larger quantity. This creates the
appearance of white flakes in the hair and shoulders, prompting
treatment. An oily scalp occurs when the
body is producing too much oil
due to a hormonal imbalance, such as during adolescence.
In some people, Dandruff can be triggered by medications used to grow
hair such as Rogainea (minoxidil).
How to cure dandruff
For mild dandruff, purchase an over the counter dandruff shampoo that
either contains selenium oxide, zinc pyrithione tar or ketoconazole.
natural product such as Cradle
can help soothe and moisturize dry skin.
A more severe case of dandruff is referred to as seborrhea. When a
scalp is oily, but not itching, crusty or inflamed, then the
condition is called seborrhea. Seborrhea refers to the over production
sebum, an oily substance manufactured by the sebaceous glands.
When itching, crusting skin and
inflammation are involved, then the scalp problem is referred to as
seborrheic dermatitis of the scalp.
Dermatitis of the Scalp
Seborrheic scalp dermatitis refers to scales that form on the face
scalp. It has
no known cause, and tends to run in families. The condition
is seen more often in:
- adults age 30 to 71
- during cold weather months
- infants under 3 months of age (called cradle cap)
dermatitis scalp symptoms include flaking the dead skin
cells on the scalp. This can be when the scalp is dry or
oily/greasy. The skin scales or flakes will appear yellow
color and greasy in texture. Scalp itch is often intense and some
patients experience hair loss. In
chronic cases (severe), pimples red/yellow pimples can form in the
dermatitis scalp treatment involves the use of
Ketoconazole cream or dandruff shampoos that contain the ingredients:
- selenium sulfide
- salicylic acid
Like other scalp conditions, anti dandruff shampoos are used
every other day and then 2x per week until
the condition is eliminated. Follow the manufacturers or your
If your condition does not respond
to over the counter treatment, be sure to see a doctor as it could
indicate that a prescription product is needed, or that there is a
systemic underlying cause such as diabetes.
Scalp Conditions that are Similar to Seborrheic Dermatitis
Seborrheic dermatitis scalp conditions appear similar to and
should be differentiated from psoriasis
(does not effect areas beyond the hairline), impetigo (skin
lesions are in one area and related dandruff is not greasy), Pityrias rosea (have
a distinct skin patch appearance that looks like a hub and spokes) and T. Cruris and corporis
(not greasy, caused by a fungus that can be determined with tests..
Hair lice is caused by insects (adults are 2-3mm in length) that feed
on a person's blood. They are primarily found on the scalp. Lice and
their eggs (nits) can also be seen on an infested person's
clothes. Lice are only spread by crawling from person to
person after close contact (they do not fly or jump).
Picture of Lice in each
life stage (egg, nymph or baby lice and adult)
Lice can be seen with the naked eye but are difficult to find.
Use a fine-toothed comb combined with the help of a
flashlight and magnifying glass.
If lice are found, check everyone living in the same home as this is
one of the scalp conditions that is contagious.
If you share a bed with another person, that person should be treated
along with the person with the lice. All items used by the
infested person should be washed in hot water and then placed into the
dryer (need temperatures of 123F to kill lice and Nits.
Lice can be treated with products that are available with and without a
prescription (called pediculicides) . Over the counter
products available for removing hair lice include RID and Pronto
(active ingredient piperonyl butoxide). You can also use a
chemical and pesticide free, non-toxic
natural lice remedy
such as Naughty
Regardless of the scalp lice treatment selected, follow the
manufacturers directions. You can download these lice
(PDF Download) developed by
the U.S. Centers for Disease Control.
Scalp ringworm is caused by a common scalp
. It causes symptoms such as
bald patches/scalp hair loss, dark skin pigmentation, itch, redness,
and scaling. The same class of fungus can cause, athletes
foot, jock itch, and rough toe and finger nails. The infection is
spread from person to person or can be spread by pets.
Scalp ringworm appears 4 days to 2 weeks after exposure.
Treatment involves the use of a prescription medication or a
natural product such as Naturasil
that uses plant extracts.
No matter which of the scalp
is causing the problem, be sure to
see a Doctor if it does not respond to over the counter treatments.
References for Scalp Conditions and Problems:
Health - Stop Your Itchin
Principles of Pediatric Dermatology
Dr. Mahmoud Hijazy