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, 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, eczema, 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.
The treatment for scalp problems depends on what is causing the problem.
Use the Check Your Symptoms section to decide if and when you should see a doctor.
Try one of the following home treatment measures to resolve a scalp problem.
- Try home treatment for dandruff that causes white flakes on your head, neck, and shoulders.
- 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.
More suggestions can be found in the Home Treatment section of topics that may be related to scalp problems.
- For treating head lice effectively, see the topic Lice.
- For hair pulling that may be related to stress, see the topic Stress Management.
- For ringworm, see the topic Ringworm of the Scalp or Beard.
Symptoms to Watch For During Home Treatment
Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:
- Signs of a skin infection develop.
- Symptoms become more severe or frequent or do not go away.
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, hot roller, 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.
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, or a curling iron?
- Have you had a recent permanent or used a hair color product?
- Do you regularly use elastic bands, barrettes, or bobby pins?
- Questions for women:
- Are you using a hormonal birth control method?
- When was your last menstrual period?
- Has your baby stopped breast-feeding within the past 6 months?
- 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?
- Have you recently lost more than 10 lb (4.5 kg)?
- 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?
|Author||Jan Nissl, RN, BS|
|Editor||Susan Van Houten, RN, BSN, MBA|
|Associate Editor||Tracy Landauer|
|Primary Medical Reviewer||H. Michael O'Connor, MD - Emergency Medicine|
|Primary Medical Reviewer||Michael J. Sexton, MD - Pediatrics|
|Specialist Medical Reviewer||Alexander H. Murray, MD, FRCPC - Dermatology|
|Specialist Medical Reviewer||Kathleen Romito, MD - Family Medicine|
|Last Updated||June 30, 2009|