Since the hair follicles are such an integral part of the scalp, it is no surprise that scalp conditions can have a serious effect on both the function of hair follicles and their viability. In fact, there are a wide range of skin and scalp conditions that can cause hair loss, either directly or indirectly.
Scalp conditions and hair loss
Scalp conditions can cause hair loss directly by compromising the blood supply to the follicles, blocking pores, or infecting the follicles themselves. There are also many scalp conditions that cause hair loss by causing itching and irritation that leads to scarring alopecia, where the follicle becomes damaged by repeated scratching of the scalp. Scarring alopecia is often permanent as the hair follicle is completely destroyed.
Autoimmune scalp conditions that cause hair loss
Autoimmune diseases occur when the body’s natural defences turn on its own cells, with white blood cells and antibodies attacking healthy tissue instead of invading pathogens. When this occurs in the scalp tissue, the hair follicles are attacked and damaged or destroyed. There are many different autoimmune scalp conditions that cause hair loss. Some of these affect the skin generally and cause hair loss when the skin on the scalp is involved:
Alopecia areata kills hair follicles in the scalp as well as other areas of the body. If this leads to total baldness, it is referred to as alopecia totalis.
Scleroderma attacks the connective tissue and manifests as puffy, itchy skin (leading to scarring alopecia as described above)
Lichen planus attacks the skin causing flat, red, itchy bumps. When this affects the scalp it is known as lichen planopilaris
Discoid lupus is a milder form of the serious autoimmune disease called lupus, which causes scaly marks on the skin and leads to hair loss
Other skin diseases that cause hair loss
Many of the common skin diseases, such as eczema, psoriasis, and dermatitis, can also lead to scalp conditions. These can cause hair loss in two ways: either temporary hair loss, due to excessive swelling, oils, or pus in the follicle area; or permanent hair loss due to severe itching leading to scarring alopecia. The main skin diseases that affect the scalp are:
Seborrheic dermatitis, known as cradle cap in infants. This condition causes excessive production of oils on the skin’s surface, clogging pores and causing redness and a scaly appearance
Psoriasis causes powdery, crusted plaques across the scalp, leading to temporary hair loss
Eczema is characterised by a build-up of red, itchy patches that can crack and ooze. An eczema-related scalp condition can cause temporary hair loss but scratching the scabs can cause permanent hair follicle damage, leading to permanent hair loss.
Many skin diseases are caused by imbalances in the body and can be controlled by simple dietary changes.
Skin infections that cause hair loss
Skin conditions of the scalp can also be caused by bacterial, fungal, or viral infections. These infections include folliculitis, which can be caused by any of the three, leading to inflammation and temporary hair loss. Folliculitis decalvans is a particularly virulent follicle infection that can present as a scalp condition. It mostly affects men, leading to baldness and scarring.
Other infections include:
Tinea capitis is a form of ringworm caused by a fungal infection; it leads to sores or lesions on the scalp that can cause temporary hair loss.
Shingles is caused by the same virus responsible for chickenpox. This can damage the scalp’s nerves and the surrounding skin.
Lichen simplex infection may be mild at first, but it sets off an itch-scratch cycle that leads to a serious scalp condition and hair loss.
Avoiding scarring alopecia
Whatever the cause of your scalp condition, it is crucial to reduce itching or to resist scratching the itch as this is what will cause most damage. Most scalp conditions will only cause temporary hair loss on their own, with normal growth returning once the problem has been treated. However, if you scratch at scabs, red skin, or lesions on the scalp, then you risk causing much more serious damage and permanent hair loss.
It is also advisable to avoid using any chemical treatments on your hair while you have a skin condition, as broken, cracked, or inflamed skin will be far more susceptible to chemical damage and hair loss will be exacerbated.
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