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Hair And Scalp Related Diseases

  • Seborrhoea ( dandruff)

  • Alopecia areata ( baldness)

  • Tinea capitis ( ringworm infection)

  • Canities ( graying of hair)

  • Pediculosis capitis and nits ( head lice)

  • Folliculitis


Dandruff, also known as seborrhea, is a common non-contagious condition of skin areas rich in oil glands (the face, scalp, and upper trunk), marked by flaking (overproduction of skin cells) and sometimes redness and itching (inflammation) of the scalp, varying in severity from mild flaking of the scalp to scaly, red patches. The normal skin yeast, Pityrosporum ovale, lives in oil-rich skin regions and plays a role in this condition. Dandruff may be worse with stress, winter, and infrequent shampooing.


Idiopathic Cause. It may be related to:

  • A yeast (fungus) called malassezia that is in the oil secretion on the skin

  • An irregular response of the immune system

  • Mental Stress

  • Age (during puberty)

  • Not regularly brushing hair

Signs And Symptoms

  • The scalp is itchy and flakey.

  • One or more of the following areas may have patches of red, scaly skin: the scalp, hairline, forehead, eyebrows, eyelids, creases of the nose and ears, ear canals, beard areas, breastbone, midback, groin, or armpit.

  • In darker skin, affected areas may look lighter in color.

  1. Mild dandruff – only some flaking with or without redness in a few small areas.

  2. Moderate dandruff – several areas affected with bothersome redness and itch.

  3. Severe dandruff – large areas of redness, severe itch, and unresponsive to self-care measures.

Alopecia Areata

Alopecia areata is an autoimmune condition resulting in hair loss. The immune system of the body mistakenly stops hair growth for unknown reasons. Hair loss may be patchy or sparse and may involve the rest of the body in addition to the scalp. Hair in most people spontaneously regrows, though recurrences of the condition are also typical. Genetic and environmental factors play a role in hair loss; the condition may be seasonal as well.

Risk Factors

Hair loss can occur in people of all ages. The most frequent association is with thyroid disease, although hair loss can be found in those with the following conditions:

  • Lichen planus

  • Vitiligo

  • Down syndrome

  • Lupus

Signs And Symptoms

Hair loss most commonly occurs on the scalp, but it can also target the eyebrows, eyelashes, beard, and other body sites. Symptoms may include the following:

  • Round, patchy areas of non-scarring hair loss, ranging from mild to severe

  1. Mild: 1–5 scattered areas of hair loss on the scalp and beard.

  2. Moderate: More than 5 scattered areas of hair loss on the scalp and beard.

  3. Severe: loss of all of the hair on the scalp and body

  • Scalp burning (without redness), accompanying lesions

  • Pitting and ridging of the fingernails

Hairs that do grow back often lack color, or may be either temporarily or permanently white. This hypopigmentation is not seen in other forms of alopecia.

Tinea Capitis

Tinea capitis is the medical term for ringworm, a very common fungal infection, of the scalp. Despite the name, there are no worms involved in scalp ringworm, rather the rash forms a scaly, round patch that sometimes clears or improves in the middle, thus looking like a ring. Ringworm can occur on other parts of the body, but scalp ringworm is commonly seen in children. It is contagious and is acquired by contact with infected people, animals, or objects (such as towels, combs, and pillows). Scalp ringworm should be treated (by a prescription medicine your doctor can prescribe) because it is contagious and because, if left untreated, the affected area can develop hair loss and sometimes another, more serious, infection called a kerion.

Signs And Symptoms

The most common locations for scalp ringworm include:

  • Scalp

  • Eyebrow (rare)

  • Eyelash (very rare)

Scalp ringworm appears as one or more round to oval areas covered with gray scale and is often associated with hair loss. The patches may be red and inflamed, and small pus-filled bumps (pustules) may sometimes be found. Also seen on the surface of the scalp may be tiny black dots, which represent broken hairs.

The lymph nodes at the back of the scalp, behind the ears, or along the sides of the neck may be swollen.

One complication of scalp ringworm is a kerion, a large, oozing, pus-filled lump. If not treated aggressively, a kerion can lead to scarring and permanent hair loss.

Scalp ringworm is usually itchy.


Premature greying of hair, also known as canities, can have a negative effects on appearance, confidence, self-esteem, and social acceptance of the affected individual. Hair is said to have greyed prematurely if it occurs before the age of 20 years in Whites, before 25 years in Asians, and before 30 years in Africans.


Cause of greying is incompletely understood. It is a complex multi-factorial process mainly considered to be an interplay of nutritional, genetic and environmental factors. Nutritional deficiencies like vitamin B12 deficiency, severe iron deficiency, chronic protein loss, copper deficiency are often found associated with premature greying of hairs. Other factors that have been incriminated are low serum ferritin, and low serum calcium and vitamin D3 levels.

Premature greying of hair has been observed with greater frequency among certain families, suggesting a familial predisposition for the condition. As hair pigmentation is a result of complex interaction between various genetic factors.

Smoking is another factor that is considered to be related to premature greying of hair. Smoking results in generation of huge amount of reactive oxygen species leading to increased oxidative stress culminating into damage to melanin producing cells, melanocytes. Prolonged exposure to ultraviolet rays is considered to initiate similar processes in hair folliclesresulting in premature greying of hair.

Pediculosis Capitis And Nits ( Head Lice)

Head lice (pediculosis capitis) are highly contagious, and the most prominent symptom of a head lice infestation includes intense scalp itching.

The human head louse is a tiny insect that feeds on human blood. The female louse lays eggs (nits) on the hair shaft close to the scalp, and they become glued to the hair shaft. The nits hatch about 8–10 days later and begin to feed with any remaining adults. The nits can stay alive for a long period of time off of the body, such as on hairbrushes, furniture, or linens.


Head lice occur in people of all ages and races. Males are affected somewhat less than females. Children are most likely to become affected by a head lice infestation, and epidemics can occur in schools, day cares, and nurseries, but adults may become infected, most often through contact with infected children. Nursing home epidemics have also occurred.

Signs And Symptoms

The most common locations for head lice infestations include:

  • Scalp, especially the hairline near the neck

  • Behind the ears

  • Neck

Moving lice or non-moving nits may be seen on the scalp and hair. Each louse is approximately 1–2 mm long and is white-gray in color. The white nits are smaller (0.5 mm), are firmly attached to the hair shaft, and are usually located very close to the scalp. In longer-standing infestations, the nits may be farther away from the scalp. In addition, small, red bumps may be seen on the scalp, neck, and shoulders. If scratched aggressively, these bumps may become scabbed.


Folliculitis is a skin condition caused by an inflammation of one or more hair follicles in a limited area. It typically occurs in areas of irritation, such as sites of shaving, skin friction, or rubbing from clothes. In most cases of folliculitis, the inflamed follicles are infected with bacteria, especially with Staphylococcus organisms, that normally live on the skin.


The most common factors that contribute to the development of folliculitis include:

  • Irritation from shaving

  • Friction from tight clothing

  • A pre-existing skin condition, such as eczema, acne, or another dermatitis (inflammation of the skin)

  • Injuries to the skin, such as abrasions

  • Extended contact from plastic bandages or adhesive tape.

Signs And Symptoms

The most common locations for folliculitis include:

  • Scalp

  • Beard area in men

  • Underarms, groin, or legs in women

  • Buttocks

  • Thighs

Individual lesions of folliculitis include pus-filled bumps (pustules) centered on hair follicles. These pus-filled bumps may be pierced by an ingrown hair, can vary in size from 2–5 mm, and are often surrounded by a rim of pink to red, inflamed skin. Occasionally, a folliculitis lesion can erupt to form a scab on the surface of the skin.

Mild and moderate cases of folliculitis are often tender or itchy. More severe cases of folliculitis, which may be deeper and may affect the entire hair follicle, may be painful.

Mild and moderate cases of folliculitis usually clear quickly with treatment and leave no scars. However, more severe cases of folliculitis may lead to complications, such as cellulitis (an infection of the deeper skin tissue), scarring, or permanent hair loss.

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