Scalp
Common Scalp Conditions
A large number of the clients I see have a scalp condition. Frequently I can provide specialist scalp treatments to relieve scaly, itchy conditions, which can work alongside antibiotic and steroid treatments from your doctor.
These are the scalp conditions I most commonly come across:
Eczema/Dermatitis
These words are often used interchangeably to describe a group of similar conditions which cause dry, itchy, inflamed patches of rough skin which can crack and bleed. Causes include genetics, stress, hormones, micro-organisms, allergy and irritants. Although there’s no cure, treatments and self-help strategies are often effective in managing symptoms and flare ups.
Trichology treatments can complement and work alongside medication available from pharmacies and GPs on the NHS. In persistent and severe cases GPs can refer to a dermatologist but the wait can be very lengthy. A trichologist can often give immediate help and relief particularly when scaly build up on the scalp has got out of control or is not adequately managed by other treatment methods.
These conditions are not infectious but sufferers worry and are embarrassed that it looks unsightly and is off-putting for others who may avoid contact or stare. These are often long term (chronic) conditions which relapse (come back) and have flare-ups. They can make life miserable if not well managed and controlled.
Avoid sharing brushes and combs, and give them a weekly clean in warm, soapy water before rinsing well.
Atopic eczema
This is the most common, including in babies and young children. Patches of scalp become dry, flaky, rough and inflamed. It feels very itchy and often sore and tight. More severe cases can crack, crust and bleed, leaving the skin open to infection. Onset in youngsters can resolve as they get older.
Dandruff
This is a very common, annoying complaint, caused by the skin on the scalp reacting to a certain type of yeast and forming white, sometimes yellowish scale which flakes off and shows up on clothes. It is a mild form of seborrheic dermatitis which can usually be controlled with treatment shampoos and the right hair care regime.
Seborrheic eczema/seborrheic dermatitis
This is a common type of chronic relapsing atopic eczema which is a more severe form of dandruff (called Cradle Cap in babies). Symptoms are inflamed, itchy, sore, flaky areas on the scalp with a greasy, white/yellowish scale. Particularly common at the hairline and behind the ears, it’s often also in other oil (sebum) rich areas like eyebrows, round the nose folds, chest and groin. Causes include excessive sebum secretion (hair’s natural oils) and the body’s reaction to Malassezia yeast (fungus) infection. Diet and food intolerances/allergies can also be involved in this condition.
Allergic contact dermatitis
A type of atopic eczema that occurs when the body is repeatedly exposed to small doses of an allergen. The delayed reaction – typically redness, heat, itch, swelling, blistering and pain – usually comes 12-72 hours after exposure and can occasionally be very serious. Once sensitised to the substance, the body’s immune system will always react to it, so the treatment is to avoid it! Hair dyes are a common cause of ACD which is why it is so important to have a patch test before any colour or in salon treatment is applied to reduce the risk.
Irritant contact dermatitis
This is an immediate but temporary skin reaction caused when detergents, bleach or water remove the natural oils in the outer layers of skin, impairing the skin’s barrier function. This allows irritant chemicals to penetrate causing redness, itching and soreness. On the scalp, this is most commonly caused by bleach, harsh sulfates in shampoos or ingredients which cause irritation (particularly in sensitive skin) in other topical products.
Neurodermatitis (lichen simplex)
This is a very itchy eczema patch that becomes worse through continued rubbing or scratching. Often it’s a single patch at the nape of the neck. A combination of medical and trichological treatments can be very effective at controlling this condition.
Psoriasis
This is a chronic disorder in which the immune system speeds up of the replacement of skin cells causing dead cells to build up and create scales or plaques in well-demarked patches. With bright pink, very inflamed skin, covered in thick, silvery and tight scales, there’s often an intense itch which can lead to bleeding when scratched. Plaques can often be found in other areas such as elbows and knees.
Mild psoriasis can often be controlled with shampoos and topical treatments. Trichological treatments can help by calming the inflammation and removing the build up of dead skin.
Pityriasis Amiantacea
A condition which causes excessive thick scaling of the scalp. The scales often flatten like tiles on a roof and trap tufts of hair.
Tinea Capitis (Scalp ringworm)
A condition caused by a fungal infection (not a worm!) affecting the scalp and hair. Children with tinea capitis usually have some patchy hair loss with broken hairs visible. Antifungal treatment and a medicated shampoo is usually very effective in clearing up the infection although it is important to get an accurate diagnosis and complete the course of treatment to prevent it recurring.
Folliculitus
A condition which causes inflammation of the hair follicle commonly caused by a bacteria. This condition presents with small pustules, and can, with deeper infection, cause scarring alopecia. It is therefore important to get an early diagnosis and treatment.
Testimonial
"I thought the itching would never stop. It was driving me mad. I can’t tell you the relief right from the first scalp treatment with Sally. Now I’ve got a plan to keep on top of it. Thank you so much."
Female, 54, Derby