Everything You Need to Know About Scalp Health

By Dr. Kally Papantoniou

Women have always been hard on their hair. From hair dyes, and styling products to straightening and extensions, the goal of lush locks often takes a toll on our scalp. Here are some interesting facts about what’s under your hair.

1. Most women these days use multiple hair products and don’t wash their hair every day.  Is this causing more problems to scalp health? 

We are seeing more women use styling mouse, anti-frizz polish, root lifting sprays, and other hair products while skipping shampooing all together in lieu of “dry shampoo.” Dry shampoo, is a spray that absorbs excess oils on hair and is used when you don’t have time or want to wash your hair. This may not be a problem for most but for those who suffer from dandruff, scalp psoriasis, or have a greasy scalp; not washing their hair and scalp every day can definitely worsen or even cause problems. If someone has sensitive skin or an allergy to ingredients in hair products; they can develop a reaction.

2. Is it important to treat hair health and scalp issues from the inside out?  

The appearance of scalp and hair can be one of the first indicators of overall well-being and stress. When we are vitamin deficient, have hormonal imbalances, or are emotionally stressed it can manifest in the appearance of our scalp and hair. For example, hypothyroidism can present as dry brittle hair and hair thinning with a flaking scalp. Iron deficiency can also present with thinning hair. It is important to supplement your nutrition to provide the support for your hair and scalp to improve. Vitamins such as Viviscal and Biotin are very important supplements that work very well.

3. What if you had a healthy scalp and all of a sudden start to get scalp breakouts? Is this from product build-up? What causes this and what are things you can do to help with breakouts? 

Product build up can definitely cause blockage of follicles on the scalp and lead to scalp folliculitis or even seborrheic dermatitis, which appear to be red bumps that can be tender and filled with pus and light pink flaking patches respectively. Washing your scalp daily can help, and alternating shampoos is another good tip to help prevent product build up. Alternating several times per week with an anti-dandruff shampoo can also help control scalp flares. If this does not help, visit with the Dermatologist for prescription shampoo or topical medicines for better control.

4. What about itchy scalp? What can you do to help with this problem?

Scalp itch can signify several points: this could just be a mild form of seborrheic dermatitis (dandruff), could be an allergy to hair dye/shampoo/other hair product, or could even be a sign of a metabolic condition or deficiency. I once had a patient that had a very itchy scalp, and did not respond to any medicated shampoos or cortisone solutions to help stop the itching after weeks of trying, but once she restarted her iron supplementation for iron deficiency her scalp itch resolved within 1 day. Depending on the cause of itch the answer can vary greatly as seen with this woman, who had Iron deficiency. If a simple over the counter shampoo is not helping your itchy scalp, seek out a dermatology consultation for further investigation and the best recommendations.

5. Does the scalp need to be exfoliated to maintain health?

Some women may never have any need to exfoliate their scalp, and do not develop buildup or dull appearance to their hair. For those that tend to have more oily hair, and have product residue using a clarifying shampoo such as Neutrogena’s can be very helpful 1-2 times per week. Neutrogena also makes a shampoo called T-Sal, with the active ingredient salicylic acid. Salicylic acid is a mild exfoliator that works well on oily pores and follicles to break up residue and dead compact skin cells to help reduce build up. For women looking to exfoliate their scalp, I would recommend lathering with T-Sal shampoo, letting this sit for 5 minutes and then rinsing thoroughly, repeat 2-3 times per week as needed. For women being treated for seborrheic dermatitis or scalp psoriasis this can help the medications topically penetrate better into the scalp.

6. Lastly, any tips on ways one can help maintain a healthy scalp? Products they should incorporate in their weekly/daily routine? Ingredients to look for?

I would definitely recommend washing hair either daily or at least every other day, and with the more products being used daily washing is recommended.  Use a clarifying shampoo weekly to help reduce build up. Alternate shampoos, this will reduce build up in hair and on scalp and prevent a dull limp look. For hair that is more dry or brittle use shampoos that contain argan oil or Moroccan oil, if your ends are still very dry apply a small amount of coconut oil to the ends. For itchy scalp try an anti-dandruff shampoo, such as clear scalp, and try a menthol shampoo to help cool the itch, such as Head & Shoulders Refresh Menthol. For dandruff shampoo a tea tree oil shampoo may be also used on alternate days.

Dr. Kaleroy Papantoniou is a Cosmetic Dermatologist, Board Certified by the American Board of Dermatology. She specializes in Injectables, Lasers, Body Contouring, Surgical and Medical Dermatology. Dr. Papantoniou is also a clinical instructor at Mount Sinai Health Center in New York City. She applies expert techniques and the newest technologies to treat her patients. Dr. Papantoniou focuses on providing her patients with the highest level of care, with special interests in natural and healthy alternatives to treatments and disease prevention. Connect with Dr. Papantoniou  via twitter @DrPapantoniou or her website www.DrPapantoniou.com