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Common Scalp Conditions

• Dandruff
• Seborrhoea
• Severe Dandruff

Inflammatory Scalp Conditions

• Contact Dermatitis
• Seborrhoeic Dermatitis
• Eczema
• Neurodermatitis

Dandruff (Pityriasis Capitis)

Scales formed upon the scalp

Dandruff, as it is commonly known, is sometimes associated with excess greasiness (seborrhoea). An excess of natural oil from the scalp, sebum, may, or may not, be present with dandruff. The scales on their own will appear as fine scale on the scalp and tends to be seen on the shoulders of sufferers, if wearing dark clothing. However, coupled with excessive oiliness these scales can adhere to the hair shaft throughout its length.

Dandruff affects people at different stages of life, particularly in adolescence but very often in adult years. It is relatively rare and mild in children and very occasionally does it persist into old age. It is commonly associated with a yeast known as pityrosporum ovale, that can be found in abundance at these areas of scale.

Because it is most common in males and that the age of incidence is around the late teens this together might suggest that there is andgrogenic influence. Plus, the fact that, the above mentioned sebaceous activity may be in excess during the years of growth and change. The two conditions are often regarded by the sufferer as one, but this is not so.

Advice

Develop a routine of cleansing scalp and hair daily. In some cases it may be necessary to shampoo and shower twice daily after sports activities and during hot weather. A regime such as this may well prevent dandruff and the effects of an oily scalp. The ‘le regime’ anti-dandruff shampoo has been developed taking into consideration the influence of the yeast pityrosporum ovale

Important Factors

Always rinse the scalp and hair very well because poor rinsing can be a cause of scales and irritation on the scalp.

It is not harmful to cleanse the scalp frequently, washing any skin area is a way of protecting against disease, your hands in particular, remembering not to touch your face or scratch your scalp, this too can be the start of irritation.

Seborrhoea

Features

Seborrhoea is the term given to a condition referred to as an oily or greasy scalp and hair. The sebaceous glands, which feed into the hair follicles, become overactive and the additional secretion of natural oil, sebum, to the scalp, causes this problem. Sebum lubricates and waterproofs the skin and is mildly antiseptic and therefore, in general, causes no problem.

Seborrhoea begins at puberty when the sebaceous glands enlarge mainly due to the circulating androgen hormones within the body but can also be found in some infants. Seborrhoea and the onset of androgenetic alopecia may be experienced at the same time but they are two different conditions and not linked.

Treatment

Frequent washing of the scalp will keep excessive oiliness to a suitable level. There is no harm in using a shampoo daily. The use of two different shampoos on alternate days can be effective. One with a tar ingredient and one shampoo without tar. It is important to rinse the scalp thoroughly, as a residue of shampoo or conditioner left on the scalp can have a dulling effect on the hair but more to the point it may cause a reaction or contact dermatitis in some people who suffer with sensitivities to perfume etc.

A non-perfumed range of shampoo, conditioner, & restructurant has been especially designed for those with sensitivities.

Pityriasis Amiantacea

Features

This term is used to describe a certain form of scaling on the scalp. Those who suffer often experience a damp feel to the scalp before the scale dries and forms a crusty scale which also sticks the hair flat to the scalp. When the scale is removed these hairs can come away with the scale, however, it must be stressed that this is a temporary loss and the hair soon replaces when the scalp is treated and kept clear. It is one of those conditions that can be cleared and in many cases will not return.

Pityriasis Amiantacea can sometimes be found on the scalp of those who suffer eczema and/or psoriasis, therefore, correct guidance and advice regarding the management of these conditions is important when they co-exist.

It is described by some as a scalp reaction and is often idiopathic (unknown origin). I have found this condition in people aged 15yrs to 70yrs, and in some it will only affect them once in a lifetime, where-as, others may have this disturbance a number of times.

Treatment

Treatment should be carried out by a clinical trichologist who is registered with the Institute of Trichologists, with letters AIT, MIT, FIT or a member of the International Association of Trichologists, giving them the letters IAT after their name.

Contact Dermatitis

Contact means ‘by touch’ or ‘being in contact with a substance’. Dermatitis, briefly, means skin irritation and the condition itself can also have the added complication of scaling. There are two types of this condition, irritant dermatitis and allergic dermatitis.

Irritant Dermatitis

This only occurs when the external substance is in contact with the skin of the scalp, or indeed, any part of the body.

Allergic Dermatitis

This can occur away from the site of initial contact. The most important point for sufferers to remember, is an allergic reaction to a substance occurs on the second exposure to that substance. Often on first exposure to a sensitising agent, e.g. a chemical, no visible signs of irritation are evident. For those individuals susceptible to allergic reactions, the sensitiser causes the production in the blood of antibodies to the agent. At any subsequent application or contact with the substance, these antibodies then produce an allergic reaction.

A substance does not necessarily have to be labelled with a ‘caution’ notice for problems to occur. After an allergic reaction even water can have an affect. Advice is given not to drink the water in some countries, in these places also do not use the water on a sensitive skin or scalp.

Sensitivity Testing (Hair colour dyes)

This procedure should be carried out prior to the use of all colouring products (semi and permanent colours) and is relatively easy to complete. Always check the label or ask your hairdresser for details. These are to be found on the instruction leaflets supplied with every colour product.

Incompatibility Testing

This is used prior to a permanent wave on coloured hair. Chemicals can react together and have adverse effects on the hair and scalp. This test will give information to the hairdresser, to enable them to decide whether to proceed or not with the service, to ensure your comfort and safety.

Seborrhoeic Dermatitis

Features

Seborrhoeic dermatitis is common in infancy, affecting the baby in the first three months of life and abating after three to six months. It is known as cradle cap and can occur again at puberty and persist into old age.

However, studies have not demonstrated that affected infants have an increased likelihood of developing seborrhoeic dermatitis at puberty and the adult form is considered by some to be a variant of psoriasis.

An itchy, inflammatory condition predominantly affecting the scalp, contrary to its name, there is no additional secretion of natural oil, sebum. Large waxy yellow scales cover the scalp, which is red and moist. These symptoms become less of a problem after the age of forty.

Seborrhoeic dermatitis is experienced by 1-3% of the general population. It is a recurrent condition and relapses will require treatment. The regularity and compliance to a regime when relapses occur can make a difference to the overall comfort of the scalp and condition of the hair, in which case the trichologist will be a most useful contact.

Eczema

Features

The meaning of the word eczema is ‘flowing over’, which describes some of the inflammatory changes. The terms, eczema and dermatitis, are used interchangeably, by some, because of the similar inflammatory changes occurring in the skin.

Eczema of the scalp is a very itchy, scaly, inflammatory dermatitis. Atopic eczema affects up to 10% of the general population. In 50 % of the cases it is first seen in infancy and may present itself at any time in life. Seborrhoeic dermatitis may also follow later in life.

Eczema often involves the scalp and may look like seborrhoeic dermatitis, but generally, it is itchier, and it can also be found at other sites on the body. Eczema is a chronic relapsing condition and therefore the treatment and management of the condition will vary from person to person.

Broken hairs and a hardening of the skin (lichen simplex) are due to continued scratching. A diffuse loss of hair can be present, usually, of a temporary nature, giving rise to new hairs, in the ever-regenerating cycles of active growth and rest. A further complication with scalp eczema can be due to secondary infection with herpes simplex virus.

Asthma and hayfever are sometimes, but not always, experienced with eczema and are described as being an autosomal dominantly inherited cluster of related disorders.

Neurodermatitis

Features

Neurodermatitis is characterised by red flaky patches that are itchy when touched and scratched. It occurs when the same spot of skin is touched or rubbed again and again. The scratching is possibly an unconscious process when a person is preoccupied and unaware of the continued action. This cycle is difficult to break and a person’s scratching is the cause of neurodermatitis. Upon examination with fingers the patches usually convey a thick, hard sensation as if there were a waxen disk beneath the skin.

Course and Prognosis

The course of this skin ailment is unpredictable in that it can reoccur at any time, depending upon the source of the itching. Often in adults, the recurrence can only be halted if the habit of constantly scratching the same skin patch is broken. Although the initial red area usually appears at the nape of the neck, the condition can present in areas of the skin (inner side if the forearms) and areas of the scalp if the person continues to irritate the spot by scratching.