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
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
- Damage to the hair from hair care products,
such as dyes and permanents, and from hot rollers, curling irons, or hair
- 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
- 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
- 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
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
- Ringworm, a fungal 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
- Ongoing (chronic) skin conditions, such as
- An uncommon, recurrent skin
lichen planus. This condition appears more often
during stress, fatigue, or exposure to medicines or chemicals.
Sores, blisters, or bumps on the scalp
blisters, or bumps that develop on the scalp may be caused by:
- Infection of the hair shafts (folliculitis) or the skin (such as
- An allergic skin reaction
- Viral infections,
- A skin condition, such as
- 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
The treatment for scalp problems depends on
what is causing the problem.
Check your symptoms to decide if and when
you should see a doctor.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
H. Michael O'Connor, MD - Emergency Medicine
December 12, 2012
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