Scalp Problems

Itching and dandruff of the scalp are two of the most common complaints relating to the scalp. The most likely cause is seborrheic dermatitis, or most commonly called dandruff. Cradle cap is the earliest form of this scalp condition, and is usually gone by the age of 6 months.

Seborrheic dermatitis usually appears again around puberty. Cradle cap is caused by the mother’s hormones stimulating the baby’s oil glands. At puberty the child’s own hormones are causing the oils glands to mature permanently. For those who are susceptible to this condition this can be a life long problem that tends to become less pronounced as one gets past age 50.

The most common symptoms are itching, and flaking of the scalp, eyebrows and around the nose. The ears, chest and back may also be affected. Often the main complaint is light spots on the face, especially along the frontal hair line.

In my 40 years in dermatology, I have found that stress is the number one cause of flare ups of this condition.

Treatment is usually very successful in most cases. One percent hydrocortisone is usually all that is needed to treat the face and ears. This is available without prescription. Treatment of the scalp is much more difficult and may require various treatments before one is found that is suitable for each individual. A dermatologist can best prescribe the right treatment. The use of hair products with lanolin should also be avoided. Shampoos with tar may relieve the symptoms and should be used once or more per week. Ordinary dandruff shampoos offer only temporary relief and do not treat the underlying cause.

Tinea Capitis or ringworm of the scalp is often confused with seborrheic dermatitis. Tinea Capitis is highly contagious fungal infection that children catch from other children. My experience is that children before the age of puberty do not develop seborrheic dermatitis. If they have flaking of the scalp, it is Tinea Capitis until proven otherwise. The most common signs and symptoms of Tinea Capitis are itching of the scalp, flaking, dry scaly patches scattered over the scalp, bald spots with little stubbles of hair remaining. Sores, pus bumps and thick crusted patches are signs of a more severe infection. It is very important that this condition be correctly diagnosed and treated properly. Treatment will require oral medication for 6-8 weeks. External treatment doesn’t work because the fungus is inside the hair shaft and must be attacked from within.

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