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Conditions of the scalp and hair can vary hugely in severity, discomfort and cosmetic effect. At OneWelbeck Skin Health & Allergy, we have highly-trained specialists to diagnose and treat a wide range of scalp and hair problems. Here we have listed some of the most common conditions and potential treatment options.

Hair loss (alopecia)

A certain amount of hair loss is very normal. However, if your hair starts to thin or you are shedding considerably, this might be an indication you need to see a dermatologist.

The medical term for hair loss is ‘alopecia’. There are various types of alopecia -which are described in the sections below. Loss of hair can either be diffuse (occurring from all over the scalp or body) or localised (occurring in one or a few sites). Alopecia might result in scarring, which then prevents regrowth.

Symptoms of alopecia can include:

  • Clumps of hair falling out resulting in patches of bald on your head, or other parts of your body.
  • Excess shedding in the bath or on the hair brush
  • Thinning so that the scalp becomes more visible
  • Recession of the hairline

What are the main causes of hair loss?

Hereditary factors: Hair loss can run in the family as the hereditary condition called male-pattern baldness or female-pattern baldness. See androgenetic alopecia below.

Hormones: hormonal changes are the most common cause of hair loss. This can happen for a variety of reasons such as pregnancy, childbirth, using birth control pills, menopause or the use of sex hormones

Medical conditions or medication: medical conditions, post pregnancy or certain medications can trigger hair loss.

Autoimmune hair loss: alopecia areata is a condition where the immune system can cause patches of hair loss by incorrectly targeting it.

Inflammation from within the body can be directed at hair follicles also causing hair loss.

What are the treatment options?

Treatment depends on correctly identifying the factors causing hair loss. Depending on the cause of your hair loss, your doctor will recommend different treatment to either to help grow back the hair that you have lost, or prevent it from getting worse. Treatments include supplements, products to be applied to the scalp, tablet medications and surgical options including hair transplantation.

Progressive thinning of the scalp hair (androgenetic alopecia)

What is androgenetic alopecia?

Androgenetic alopecia is the most common type of progressive hair loss – also referred to as male-pattern baldness, female-pattern baldness, or just common baldness. It commonly affects men earlier than women.

What causes it?

Androgenetic alopecia is caused by a combination of hereditary and hormonal factors. A hormone known as dihydrotestosterone is known to cause hair loss by inducing some changes in the hair follicles by causing them to shrink in diameter Eventually the follicles shrink completely and stop producing hair. For men the hairline recedes and/or a bald patch enlarges over the crown. In women the parting may widen and the scalp becomes more visible through the hair.

How can it be treated?

There is no current cure for androgenic alopecia, but treatment can slow the progression of the condition or induce varying degrees of regrowth. Topical and oral treatments are available, and so is surgery in some cases.

Dandruff & itchy scalp

What causes someone to have dandruff or an itchy scalp?

Dandruff is the body’s reaction to a yeast that normally lives on the skin. It is very common among adults. The body’s immune system reacts to the yeast causing inflammation, redness and itching, usually resulting white or grey flakes of skin to appear on the scalp.

Some fungal infections and inflammatory skin conditions can result in scalp flaking and itching. Inflammatory conditions include psoriasis, eczema, lichen planopilaris.

What are the treatment options available?

For seborrheoic dermatitis, shampoos, anti-inflammatory lotions and tablet treatments are available. A large number of treatment options are available for psoriasis, and eczema and are prescribed taking into account other skin sites that may be affected. Anti-inflammatory lotions and tablets are used for lichen planus.

Fungal infections (tinea capitis)

What is tinea capitis?

Tinea capitis is a medical phrase for ringworm, which specifically occurs on the head. It is a very common condition especially in children which can usually be treated with antifungal gel purchased from a pharmacy. The name ‘ringworm’ has nothing to do with worms, but is rather due to the shape of the rash, which is usually circular, though not always. Ringworm has a distinctive feature of a red or silver rash, which may be scaly, swollen or itchy. These rashes can occur anywhere on the body, including the scalp, groin arms and legs.

What are the treatment options available?

You may need to see a dermatologist if your ringworm doesn’t improve following treatment by your pharmacist or GP.

Patches of hair loss

What causes patches of hair loss?

This is often caused by a condition called alopecia areata where the immune system is overactive again the hair follicles causing them to fall out. Patches come and go and hair loss can affect any body site, commonly including the beard area in men.

Inflammatory skin and scalp conditions such as discoid lupus and lichen planus can also cause patches of hairless. The loss is often associated with inflammation of the scalp (red, tender, itchy) and the hair may not grow back without early treatment.

What treatments are available?

A large number of treatment options are available for alopecia areata and depend on the extent of hair loss. These include lotions applied to the patches, injections into the patches, light treatment, immunotherapy and tablets that suppress the immune system. New treatments are in the pipeline.

Inflammatory conditions are treated with anti-inflammatories in the forms of scalp applications, injections and tablets. An assessment of a person’s general health is also an important part of treatment

Excess shedding

What causes excess hair shedding?

This is often referred to as telogen effluvium and can be a result of general health issues, stress, nutrient deficiencies, post pregnancy and many medications.

What treatments are available?

It is important to investigate and treat the underlying cause which includes a holistic assessment of one’s health.