Table of ContentsView AllTable of ContentsAndrogenetic AlopeciaPsoriasisFolliculitisAlopecia AreataRingworm (Tinea Capitis)EczemaSeborrheic DermatitisLichen PlanusHead LiceDiagnosis
Table of ContentsView All
View All
Table of Contents
Androgenetic Alopecia
Psoriasis
Folliculitis
Alopecia Areata
Ringworm (Tinea Capitis)
Eczema
Seborrheic Dermatitis
Lichen Planus
Head Lice
Diagnosis
Scalp conditions can be irritating, but do not usually cause any major complications. Most are not contagious.
Verywell / Jessica Olah
Many types of scalp conditions share similar symptoms likeitching, inflammation, skin flaking, and more. Therefore, to receive proper treatment, it’s vital to consult with an experienced healthcare provider—such as a dermatologist— for a thorough examination and proper diagnosis.
This article goes over some of the most common conditions of the scalp and how they are usually treated.
Androgenetic alopecia is commonly known asmale-pattern baldnessbecause the hair loss usually occurs in a specific pattern—beginning above the temples and forming a characteristic M shape.
In women, the hair loss pattern differs; it involves thin hair that is distributed over the entire head and the hairline doesn’t usually recede as it does in men. Women with androgenic alopecia rarely become bald, but rather, develop thinning of the hair.
Reproduced with permission from ©DermNet New Zealandwww.dermnetnz.org2023.
Treatment
Studies have shown a sustained effect of long-term use of topical minoxidil in promoting hair growth.
Is Male- or Female-Pattern Baldness Reversible?
Psoriasisis an autoimmune disorder that tends to run in families.It is a chronic (long-term) inflammatory condition that involves periods of remission (when symptoms go away) and relapse.
Half of those with psoriasis will have scalp involvement.
In psoriasis, rapid cell growth results in thick, white, or red plaques, covered with silver-gray scales, itching, scalp lesions (similar to those in seborrheic dermatitis), and progression of symptoms, starting with dandruff-like flakes.
Symptoms of Psoriasis
Scalp psoriasis is known to be difficult to treat. Treatment can include:
Severe scalp psoriasis may require systemic (involving the entire body) treatment using antipsoriatic treatment modalities. Systemic medications for psoriasis include those such as cyclosporine or methotrexate.
The prognosis (outcome) of psoriasis treatment depends on many factors, such as:
A 2021 study found that there was a favorable prognosis in 48% of those with a type of psoriasis called guttate-onset psoriasis.
Those with high disease activity (52% of the study participants) at the onset of the disease were more likely to develop severe psoriasis than those with low disease activity.
Scalp Rash: Reasons for Itchy Bumps and Sores
Folliculitisis an inflammation of the hair follicles located on any part of the body (including the scalp), but more commonly, it occurs in the beard, arms, back, buttocks and legs.
Hair follicles are very tiny pouches of skin in which hairs grow and sebum (oil on the scalp or skin) is produced.
The symptoms start as a reddened, painful, burning, or itchy area at or near one or more hair strands. It appears like red pimples, with a strand of hair in the center, that may have pus inside.
Treatment for mild folliculitis may involve home remedies such as warm compresses to help alleviate itching and promote the removal of pus.
Treating Painful Scalp Pimples
Mild folliculitis usually heals without treatment in approximately two weeks. When folliculitis is severe, oral antibiotics or antifungal medication will most often resolve the infection.
Alopecia areatais an autoimmune skin disease, that causes hair loss on the scalp, face, and other areas of the body.
The condition affects 6.8 million people in the United States.The body’s immune system attacks the hair follicles, causing them to shrink in size and dramatically slow down the growth of hair, so much that hair may completely stop growing. There may be a cycle of hair loss that involves unpredictable regrowth and loss of hair, over and over.
Treatment of alopecia areata depends on:
In those with mild forms of the disease—involving less than 50% hair loss—treatment may involve interventions to prevent the immune systems’ attack on the hair follicle.
For more severe conditions—with over 50% hair loss on the scalp or other areas—oral and injectable medications (including JAK inhibitor treatment) may be prescribed.
Medications for the treatment of alopecia areata don’t work for every person with the condition. It’s important to consult with your healthcare provider about the risks and benefits of the medications.
Alopecia Areata Self Care and Medical Treatment
Ringwormis a fungal infection involving the scalp’s outer layer. Symptoms ofscalp ringworm (tinea capitis)involve a rash that is comprised of circular patches with raised, red edges.
The rash spreads from the edges with the inside of the circle being unaffected. This gives the rash a ring-shaped appearance.
Ringworm can be treated with a special, antifungal shampoo or prescription medication, such as griseofulvin (Grifulvin V, Gris-PEG), terbinafine, and itraconazole.
Be sure to wash your hands before and after using topical medication to prevent spreading ringworm to other parts of your body. Because ringworm is so contagious, everyone in the house will need to use antifungal shampoo.
How to Get Rid of Ringworm
It may take more time to treat ringworm scalp conditions than other types of ringworm.
It’s important to follow the dermatologist’s recommendation and finish all medications, as well as keep follow-up appointments to ensure ringworm is resolved.
Eczemaincludes several skin disorders that affect the scalp and other areas of the body including the scalp, face, neck, and creases of the knees and elbows.
The goal of eczema treatment is to alleviate symptoms and control the rash.The exact treatment modality depends on the type of eczema and other factors.
Treatment may include preventative measures (such as washing the hair with a gentle shampoo with no harsh chemicals) or the use of a medicated shampoo.
Sometimes scalp eczema can clear up without treatment, but most often it lasts for many years with periods of flare-ups and remissions. Treatment is usually aimed at controlling symptoms such as pruritus (itchiness) and scales.
Coping With Eczema
Seborrheic dermatitis, also called seborrhea, is a type of eczema. It is considered a long-term inflammatory disorder, commonly found in areas of the body where there are a lot of oil glands, such as the scalp.
Seborrheic dermatitis manifests with symptoms of red rash, and greasy, yellowcrusts on the scalpor other parts of the body.
In babies, seborrheic dermatitis is known ascradle cap.
Treatment of seborrheic dermatitis is aimed at helping to decrease visible signs of the disorder and reduce symptoms (such as itching).
Over-the-counter medicated shampoos and topical (on the scalp) antifungal medications as well as calcineurin inhibitors and steroids may be ordered.
Seborrheic dermatitis is not a curable disorder. Because it is chronic (long-term), ongoing maintenance treatment is usually necessary to stave off symptoms.
The Link Between Seborrheic Dermatitis and Hair Loss
Lichen planusis thought to be an uncommon autoimmune disease. The condition is an inflammatory skin condition that may cause itchy, small patches of hair loss on the scalp, called scarring alopecia.
Treatment of lichen planus aims to relieve symptoms (such as itching or pain) with medicated creams or prescription medication.
If a person does not have any discomfort associated with the disease, treatment may not be necessary.
Topical (on the skin) numbing agents can be given to alleviate pain and corticosteroids can lower inflammation and alleviate itching. Other treatment modalities may include antihistamines to relieve itching, or a type of ultraviolet light called PUVA.
The symptoms of lichen planus usually go away on their own without treatment, but it may persist for a long time, perhaps even years.
The Goal of Lichen Planopilaris Treatment
Thelice are not easily seen(because they are so small) but their eggs, which are called nits, can be easily detected in the hair.
The nits are round or oval-shaped globs that look like dandruff, tightly attached to the hair near the scalp. The nits cannot easily be removed.
Treatment of lice involves shampooing the hair with medicated shampoo to kill the lice, then picking out the nits with a special comb.
Head lice is a very contagious condition, so all members of the family may need to use the medicated shampoo. Avoid sharing personal items such as hats, combs, and towels.
How Head Lice Is Treated
Many scalp conditions can be diagnosed during a history and physical examination. The diagnostician can examine the scalp and gather information on the history of symptoms and oftentimes make a diagnosis.
But many of the symptoms of scalp conditions overlap.
Sometimes diagnostic tests need to be done. A dermatologist may be consulted when the healthcare provider is differentiating between several possible diagnoses. A scalp condition diagnosis may include:
Summary
Scalp conditions are common and usually not serious, though they can be irritating. Some common conditions of the scalp include adrogenetic alopecia, psoriasis, ringworm, and head lice.
Scalp conditions are usually diagnosed through a simple physical examination and history. In most cases, a dermatologist can help you discover the cause of your scalp condition.
How to Exfoliate Your Scalp
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Center for Biotechnology Information.Male androgenetic alopecia.Medline Plus.Androgenetic alopecia.Ogawa K, Okada Y.The current landscape of psoriasis genetics in 2020.J Dermatol Sci. 2020;99(1):2-8. doi:10.1016/j.jdermsci.2020.05.008Merola JF, Li T, Li WQ, Cho E, Qureshi AA.Prevalence of psoriasis phenotypes among men and women in the USA.Clin Exp Dermatol. 2016;41(5):486-9. doi:10.1111/ced.12805Svedbom A, Mallbris L, Larsson P, et al.Long-term outcomes and prognosis in new-onset psoriasis.JAMA Dermatol. 2021;157(6):684. doi:10.1001/jamadermatol.2021.0734Al Bayati S.Antibacterial effect of ethanolic extract of allium sativum on biofilm forming staphylococcus aureus which cause folliculitis.Int J Curr Microbiol App Sci. 2018;7(1):1904-13. doi:10.20546/ijcmas.2018.701.229National Alopecia Areata Foundation.Alopecia areata.American Academy of Dermatology Association.JAK inhibitors: what your dermatologist wants you to know.Alkeswani A, Cantrell W, Elewski B.Treatment of tinea capitis.Skin Appendage Disord. 2019;5(4):201-10. doi:10.1159/000495909American Academy of Dermatology Association.Ringworm: diagnosis and treatment.National Eczema Society.Scalp eczema.Clark GW, Pope SM, Jaboori KA.Diagnosis and treatment of seborrheic dermatitis.Am Fam Physician; 2015;91(3):185-90.Solimani F, Forchhammer S, Schloegl A, Ghoreschi K, Meier K.Lichen planus - a clinical guide.J Dtsch Dermatol Ges. 2021;19(6):864-882. doi:10.1111/ddg.14565Hopkins Medicine.Lichen planus.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Center for Biotechnology Information.Male androgenetic alopecia.Medline Plus.Androgenetic alopecia.Ogawa K, Okada Y.The current landscape of psoriasis genetics in 2020.J Dermatol Sci. 2020;99(1):2-8. doi:10.1016/j.jdermsci.2020.05.008Merola JF, Li T, Li WQ, Cho E, Qureshi AA.Prevalence of psoriasis phenotypes among men and women in the USA.Clin Exp Dermatol. 2016;41(5):486-9. doi:10.1111/ced.12805Svedbom A, Mallbris L, Larsson P, et al.Long-term outcomes and prognosis in new-onset psoriasis.JAMA Dermatol. 2021;157(6):684. doi:10.1001/jamadermatol.2021.0734Al Bayati S.Antibacterial effect of ethanolic extract of allium sativum on biofilm forming staphylococcus aureus which cause folliculitis.Int J Curr Microbiol App Sci. 2018;7(1):1904-13. doi:10.20546/ijcmas.2018.701.229National Alopecia Areata Foundation.Alopecia areata.American Academy of Dermatology Association.JAK inhibitors: what your dermatologist wants you to know.Alkeswani A, Cantrell W, Elewski B.Treatment of tinea capitis.Skin Appendage Disord. 2019;5(4):201-10. doi:10.1159/000495909American Academy of Dermatology Association.Ringworm: diagnosis and treatment.National Eczema Society.Scalp eczema.Clark GW, Pope SM, Jaboori KA.Diagnosis and treatment of seborrheic dermatitis.Am Fam Physician; 2015;91(3):185-90.Solimani F, Forchhammer S, Schloegl A, Ghoreschi K, Meier K.Lichen planus - a clinical guide.J Dtsch Dermatol Ges. 2021;19(6):864-882. doi:10.1111/ddg.14565Hopkins Medicine.Lichen planus.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Center for Biotechnology Information.Male androgenetic alopecia.Medline Plus.Androgenetic alopecia.Ogawa K, Okada Y.The current landscape of psoriasis genetics in 2020.J Dermatol Sci. 2020;99(1):2-8. doi:10.1016/j.jdermsci.2020.05.008Merola JF, Li T, Li WQ, Cho E, Qureshi AA.Prevalence of psoriasis phenotypes among men and women in the USA.Clin Exp Dermatol. 2016;41(5):486-9. doi:10.1111/ced.12805Svedbom A, Mallbris L, Larsson P, et al.Long-term outcomes and prognosis in new-onset psoriasis.JAMA Dermatol. 2021;157(6):684. doi:10.1001/jamadermatol.2021.0734Al Bayati S.Antibacterial effect of ethanolic extract of allium sativum on biofilm forming staphylococcus aureus which cause folliculitis.Int J Curr Microbiol App Sci. 2018;7(1):1904-13. doi:10.20546/ijcmas.2018.701.229National Alopecia Areata Foundation.Alopecia areata.American Academy of Dermatology Association.JAK inhibitors: what your dermatologist wants you to know.Alkeswani A, Cantrell W, Elewski B.Treatment of tinea capitis.Skin Appendage Disord. 2019;5(4):201-10. doi:10.1159/000495909American Academy of Dermatology Association.Ringworm: diagnosis and treatment.National Eczema Society.Scalp eczema.Clark GW, Pope SM, Jaboori KA.Diagnosis and treatment of seborrheic dermatitis.Am Fam Physician; 2015;91(3):185-90.Solimani F, Forchhammer S, Schloegl A, Ghoreschi K, Meier K.Lichen planus - a clinical guide.J Dtsch Dermatol Ges. 2021;19(6):864-882. doi:10.1111/ddg.14565Hopkins Medicine.Lichen planus.
National Center for Biotechnology Information.Male androgenetic alopecia.
Medline Plus.Androgenetic alopecia.
Ogawa K, Okada Y.The current landscape of psoriasis genetics in 2020.J Dermatol Sci. 2020;99(1):2-8. doi:10.1016/j.jdermsci.2020.05.008
Merola JF, Li T, Li WQ, Cho E, Qureshi AA.Prevalence of psoriasis phenotypes among men and women in the USA.Clin Exp Dermatol. 2016;41(5):486-9. doi:10.1111/ced.12805
Svedbom A, Mallbris L, Larsson P, et al.Long-term outcomes and prognosis in new-onset psoriasis.JAMA Dermatol. 2021;157(6):684. doi:10.1001/jamadermatol.2021.0734
Al Bayati S.Antibacterial effect of ethanolic extract of allium sativum on biofilm forming staphylococcus aureus which cause folliculitis.Int J Curr Microbiol App Sci. 2018;7(1):1904-13. doi:10.20546/ijcmas.2018.701.229
National Alopecia Areata Foundation.Alopecia areata.
American Academy of Dermatology Association.JAK inhibitors: what your dermatologist wants you to know.
Alkeswani A, Cantrell W, Elewski B.Treatment of tinea capitis.Skin Appendage Disord. 2019;5(4):201-10. doi:10.1159/000495909
American Academy of Dermatology Association.Ringworm: diagnosis and treatment.
National Eczema Society.Scalp eczema.
Clark GW, Pope SM, Jaboori KA.Diagnosis and treatment of seborrheic dermatitis.Am Fam Physician; 2015;91(3):185-90.
Solimani F, Forchhammer S, Schloegl A, Ghoreschi K, Meier K.Lichen planus - a clinical guide.J Dtsch Dermatol Ges. 2021;19(6):864-882. doi:10.1111/ddg.14565
Hopkins Medicine.Lichen planus.
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