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Scalp problems are conditions or symptoms that affect the skin of the top of the head.

What is going on in the body?

Scalp conditions can be minor problems, such as a minor infection that may be easily treated and "cured." Or a scalp problem may be much more serious, such as a life-threatening cancer.

What are the signs and symptoms of the condition?

When a healthcare professional is evaluating a scalp problem, he or she may want to know:

• When did the problem start? How often does it occur? Is it constant or does it come and go?
• Where on the scalp is the problem located?
• Is the problem related to cold weather, stress, or smoking?
• Are there any other symptoms, such as fever, weight loss, night sweats, joint pain, shortness of breath, or a skin rash?
• Is there pain on the scalp or is it tender to the touch?
• Have there been any injuries to the scalp, such as scratches, cuts, or insect or animal bites?
• Is there any history of other illnesses or conditions?
• Does anything make the symptoms better or worse?
• What medications does the person take, if any?
• What shampoos or other hair preparations is the individual using?

What are the causes and risks of the condition?

• acne or pimples
• eczema, an itchy swelling and redness of the skin
• allergic reactions, such as to shampoos, hair sprays, or food
• hormone changes, such as diabetes, or a low thyroid hormone level known as hypothyroidism
• excessive irritation, such as shampooing too often
• trichotillomania, a condition in which a person pulls out his or her hair due to psychological problems
• anorexia nervosa, an eating disorder that causes people to not eat enough to maintain a normal weight
• dandruff
• cradle cap in infants
• psoriasis, a skin condition that causes red scaly sores
• moles, which are usually harmless, but in rare cases, can turn into melanoma, a serious skin cancer
• cancer of the skin
• ringworm, an infection of the skin caused by a fungus
• head lice
• physical or emotional stress
• pregnancy
• autoimmune disorders, in which a person's immune system attacks his or her own body. For example, the autoimmune disorder called systemic lupus erythematosus can cause hair loss.
• medications, including vitamin A, oral contraceptives, or chemotherapy
• trauma or injury, such as insect bites, cuts, or burns
• bacterial infections
• hair loss
• HIV, the virus that causes AIDS, which can cause infections and rashes

Many other conditions can also affect the scalp.

What can be done to prevent the condition?

A person should avoid using other people's brushes and hats to prevent lice and ringworm of the scalp. Many scalp problems cannot be prevented.

How is the condition diagnosed?

In some cases, the nature of the scalp problem is obvious to the healthcare professional from the history and physical exam. In other cases, further testing is needed. A complete blood count, or CBC, can help detect an infection or blood cancer. A chest x-ray can help diagnose some infections and cancers. In some cases, a biopsy of the skin may be needed. A piece of skin from the scalp is sent to the lab for testing and examination.

What are the long-term effects of the condition?

Some scalp problems may cause skin damage or permanent scarring of the skin. A person who has cancer or certain other underlying conditions may need lifelong treatment.

What are the risks to others?

Scalp problems are usually not contagious. However, if the underlying cause is an infection, the infection may be contagious.

What are the treatments for the condition?

Treatment of a scalp problem may be as simple as using a medicated shampoo. Other infections are often treated with antibiotics, either as creams that are rubbed into the scalp or pills. Special medications for hair loss, or to promote hair growth, may be advised for those who are losing hair. Pain medications may be given if the scalp problem is painful. Treatment for autoimmune disorders may include medications to reduce inflammation and immune response. Surgery, chemotherapy, or radiation therapy may be needed for cancer.

What are the side effects of the treatments?

Side effects depend on the treatments used. For example, antibiotics can cause stomach upset and allergic reactions. Surgery can be complicated by infection, bleeding, or reactions to anesthesia. Chemotherapy can cause many side effects.

What happens after treatment for the condition?

In many cases, no further measures are needed after the scalp problem is treated, because the person may be "cured." In other cases, the cause cannot be cured and the person needs further treatment.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare professional. A person with HIV may need repeated blood tests to monitor the immune system. Any medications used may also need monitoring with blood tests.