Scalp Problems and Treatments

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Scalp Problems  and Treatments

The soft tissue envelope of the cranial vault is called the scalp. The scalp extends from the external occipital protuberance and superior nuchal lines to the supraorbital margins.

The scalp consists of 5 layers:
  • The skin
  • Connective tissue
  • Epicranial aponeurosis
  • Loose areolar tissue
  • Pericranium
The first 3 layers are bound together as a single unit. This single unit can move along the loose areolar tissue over the pericranium, which is adherent to the calvarium.1

The scalp plays a key role in the aesthetics of the face. Androgenic alopecia, or male pattern hair loss, is a frequent cause of concern and apprehension to men. It may be treated by medication or hair transplantation with variable success.

Scalp conditions that may cause itching or flaking:
  • Dandruff -- A common problem due to the excessive shedding of dead skin cells from the scalp. It causes a shedding of the skin on the scalp that leaves white flakes usually on the head, neck, and shoulders.
  • Head lice - these are parasitic wingless insects. They live on the scalp and feed on the blood. An adult is called a louse and is about the size of a sesame seed. The eggs, called nits, are even smaller - almost like a dandruff flake. Head lice are very contagious. Close contact or sharing personal belongings, such as hats or combs puts people at risk. Personal hygiene has nothing to do with getting head lice. The most essential step in treating head lice is to treat the person and other family members with medicine to kill the lice
  • Trichodynia -- a condition where the patient experiences a painful sensation on their scalp. The pain sometimes is described as burning. Trichodynia often is associated with hair loss; often there is an underlying psychosomatic cause, such as stress, depression or anxiety.
Only a few studies have been conducted on this condition. A theory behind the condition is that nerves innervating scalp hair follicles send pain messages back to the brain when the follicle no longer has a hair in it, in a similar way to phantom limb pain. A possible treatment is to halt hair loss in the patient.
  • Ringworm – an infection of the outer hair of the scalp and hair characterized by a reddish to brownish raised or bumpy patch of skin that may be lighter in the center, giving the appearance of a “ring.” Contrary to its name, ringworm is not caused by a worm but by parasitic fungi.
  • Psoriasis – is a noncontagious, lifelong skin disease. The most common form, plaque psoriasis, appears as raised, red patches covered with a silvery white buildup of dead skin cells, called scale.

    Scalp psoriasis is very common. In fact, at least half of all people who have psoriasis have it on their scalp. As with psoriasis elsewhere on the body, skin cells grow too quickly on the scalp and cause red lesions covered with scale to appear. Scalp psoriasis can be very mild, with slight, fine scaling. It can also be very severe with thick, crusted plaques covering the entire scalp, which commonly can cause hair loss. Psoriasis can extend beyond the hairline onto the forehead, the back of the neck and around the ears (a common area). Most of the time, people with scalp psoriasis have psoriasis on other parts of their body as well. But for some, the scalp is the only affected area.
  • Eczema – this is broadly applied to a range of persistent skin conditions that include dryness and recurring skin rashes which are characterized by any one or more of these symptoms: redness, skin edema or swelling, itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding.
There are several types of eczemas. The most common are:
  1. Atopic eczema (or infantile edeman, flexural edema, atopic dermatitis).
    This is believed to have a hereditary component, and often runs in families whose members also have hay fever and asthma. Itchy rash is predominantly found on head and scalp, neck, inside of elbows, behind knees, and buttocks.
  2. Contact dermatitis
    Allergic dermatitis - resulting from a delayed reaction to some allergen
    Irritant dermatitis - resulting from direct reaction to a solvent.
    About three quarters of cases of contact eczema are of the irritant type, which is the most common occupational skin disease. Contact eczema is curable provided the offending substance can be avoided, and its traces removed from one’s        environment.
  3. Xerotic eczema (or asteatotic eczema, winter itch, pruritus hiemalis) is dry skin that becomes so serious it turns into eczema. It worsens in dry winter weather. This disorder is very common among the older population.
  4.  Seborrhoeic dermatitis (or cradle cap in infants} causes dry or greasy scaling of the scalp and eyebrows. Scaly pimples and red patches sometimes appear in various adjacent places. In newborns it causes a thick, yellow crusty scalp rash called cradle cap that seems related to lack of biotin, and is often curable.
  5. Scalp Folliculitis – commonly called hot tub folliculitis and barber's itch. It is an inflammatory disorder of the hair follicles in the scalp. The condition is also medically known as ‘acne necrotica miliaris’ or ‘Proprionibacterium’ folliculitis. Folliculitis is an infection of the hair follicles and severe cases may cause permanent hair loss and scarring, and even mild folliculitis can be uncomfortable and embarrassing. Folliculitis usually appears as small, white-headed pimples around one or more hair follicles — the tiny pockets from which each hair grows. Most infections are superficial, and they may itch, but on occasion they're painful. Superficial folliculitis often clears by itself in a few days, but deep or recurring folliculitis may need medical treatment.
  6. Lichen planus – is an inflammatory disease that presents itself in the form of lesions, papules, or rashes. Lichen planus isn't an infectious disease and isn't contagious but it can be persistent, lasting for several months or even years. Lichen planopilaris is the specific name given to lichen planus on the scalp that may cause permanent, scarring alopecia. If left untreated the scarring will cause permanent hair loss.
  7. 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. Dermatophytes can be found in humans, other animals (most commonly household pets such as cats, dogs, and farm animals such as cattle), and soil. Fungal spores can be transmitted through contact with an infected person, fallen infected hairs, or fomites, which are contaminated objects. These may include objects such as barbershop instruments, hats, movie theater seats, hairbrushes, bedding, and clothing.

Management of scalp problems:

Before looking into the medical causes of scalp problems, first be sure that your hair is clean. Oftentimes, a build-up of oils or dirt can clog up pores and make your scalp feel itchy. Every so often, a good shampoo is the best cure for an itchy scalp. Use a shampoo with a pH between 4.5 and 5.5 to keep your scalp balanced and moisturized.

You must also consider your hair products. A new product may have irritated your scalp or your scalp may have developed a reaction to an old product. Check for other chemicals or substances that you may have used. Hair dyes, hair gels, and chemicals used in perms can irritate the scalp. Exposure of the scalp to several chemicals may trigger an allergic reaction, causing inflammation and itching. See whether you have white flakes in your hair or your shoulders. Dandruff is a may cause of scalp itchiness. Every so often, an itchy scalp may be caused by excessive exposure to the sun. This type of itchiness resolves once your skin recovers. Find out whether you have lice. If your itchy scalp persists for more than a few days, check your hair for white or grayish eggs that can reveal lice. The eggs appear like dandruff, but they are attached to individual hairs and do not move when you touch them. Lice infestation should be treated immediately with prescription and over-the-counter shampoos to avoid passing it over to other family members.

Ringworm of the scalp can sometimes heal without treatment, but consulting a doctor is advised. To ensure timely management of the infection, it must be treated with a course of oral antifungal medications. Shampoo with selenium sulfide (2.5%) or zinc pyrithione (1-2%) used 2-3 times weekly at home can help decrease shedding of spores and should be used together with the oral medications. Oral steroids can also be added for severe inflammatory types of scalp ringworm.

Several treatments are presently available for psoriasis. Topical treatments are typically the first line of defense in treating psoriasis. These may be purchased over the counter or may be available by prescription only. Recently, it has been found that people with psoriasis who have tried using NISIM products to treat their condition and have gotten promising results. Because one goal in treating psoriasis is to help the scalp recover its natural balance, it is best to use natural and organic products. The combination of herbs, amino acids, and vitamins in Nisim Shampoo has been found to gently and evenly regulate and balance the conditions in the scalp.

Eczema is best managed by using only mild liquid cleansers that will gently remove dirt, excess oil, bacteria and cosmetics without damaging the skin. Only shampoos and hair products that are created and tested to be safe are recommended for use. The entire product line of NISIM formulated to be safe for all types of hair and color and chemically treated hair. All active ingredients are herbal and organic origin and completely drug-free. The goal of therapy is to control the signs and symptoms, control the inflammation and itch, and realize that long-term care is required.
Dandruff is a skin disorder that results from neither too little moisture nor too much oil. It is a form of skin inflammation (dermatitis), which has no known cause. This condition can appear at any time from infancy to old age, and can come and go more or less at random. Treatment of seborrhea (dandruff) is directed at fighting the skin inflammation. This is done either directly, by using cortisone-based creams and lotions (which reduce inflammation), or by reducing the yeast that builds up on scaly areas and adds to the problem. Note, though, that dandruff is not a yeast infection.7 Dandruff is a persistent condition that can almost always be controlled, but dandruff treatment may take a little patience and determination. In general, daily cleansing with a gentle shampoo to reduce oiliness and buildup can often help. Dandruff shampoos may succeed when regular shampoos fail but dandruff shampoos aren't all the same, and you may need to experiment until you find one that works best for you. NISIM Shampoos provide a non-medicated approach that rivals the effects of the others. The deep cleansing shampoo is very effective in removing the excess dead skin cells that form the visible flakes.

The Nisim NewHair Biofactors Line of Shampoos/Conditioners/Hair and Scalp Extracts have been extremely effective in helping to address a number of skin and scalp disorders such as Psoriasis, Alopecia Areata , Dandruff/itchy scalp, and even cradle cap.
To keep the scalp healthy, it is vital to keep it clean. Products with chemicals can dry out the skin, stripping it of its natural oils and consequently cause an itchy, flaky scalp. It is recommended to try and replace your current shampoo with a natural one – one that restores the pH balance in the scalp and contains only organic and natural ingredients.
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