Medical Dermatology

Hair Conditions

Seborrheic Dermatitis is the primary cause of an itchy, flaky scalp, also known as dandruff. It can occur in adults as well as infants, when it is called cradle cap. In the past, overactive oil glands were believed to be responsible, but more recently this condition has been linked to a microscopic yeast. Most people have a small amount of yeast on their scalps, but in a few genetically predisposed individuals, an overgrowth of this yeast results in inflammation and itchy, red, flaky patches. This can spread to other zones of the skin including the eyebrows, ears, skin around the mouth, beard/moustache area, and even the chest and back.

Mild cases usually respond to over-the-counter dandruff shampoos. More severe cases may require prescription-strength shampoos and/or lotions. Since medicated shampoos tend to dry out hair and may interact adversely with chemically colored or treated hair, they should only be used as often as needed.

Fungus infections of the scalp, also known as ringworm, can produce itchy, flaky patches. Unlike seborrheic dermatitis, fungus infections usually cause some hair loss. There can also result in pimples and areas of pus drainage. The diagnosis can be confirmed by performing a fungus culture on a sample hair from the affected area. This condition can be treated with anti-fungal pills, and since it’s contagious, don’t share brushes, hats and pillows until treatment is completed.

Alopecia is the medical term for hair loss, which can appear in a number of versions. Alopecia areata produces bald patches of various sizes on the scalp in both men and women. The eyelashes, eyebrows or beard/moustache area can also be affected. The exact cause of this condition is unknown, although it seems to be related to over-activity of the immune system. In addition, certain people are genetically predisposed to alopecia areata. Treatment includes prescription-strength creams and sometimes injections directly into the affected areas.

Male pattern baldness, or androgenetic alopecia, is the most common type of hair loss. In men who are genetically predisposed to hair loss, the hair follicles become sensitive to the male hormone testosterone. Over years, the follicles shrink and eventually stop producing hair in response to the presence of testosterone. Minoxidil liquids such as Rogaine and Propecia pills both counteract the effect of testosterone on the follicles. This allows hair to grow thicker and stronger, and it may stimulate new hairs to grow. With both treatments, it takes at least 4-6 months and sometimes up to a year for new hair growth to be apparent. Also, if treatments stop, any new hair will fall out (although stopping treatment will not make hair fall out faster). Minoxidil is available without a prescription. Propecia is available by prescription; it is not approved for use by women with hair loss.