Scalp Problems and Treatments

irritating scalp conditions

By: Dr. Masoud Abdar

Scalp Products

Too much use of hair products such as styling gels and oils can cause build-up and skin irritation when not washed out frequently or adequately enough. You may not think of some of these as other irritating products but hair straighteners, relaxers, dyes, shampoos, and conditioners also cause scalp damage.

When the skin becomes red and/or itchy due to frequent exposure to these substances, you end up with irritant contact dermatitis.

Not to mention, some individuals are sensitive and their immune systems get triggered easily from exposure to these products, leading to allergic contact dermatitis.


Dry, flaking skin on the scalp due to:

  • poor scalp hygiene
  • hair care products
  • general dry scalp
  • fungal (ringworm) infections
  • psoriasis
  • eczema
  • seborrheic dermatitis


Age, dry climates, washing the hair too frequently, and overuse of harsh hair care products that strip the scalp of its natural oils, are culprits. Moreover, some people are more prone to dry skin than others. Climatic changes also need to be taken into account (dry air, colder regions, or constant changing of weather). Skin diseases like psoriasis and eczema, cause excessive dryness of the skin too.

*Just like how dry mouth in the elderly cultures a perfect environment for bacterial growth while sleeping, dryness of the skin increases the chances of secondary infections arising on the scalp, as it harbors a suitable environment for bacteria development too.


This is when pores on the scalp/follicles becoming blocked with excess oil/sebum, causing pimples on the scalp. Causes include:

  • Oily scalp, either from natural oils not washed off often enough or oily, synthetic hair products
  • Hormonal changes
  • Medication
  • Hot and humid environments
  • Air/water pollution
  • Genetics
  • Psychological stress

*Contrary to common misconception, acne on any part of the body is not caused by oily foods or chocolate


Folliculitis is an infection of the follicles with bacteria. It is more likely to occur in a person who shaves the hair on the head and partakes in communal bathing like in hot tubs hence the common name: hot tub folliculitis. Folliculitis appears as small white to yellow pus-filled pimples, which initially start as tiny red eruptions. If the condition is severe and left untreated for long periods of time, it can lead to significant scarring: Keloid scarring.


Skin condition where the cells rapidly grow causing thickened plaques of dry, scaly skin. It is believed that scalp psoriasis is due to the immune cells targeting the skin. Psoriasis is a chronic condition (treatable but not curable) that goes into periods of remission but recurs thereafter within months or years.


Scalp ringworm is a fungal infection of the scalp. One type of fungi known as dermatophytes causes a round ring-like rash hence the term ringworm. This type of fungal infection on the scalp is known as tinea capitis. Other types of fungi known as yeasts also cause a ringworm infection of the scalp.


Head lice are a type of parasite that infests the scalp. These types of infestations are more common in children as the lice tends to spread aggressively within highly populated environments like day care centers and schools. Lice cause intense itching and a tickling sensation on the scalp. The rash they cause, appear as reddish bumps and sores on the scalp.

Seborrheic Dermatitis

Seborrheic dermatitis is an inflammatory skin disease of the oily areas of the body. The skin becomes scaly and greasy and eventually peels away to expose the underlying reddish skin.  The exact cause of seborrheic dermatitis has not been conclusively identified but it is believed to be an immune mediated reaction to the presence of the normal skin flora – bacteria and fungi that live on the skin without causing any disease. Another form of seborrheic dermatitis that is seen on the scalp of newborns where it is known as cradle cap.

Treatment of Scalp Problems

The causative condition should first be diagnosed by skin professional, and then the appropriate treatment should be provided. Sometimes simple lifestyle measures are sufficient to ease the symptoms and possibly resolve the condition when it is related to poor scalp hygiene and irritation from the use of hair care products. Examples:

  • Washing hair at least every second day
  • Using mild shampoos and conditioners, such as baby shampoo
  • Avoid or minimize the use of harsh products. Hair dyes are among the hardest on the scalp.
  • Refrain from excessive scarf or hat use, as they trap and spread local bacteria

*Some skin diseases require medicated shampoos, creams and ointments or oral medication

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