Scales on the Scalp With Hair Loss

Fine flakes may occur with dandruff or seborrhoeic dermatitis, while thicker plaques can occur with scalp psoriasis. Scalp ringworm may cause scale, broken hairs, tenderness or patchy loss and needs specific treatment. Hair loss can also occur from alopecia areata, pattern hair loss, telogen effluvium or traction; these conditions do not all cause visible scale. The appearance of the scalp, hair breakage, itch and timing help distinguish them.

Use a gentle shampoo and avoid scratching, tight hairstyles, harsh chemicals and picking at scale. Do not share combs, brushes, hats or pillow coverings if infection is possible. Note whether loss is patchy or diffuse, whether hairs break near the scalp, and whether there is pain, itch or contact with an affected person or animal. A clinician may inspect the scalp and arrange testing when ringworm is suspected.

Arrange prompt assessment for rapidly expanding patches, broken hairs, pus, marked tenderness, swollen neck glands, or a smooth area that becomes inflamed. Seek earlier care for a child with scalp scaling and hair loss because untreated infection can damage follicles. Review is also sensible when shedding persists or the scalp becomes painful.

Ask whether the scale looks inflammatory or infectious, whether testing is needed, which products to stop, and whether the hair loss is expected to improve after the scalp problem is treated.