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Scalp Problems

Overview

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 aren't caused by serious medical problems.

Hair loss

Hair loss, including thinning and breaking, is the most common scalp problem. Most people lose from 50 to 100 hairs a day.

Hair gradually thins as people age. But 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 they stop breastfeeding.

Other possible causes for excessive hair loss, thinning, or breakage include:

  • Damage to the hair from hair care products. These products include dyes, permanents, hot rollers, curling irons, and hair dryers.
  • Hair-pulling or hair-twisting habits. Trichotillomania is a mental health problem in which a person pulls out their own hair, usually from the head, eyelashes, and eyebrows.
  • Side effects of medicines or medical treatments, such as chemotherapy or radiation therapy.
  • 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 lupus and hyperthyroidism.
  • 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

Itching, flaking, or crusting of the scalp may be caused by:

  • Cradle cap, an oily, yellow crusting on a baby's scalp. It's common in babies. It's not caused by an illness. And it doesn't mean that a baby isn't being well cared for.
  • Dandruff. This is 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. These are tiny wingless insects that cause itching and raw patches on the scalp. Head lice are most common in school-age children.
  • Ringworm. This is 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 look like worms. The rash spreads from these edges, often leaving the center clear, so the rash has a ring shape.
  • Ongoing (chronic) skin conditions, such as psoriasis and seborrhea.
  • An uncommon, recurrent skin condition called lichen planus. This condition appears more often during stress, fatigue, or exposure to medicines or chemicals.

Sores, blisters, or bumps on the scalp

Painful sores, blisters, or bumps that form on the scalp may be caused by:

Skin cancer can occur on the scalp, most often 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 doesn't heal, or irritation of the skin. The three most common types of skin cancer are basal cell skin cancer, squamous cell skin cancer, and melanoma.

Treatment

The treatment for scalp problems depends on what is causing the problem.

Health Tools

Health Tools help you make wise health decisions or take action to improve your health.

Actionsets are designed to help people take an active role in managing a health condition.

Check Your Symptoms

Do you have a scalp problem?
This also includes hair loss.
Yes
Scalp problem
No
Scalp problem
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Do you have a rash?
Yes
Rash
No
Rash
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have a health problem or take medicine that weakens your immune system?
What weakens the immune system in an adult or older child may be different than in a young child or baby.
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Do you have a painful rash or painful blisters on your scalp?
Yes
Painful rash or blisters on scalp
No
Painful rash or blisters on scalp
Does your scalp itch; have red, flaky areas; or have crusty, oozing sores?
Yes
Scalp is itchy or flaky or has crusty sores
No
Scalp is itchy or flaky or has crusty sores
Is the itching and flaking severe, moderate, or mild?
Severe means that it is bad enough to interfere with sleep and your normal activities.
Severe
Severe itching or flaking
Moderate
Moderate itching or flaking
Mild
Mild itching or flaking
Have you tried home treatment for more than 2 days?
Yes
Home treatment for more than 2 days
No
Home treatment for more than 2 days
Is it helping?
Yes
Home treatment is helping
No
Home treatment is helping
Has there been a change in a mole or other skin spot?
Yes
Changes in mole or skin spot
No
Changes in mole or skin spot
Do you think that a medicine could be causing hair loss or the scalp problem?
Think about whether the problem started after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing scalp problem or hair loss
No
Medicine may be causing scalp problem or hair loss
Are you concerned about hair loss or about your hair thinning or breaking?
Yes
Concern about hair loss, thinning, or breakage
No
Concern about hair loss, thinning, or breakage

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Many prescription and nonprescription medicines can cause hair loss or thinning or other scalp problems. A few examples are:

  • Medicines used to treat cancer (chemotherapy).
  • Birth control pills.
  • Seizure medicines.
  • Amphetamines, such as dextroamphetamine (for example, Dexedrine) or methamphetamine.
  • Vitamin A in high doses.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
  • Steroid medicines, which are used to treat a variety of conditions.
  • Medicines taken after organ transplant.
  • Chemotherapy and radiation therapy for cancer.
  • Not having a spleen.

A change to a mole or other skin spot can mean that the spot has:

  • Gotten bigger.
  • Developed uneven borders.
  • Gotten thicker, raised, or worn down.
  • Changed color.
  • Started to bleed easily.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.
Rash, Age 12 and Older
Rash, Age 11 and Younger

Self-Care

Here are some things you can do at home to care for some minor scalp problems.

  • Try home treatment for dandruff. For example, use an anti-dandruff shampoo if dandruff causes white flakes on your head.
  • Perform a skin self-exam to help identify suspicious scalp growths. Part your hair to look at your scalp. If you have trouble seeing your scalp, ask a friend or family member to check the spot for you.
  • If your baby has yellow crusting on his or her scalp, try home treatment for cradle cap.
    • An hour before shampooing, rub your baby's scalp with baby oil, mineral oil, or petroleum jelly to help lift the crusts and loosen scales.
    • When you're ready to shampoo, first get the scalp wet. Then gently scrub the scalp with a soft-bristle brush (a soft toothbrush works well) for a few minutes to remove the scales. You can also try to gently remove the scales with a fine-tooth comb.
    • Then wash the scalp with baby shampoo, rinse well, and gently towel dry.
  • If your baby has a bald spot at the back or side of the scalp, change your baby's position often. Lying in one position may be causing the bald spot.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • New or worse signs of infection, such as redness, warmth, swelling, pus, or a fever.
  • Symptoms occur more often or are more severe.

Learn more

Preparing For Your Appointment

Credits

Current as of: November 15, 2021

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Kathleen Romito MD - Family Medicine

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