Most people are extremely concerned about hair growth and growing long hair, especially in Pakistan, where I come from. Any discussion around hair growth however, needs to start from the scalp. The scalp is where the hair follicles reside, and it is where hair growth begins. Healthy hair growth requires a healthy scalp, which means that the scalp must be well-nourished and free of irritation or inflammation. An unhealthy scalp can lead to hair loss, hair thinning, and other hair and scalp problems. It can also result in weaker hair that is more prone to breakage.
Common Unhealthy Scalp Conditions & Their Causes
The scalp contains numerous hair follicles, sweat glands, and sebaceous glands. Hair follicles are responsible for producing hair, while sweat glands and sebaceous glands help to moisturise and nourish the scalp.
The scalp is also richly supplied with blood vessels and nerves, which provide nutrients and oxygen to the hair follicles and skin cells. Many different scalp conditions can affect the health of your hair and scalp leading to hair loss. Here are some of the most common scalp conditions and their causes:
Dandruff and seborrheic dermatitis
Dandruff and seborrheic dermatitis are two common, similar conditions that affect the scalp. Dandruff causes itchy, flaking skin on the scalp, but without visible inflammation. Seborrheic dermatitis is a more severe form of dandruff that can also involve other oily areas of the body such as the face, ears, back and upper chest. Seborrheic dermatitis results in itchy and scaling skin and inflammation.
The causes of dandruff and seborrheic dermatitis are not fully understood, but it is thought that both internal and external factors lead to their development. These include excessive oil or sebum production and the overgrowth of the Malassezia fungus on the skin’s surface. You may already be familiar with Malassezia if you’re aware of fungal acne or have read my blog on it. Malassezia is found on the skin of most adults and is an opportunistic pathogen; this means that it can cause problems when the right conditions arise.
Dandruff and seborrheic dermatitis can be aggravated by sensitivity to hair products, scalp hygiene, changes in the weather, hormonal changes, and stress. Seborrheic dermatitis is also associated with medical conditions including Parkinson's disease, HIV/AIDS, and depression. It can also affect infants; in infants it is known as cradle cap.
Psoriasis is an autoimmune disease that can affect the scalp and other areas of the body. It leads to scaly patches on the surface of the skin. The exact cause of psoriasis is not known, but it is believed to be an autoimmune disorder that occurs when skin cells are replaced more quickly than usual. New skin cells are produced in the deepest layer of our epidermis and gradually move up through the layers of skin until they reach the outermost level, where they die and flake off. While a single cycle of this process usually takes 28 days on average, in people with psoriasis, this cycle occurs much faster, causing immature skin to build up rapidly on the surface of the skin, leading to flaky, crusty patches covered with scales that are characteristic of psoriasis.
Researchers believe that both genetics and environmental factors play a role in the development of psoriasis, and common triggers include infections, cuts or burns, certain medications, stress, alcohol, and tobacco.
Scalp folliculitis is an infection of the hair follicles that can cause redness, inflammation, and pus-filled bumps on the scalp that look similar to an acne breakout. Over time, the bumps may get larger and more inflamed, and the infection can spread to other follicles and cause scarring or permanent hair loss if left untreated. Mild cases of scalp folliculitis often clear up on their own, but more serious or recurrent infections may require prescription medicine.
Scalp folliculitis can be caused by bacteria, fungi, viruses, or mites. The most common cause of scalp folliculitis is bacterial infection, especially infection by Staphylococcus aureus, but scalp folliculitis can also be caused by viruses, fungi, parasites, medications, or physical injury. Yeasts, especially the aforementioned Malassezia species, are also known to cause scalp folliculitis.
Alopecia is a medical condition that causes hair loss and there are several different types of alopecia. Alopecia areata is an autoimmune disorder where the immune system mistakenly attacks hair follicles, resulting in hair loss. The exact cause of alopecia areata is not fully understood, but it is believed to have a genetic component, as it often runs in families.
Alopecia areata affects around 6.8 million people in the United States and approximately 147 million people worldwide. It often starts as small patches of hair loss, but can progress to more significant areas of the scalp. In some cases, the condition can cause complete hair loss on the scalp. This is known as alopecia areata totalis. It can even cause hair loss across the entire body, which is called alopecia universalis. The bald patches are typically smooth, without any rash or redness, but some people may experience tingling, itching, or burning on their skin before hair loss occurs.
Another type of alopecia is pattern baldness. This is related to ageing, heredity, and changes in hormone levels. It is more common in men than women and can occur at any time after puberty. Unlike alopecia areata, pattern baldness typically occurs gradually and affects the hairline and crown of the scalp.
Seek medical attention if you experience unexplained hair loss, since unexplained hair loss can often be a symptom of underlying health issues. Early treatment can often help slow down or stop hair loss and even promote regrowth in some cases.
Understanding the causes of these scalp conditions can help you take steps to prevent them and maintain a healthy scalp. In the next part of this article, we’ll discuss what factors affect scalp health and give you tips on how to maintain a healthy scalp and prevent these common scalp conditions so you can maximise the potential for hair growth while minimising loss of hair from the scalp. Let’s dive right in.
How To Care For Your Scalp To To Maximise The Potential For Hair Growth & Minimise Hair Loss
What factors affect scalp health?
Several factors can affect the health of your scalp, including:
Genetics: The impact of genes on scalp health is not fully understood, but we know that they have a definite impact. Hereditary hair loss (androgenic alopecia) for instance, is caused by genes that affect how sensitive the scalp is to a hormone called dihydrotestosterone (DHT). DHT shortens the growth phase of hair and shrinks hair follicles resulting in fewer, finer hair. Other scalp conditions, including alopecia areata and psoriasis, are also believed to have a genetic component.
Hormones: As was evident from the previous point, the hair cycle and hair follicle structure are also highly affected by hormones. Oestrogen, for instance, increases the anagen (growth) phase of the hair cycle, while androgens shorten the anagen phase and increase the telogen (rest) phase, leading to hair loss. Hormonal imbalances can also lead to changes in the scalp, such as excessive oiliness and the development of conditions like seborrheic dermatitis that can also result in increased rates of hair loss.
Diet: A healthy balanced diet that is rich in nutrients is essential for optimal scalp health. Substantial weight gain or loss, fad diets, and diets that are lacking in nutrients, negatively affect scalp health and can cause hair loss. What we eat also affects our hormones and gene expression, which as we’ve already discussed, impact the health of our scalp and the rate at which our hair grows or falls out.
Hygiene and cosmetic products: Poor scalp hygiene, including infrequent shampooing, and the use of ill-formulated hair care products, can also lead to scalp conditions like dandruff and folliculitis.
Sleep: Sleep deprivation has negative impacts on all parts of our health. It can impact the rate of hair loss and also affects the production and balance of the hormones necessary for scalp health.
Stress: Lastly, chronic stress also negatively impacts every part of our physiology, including scalp health. Stress compromises our skin’s barrier function, making it easier for moisture to escape and irritants to get in. Stress also affects scalp health by directly messing with the balance of our hormones. This is also why some people notice that their scalp becomes oilier when they’re stressed. Many people also notice increased hair fall after a period of intense stress.
Addressing these factors is essential for the maintenance of a healthy scalp.
Tips for maintaining a healthy scalp & preventing common scalp conditions to maximise the potential for hair growth & minimise hair loss
Maintaining a healthy scalp requires a combination of good hygiene practices, proper nutrition, and stress management. Here are some tips for maintaining a healthy scalp and preventing common scalp conditions:
Most people believe that you shouldn’t shampoo your hair everyday. This is not true. Infrequent shampooing can cause oil, dirt, dead cells, microbes and hair care products to build up in the scalp causing itching, dandruff and other conditions, including hair loss, associated with an unhealthy scalp. Shampoo your hair every day, or every other day if you have an excessively dry scalp.
Choose a gentle, pH-balanced shampoo formulated to promote scalp health. Most shampoos on the market are overly drying. They disrupt the scalp’s skin barrier and also cause your hair to swell, leading to hair damage and breakage. We’ve formulated our Clarify & Rebalance Shampoo keeping the health of your hair and scalp in mind. You’ll notice the difference after the very first wash.
Don’t buy into popular myths (including “sulphate-free” and “paraben-free”). Parabens are some of the safest and most well-researched preservatives. They are also legal to use in the EU, which has one of the most stringent cosmetics regulatory frameworks in the world. Sulphates, on the other hand, are an entire class of ingredients with highly variable properties. Always remember that the entire formulation is essential for determining the quality of a product and how it will affect your hair and scalp.
Shampoo is meant for the scalp while conditioner is meant for the hair. Apply shampoo only on your scalp and not your hair. Apply conditioner starting from the ends of your hair and work your way up. Conditioner is not formulated to be applied to skin; avoid applying it to your scalp.
Scalp exfoliation can help to remove dead skin cells, excess oil, and product buildup from the scalp, all factors that can contribute to scalp conditions like dandruff, itching and folliculitis. Use a gentle scalp exfoliating product, like our Salicylic Acid Shampoo, which is also fantastic for dandruff, once a week to maintain a healthy scalp.
Scalp massage can help promote the flow of blood to the scalp, potentially helping to promote hair growth and reduce hair loss.
Avoid wearing tight hairstyles, as they can pull on the scalp and lead to hair breakage and in some cases, even alopecia.
Wear a hat or sunscreen when spending time outdoors. The sun doesn’t only damage exposed skin, but can also damage hair and the skin on the scalp, making it more susceptible to unhealthy scalp conditions.
Lastly, ensure that you have a healthy balanced diet, exercise regularly, manage stress well and avoid smoking, drugs and alcohol.
Following these tips can help you maintain a healthy scalp and help prevent common scalp conditions.
Treatment Options for Common Scalp Conditions
Before I round up, I’ll leave you with some treatment options for the common scalp conditions discussed previously. I’ll keep this section short and write separate blogs on the detailed causes and treatments of each one of these conditions in the weeks to come.
Dandruff and seborrheic dermatitis
Over-the-counter shampoos containing ingredients such as zinc pyrithione, salicylic acid, and selenium sulphide can help control dandruff. As always, salicylic acid is my favourite option since, in addition to controlling the over growth of microbes on the scalp, it also exfoliates the scalp, clears out clogged pores and has anti-inflammatory effects. This is also why our Salicylic Acid Shampoo is dropping soon... shhh!
On days that you don't use the medicated shampoos, our Clarify & Rebalance Shampoo is an excellent, gentle option that helps preserve the health of both your hair and your scalp.
For both these conditions, it’s also essential to avoid trigger ingredients in skincare that promote the growth of the Malassezia fungus.
Psoriasis presently has no known cure. Salicylic acid shampoos can usually help some people soften the scales that form as a result of psoriasis. However, depending on the severity of your condition, it might be a good idea to see a good dermatologist who can help you manage the condition.
Folliculitis and alopecia
While these conditions aren’t necessarily related, the treatment for both is heavily dependent on the underlying cause. Seek the help of a professional who can help diagnose what the underlying cause is and treat the condition accordingly.
If you’re taking all the right steps to care for your hair and scalp, have a good diet and are managing stress well, your scalp should stay healthy. If you still experience unhealthy scalp changes, see a dermatologist for an accurate diagnosis and treatment plan since scalp conditions, if left untreated, can worsen and lead to hair loss or other complications. As always, you can also reach out to us for a free skin and hair care consultation on our WhatsApp number: 0302-2228349.