Scalp health is directly linked to hair health. Several common scalp conditions can cause or contribute to hair shedding, follicle damage, or — in some cases — permanent scarring alopecia. Understanding these conditions helps determine the most appropriate treatment.
Seborrheic Dermatitis
Seborrheic dermatitis is one of the most common scalp conditions — a chronic inflammatory condition caused by the Malassezia yeast and an overactive sebaceous gland response. It produces flaking, oily scales and redness on the scalp.
Hair loss association: Chronic inflammation from seborrheic dermatitis can push follicles into telogen and contribute to diffuse shedding. The condition does not directly destroy follicles, so hair loss from seborrheic dermatitis alone is typically reversible when the condition is controlled.
Treatment: Anti-fungal shampoos (ketoconazole 2%, zinc pyrithione, selenium sulfide), regular scalp cleansing, and topical corticosteroids for flares.
Scalp Psoriasis
Psoriasis on the scalp produces thick, silvery plaques with associated inflammation. It can range from mild flaking at the hairline to severe, thick coverage of the entire scalp.
Hair loss association: Severe scalp psoriasis can cause temporary hair loss through mechanical damage (scratching, thick scale) and inflammation. Psoriasis does not typically cause permanent follicle damage unless extremely severe.
Treatment: Medicated shampoos (coal tar, salicylic acid), topical steroids, vitamin D analogues (calcipotriol), and biological treatments for severe cases.
Folliculitis
Folliculitis is inflammation or infection of individual hair follicles, producing pustules and red bumps on the scalp. Bacterial (usually Staphylococcus aureus) or fungal infections are the most common causes.
Hair loss association: Repeated episodes of folliculitis can damage follicles. Severe or untreated cases can lead to permanent scarring alopecia (folliculitis decalvans).
Treatment: Topical or oral antibiotics, antifungals depending on cause. Prompt treatment prevents permanent damage.
Scarring Alopecia
Unlike the above conditions, scarring alopecias permanently destroy hair follicles. Conditions include lichen planopilaris, frontal fibrosing alopecia, discoid lupus, and folliculitis decalvans. Early diagnosis and treatment (typically immunosuppressive) is essential to stop progression. Once follicles are destroyed, the loss is permanent.
Hair transplant may be considered in fully stable, burnt-out scarring alopecia where the causative process has been inactive for at least 2 years.
Scalp Conditions and Hair Transplant
Active scalp conditions must be treated and stabilised before any hair transplant procedure. Surgery into an inflamed or infected scalp carries high risk of complications and poor graft survival. Our pre-operative assessment includes evaluation of scalp health.
Concerned about a scalp condition affecting your hair? Our team will assess your scalp health as part of the consultation process and advise on treatment before any hair restoration procedure.