With what kind of scalp problems patients come more often to you as a doctor?
Most patients complain about hair loss, which may show different distribution patterns, e.g. Diffuse or spot-shaped. Causes are, for example, inflammatory diseases, also autoimmunological genesis, deficiency with iron or ferritin deficiency and naturally also hereditary hormonal. Often hair loss is accompanied by symptoms such as dandruff, itching, tension, or even pain in the area of hair roots (trichodynia). Symptoms of this kind occur mainly in the context of a desiccation period (drying-out period), which is often the result of care defects. Special shampoos can provide relief and balance the scalp. Other causes of itching are the atopic scalp eczema, the seborrhoic eczema or in rare cases also toxic contact reactions or allergies. In case of suspicion of an allergy, e.g. On hair dyes, an examination test can be carried out in our clinic. If no cause of itching or feeling of tension is found, one speaks of “Pruritus sine materia”.
How much per cent of the hair problems complain about the patients actually go back to scalp problems?
Dr. med. Anja Miesel : symptoms such as itching, tingling or tension are usually accompanied by symptoms of inflammation or dehydration of the scalp. This is due to a diminished secretion of the sebum, which leads to dry, brittle hair and dry scaly scalp. Another cause can be the hair wash with strongly drying shampoos, v.a. If the subject himself tends to dry scalp under an atopic predisposition. Hair loss is only caused in exceptional cases by diseases of the scalp, for example. Atopic scalpcemes or psoriasis capitis (psoriasis).
How does the scalp skin differ from the rest of the body?
The scalp is significantly thicker and richer than the skin of the rest of the body and is therefore also referred to as a “head skin guard”. Sebum and sweat glands as well as hair follicles are clearly denser with about 100,000 per head than on the rest of the skin. Especially in the summer, there is an increased tendency to sweat in this area. All these factors require a moist and warm microclimate, which provides a perfect breeding ground for bacteria and fungi. In addition, the numerous hair follicles are a kind of entry port, so that applied substances can penetrate very well into the skin. The maintenance of this body is particularly important, but at the same time particularly difficult because the dense hair is a challenge for the distribution and wash-out of a shampoo. This should have a good fat-dissolving power, but at the same time do not dry out.
Is headache a problem too? Why?
Stress in everyday life and work is increasing in our fast-moving times. Hypersensitivity and allergies associated with atopic eczema occur more frequently, so that an increase in scalp problems is also conceivable in this context. The scalp reacts particularly sensitive, so frequently symptoms such as itching occur isolated on the scalp.
Why is it so difficult to handle head skin problems?
The application and distribution of care products is particularly difficult on the scalp due to the high density of terminal hair. We apply creams or ointments with a high fat content, rehydrating ingredients or a medicinal active substance to the rest of the body’s skin when irritation, dryness or diseases occur. On the scalp, this is also not possible for cosmetic reasons, since the hair should not appear greasy. Instead, shampoos are generally used, but with an average contact time of 30 seconds (so-called “rinse-off” products) in order to have their effect. “Leave-on” products, e.g. Haaronics, on the other hand, remain on the scalp and are not washed out, so that the contact time is much longer and active substances can penetrate better into the skin.
Interview: Head skin problems from the dermatological point of view How much per cent of the head skin problems are caused by the system and how much per cent are attributable to care mistakes?
Plant-related diseases of the head can be caused by e.g. Atopic eczema or psoriasis capitis (psoriasis). Approximately a third of the patients in our hair talks suffer from constitutionally dry scalp, which is also caused by the above-mentioned diseases.
Which care problems can be behind irritated, dry, irritated scalp?
The use of a shampoos not suitable for the skin type is a common cause. Ingredients such as emulsifiers, alcohol and etc.