Topic Overview
Many people have hair or scalp problems.
Hair may thin or fall out, break off, or
grow slowly. Dandruff or an itching or peeling scalp
may cause embarrassment and discomfort. Hair and scalp problems can be
upsetting, but they usually are not caused by serious medical problems.
Hair loss
Hair loss, including thinning and breaking,
is the most common scalp problem. Most people lose from 50 to 100 hairs per
day.
Hair gradually thins as people age, although not all people
are affected to the same degree. Hereditary thinning or balding is the most
common cause of thinning hair. You can inherit this from either your mother's
or father's side of the family. Women with this trait develop thinning hair,
while men may become completely bald. The condition can start in the teens,
20s, or 30s.
Babies often lose their fine baby hair, which is then
replaced by mature hair. Because of changes in hormones, women often lose hair
for 1 to 6 months after childbirth or after breast-feeding is completed.
Other possible causes for excessive hair loss, thinning, or
breakage include:
- Damage to the hair from hair care products,
such dyes and permanents, and from hot rollers, curling irons, or hair
dryers.
- Hair-pulling or hair-twisting habits. Trichotillomania is a
mental health problem in which a person pulls out his or her own hair, usually
from the head, eyelashes, and eyebrows.
- Side effects of medicines
or medical treatments, such as
chemotherapy or
radiation therapy.
- Recent surgery, high
fever, or emotional stress. You may have a lot of hair loss 4 weeks to 3 months
after severe physical or emotional stress. This type of hair loss usually stops
within a few months.
- Diseases, such as
lupus and
hyperthyroidism.
- Heavy metal poisoning,
such as thallium or arsenic poisoning.
- Poor nutrition, especially
lack of protein or iron in the diet.
- Damage to the hair shafts
from burns or other injuries.
Itching, flaking, or crusting of the scalp
Itching,
flaking, or crusting of the scalp may be caused by:
- Cradle cap, an
oily, yellow crusting on a baby's scalp. It is common in babies and is not
caused by an illness. It does not mean that a baby is not being well cared for. See a picture of
cradle cap.
- Dandruff, a shedding of the skin on the scalp that
leaves white flakes on the head, neck, and shoulders. It may be a form of a
skin condition called
eczema, which causes increased shedding of normal
scalp skin cells. Dandruff can also be caused by a
fungal infection. Hormonal or seasonal changes can
make dandruff worse.
- Head lice, tiny wingless insects that
cause itching and raw patches on the scalp. Head lice are most common in
school-age children.
- Ringworm, an infection of the outer
layer of the scalp and in the hair. It usually causes a rash made up of
circular patches with raised, red edges that resemble worms. The rash spreads
from these edges, often leaving the center clear, giving it a ring
shape.
- Ongoing (chronic) skin conditions, such as
psoriasis and
seborrhea.
- An uncommon, recurrent skin
condition called
lichen planus. This condition appears more often
during stress, fatigue, or exposure to medicines or chemicals.
Sores, blisters, or bumps on the scalp
Painful sores,
blisters, or bumps that develop on the scalp may be caused by:
- Infection of the hair shafts (folliculitis) or the skin (such as
impetigo).
- An allergic skin reaction
(contact dermatitis).
- Viral infections,
such as
chickenpox and
shingles.
- A skin condition, such as
acne.
- A cyst, such as an epidermal or
sebaceous cyst, a sac beneath the outer layer of the skin that is filled with a
greasy white material. These cysts most often appear on the scalp, ears, face,
back, or scrotum and are caused by plugged ducts at the site of a hair shaft.
Other problems can develop if the cyst becomes infected.
Skin cancer can occur on the scalp, particularly in
areas not well-covered by hair. It can destroy skin cells and tissues and, in
some cases, spread (metastasize) to other parts of the body. Skin cancer may
appear as a growth or mole, a
change in a growth or mole, a sore that does not heal,
or irritation of the skin. The three most common types of skin cancer are
basal cell skin cancer,
squamous cell skin cancer, and
melanoma.
Treatment
The treatment for scalp problems depends on
what is causing the problem.
Check your symptoms to decide if and when
you should see a doctor.
Check Your Symptoms
Home Treatment
Try one of the following home
treatment measures to resolve a scalp problem.
- Try
home treatment for dandruff, such as using an antidandruff shampoo for dandruff that causes white flakes on your head.
- Perform a
skin self-exam to help identify suspicious scalp growths. Part your hair to
look at your scalp. If you have trouble seeing your scalp, ask a friend or
family member to check the spot for you.
- If your baby has yellow
crusting on his or her scalp, try home treatment for cradle cap.
- An hour before shampooing, rub your baby's
scalp with baby oil, mineral oil, or petroleum jelly to help lift the crusts
and loosen scales.
- When ready to shampoo, first get the scalp wet,
then gently scrub the scalp with a soft-bristle brush (a soft toothbrush works
well) for a few minutes to remove the scales. You can also try gently removing
the scales with a fine-tooth comb.
- Then wash the scalp with baby
shampoo, rinse well, and gently towel dry.
- If your baby has a bald spot at the back or side
of the scalp, change your baby's position frequently. Lying in one position may
be causing the bald spot.
There may be other things you can do at home for other kinds of scalp problems.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
Prevention
To maintain normal hair production, eat 2
to 3 servings of
protein a day. Protein is found in meat, chicken,
fish, eggs, some cheeses, dried beans, tofu, grains, and nuts. For more
information, see the topic Healthy Eating.
Treat your hair gently.
If your hair breaks easily:
- Shampoo, comb, and brush your hair less
frequently.
- Use a cream rinse or conditioner after shampooing your
hair. This will make your hair easier to comb and more
manageable.
- Use wide-tooth combs and brushes with smooth
tips.
- Avoid rough combing, brushing, or rubbing with a towel when
your hair is wet. Wet hair is more fragile and thus more likely to
break.
- Avoid hairstyles that pull on your hair, such as ponytails,
cornrows, and braids. The constant pulling causes some hair loss, especially
along the sides of the scalp. If you do use these hairstyles, avoid tight
ponytails and braids. Alternate with looser hairstyles.
- Limit your
use of curling irons, flat irons or straighteners, hot rollers, and hair dryers. If you use these products,
use the low heat setting.
- Avoid chemical treatments until hair you
have previously treated with chemicals has grown out.
To prevent head lice, do not share hats, combs, or other
items. For more information, see the topic
Lice.
To prevent skin cancer, protect your
scalp (and the rest of your skin) from the sun.
- Limit your exposure to the sun, especially from
10:00 a.m. to 4:00 p.m.
- Wear a wide-brimmed hat.
- Do
not use tanning booths or sunlamps.
For more information, see the topics
Skin Cancer, Melanoma and
Skin Cancer, Nonmelanoma.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions:
- What are your main symptoms?
- How long have you had
your symptoms?
- Have you had this problem in the past? If so, how was it treated?
Did the treatment help?
- If you are concerned about hair loss or thinning, when did you last
have what you consider a normal head of hair?
- Do you have a family
history of hair loss?
- What are your hair care habits?
- How often do you wash your
hair?
- Do you use hot rollers, a hair dryer, a curling
iron, or a flat iron or straightener?
- Have you had a recent permanent or used a hair color
product?
- Do you regularly use elastic bands, barrettes, or bobby
pins?
- Question for women:
Are you using a hormonal birth control
method?
- What nonprescription and prescription medicines,
including vitamins, have you taken in the last 6 months?
- Have you
had any recent illness or surgery?
- Do you have any skin disorders
or chronic illnesses?
- Do you think you may have been exposed to head
lice or
ringworm?
- Does anyone in your family have
similar symptoms?
- Do you have any
health risks?
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
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| Specialist Medical Reviewer | H. Michael O'Connor, MD - Emergency Medicine |
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| Last Revised | April 26, 2011 |
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