SCALP DISORDERS

The scalp is prone to a number of conditions ranging from dandruff to more inflammatory concerns and are frequently seen and addressed successfully in clinic. They can be managed very effectively with trichological preparations.

Scalp complaints can have underlying contributing factors and be symptomatic to stress, poor diet, allergies and metabolic issues. A scalp problem can be very uncomfortable when it flares up, creating intense itching and built up areas of scale and plaques, which can be quite distressing. Some scarring conditions can present as a scalp complaint and be extremely sore and itchy with the hair loss not noticed initially by the patient. The take home message is the sooner you seek help the better the chance of halting any damage. Below is a summary of the conditions most prevalently seen in clinic, although it is not exhaustive.

Psorisis

Psoriasis is a chronic disease and often affects the scalp. There are differing forms of psoriasis, it is usually plaque psoriasis that is seen on the scalp. The plaques are clearly demarcated at the margins showing a redness that differs to the normal adjacent skin. The plaques are covered with dry white, adherent silvery scales. These plaques can be difficult to remove and beneath them the skin is rough with bleeding points. For some, psoriasis can be extremely pruritic (itchy) and for others, the feeling of a tight and uncomfortable scalp.

Psoriasis can have a genetic origin and it is thought to be caused by a problem with the immune system which alters the skin cell production in the areas affected. This skin disease can be impacted by factors such as stress illness and injury. It cannot be cured but it is possible to manage it with the possibility of long remissions.

Trichological preparations can help with the treatment of psoriasis present on the scalp as can UV light therapy. For severe cases that also affect the whole-body medical treatment is often necessary.

Seborrhoeic Eczema

Seborrhoeic eczema is also referred to as seborrheic dermatitis, it is a relapsing chronic inflammatory condition, which occurs to the areas of the skin that has more sebaceous glands such as the scalp.

It is not necessarily an oily condition; it can differ for each individual with symptoms ranging from mild scale and itch to excessive pruritus coupled with excessive scale and possibility of crusting due to an eczematous weeping to the area. There are infantile and adult variations.

The whole scalp can be affected, it often presents along the margins and behind the ears. As this condition can be very pruritic it often leads to secondary infections from the patient scratching the affected areas.

Seborrhoeic eczema is a commonly seen condition by trichologists and it is caused by the patient’s individual sensitively to the Malassezia yeasts that are present on the scalp. This condition can be managed well in clinic with treatment and flare ups can be brought under control.

Pityriasis Amiantacea

Pityriasis Amianticea also termed Fausse Teinge amianticea is a scaly condition that produces heavy sticky scale, which builds up along the hair shaft. It can affect one or more areas of the scalp, this type of scale firmly attaches to the scalp and can build up significantly without treatment.

It follows an eczematous reaction to the scalp from trauma, infection or it can be idiopathic. This condition can be sore and extremely pruritic. It often follows a period of intense emotional stress or a localised infection. Pityriasis amiantacea can come about as an extension to seborrheic eczema or psoriasis.

This condition can be treated well in clinic with trichological preparations. It is important to note that on rare occasions this condition and cause hair loss especially if there is secondary infection.

Folliculitis

Folliculitis is a common condition that is caused by bacteria in the follicle. It can become extremely pruritic and troublesome creating the patient to continually touch and scratch therefore spreading the infection into the nearby follicles.

Prompt treatment and correct guidance on causative factors is required to settle the infection to avoid creating permanent scaring and potential hair loss. This is often a recurrent problem and can be difficult to cure completely.

Contact Dermatitis

Contact dermatitis can vary in intensity but it can cause significant reaction of the scalp, with weeping crusting, erythema and swelling. It occurs when the area affected has come into contact with an irritant or an allergen, the latter can create an allergic reaction within the body which will require medical intervention.

If an irritant reaction occurs it can be to a variety of substances, it can occur on the first application if the irritant is strong such as bleach, or sodium hydroxide (relaxer). It may also occur due to long-term exposure to everyday products such as shampoo, and oils etc.

A trichologist can help identify the problem with a thorough background check of the procedures and practices the patient performs to the hair and scalp. Treatment may be offered in clinic once a diagnosis as been established.