What it is
Medical treatment of the scalp skin itself, as distinct from the hair growing out of it: the flaking and itch of dandruff and seborrhoeic dermatitis, the thick adherent scale of scalp psoriasis, fungal infection, and the recurrent inflamed bumps that scar. What is prescribed, and in what form — shampoo, foam, oil, gel or tablet — is chosen around hair texture, washing frequency and how long the head stays covered, because a regimen that ignores those is simply not followed. Some of these conditions scar the follicle if they run untreated, which is why they are named early rather than managed as cosmetic thinning.
What this page covers
- Seborrhoeic dermatitis of the scalp and dandruff
- Scalp psoriasis, with the vehicle chosen for hair texture
- Tinea capitis (fungal scalp infection), including in children, with household screening
- Head lice
- Bacterial folliculitis, boils and abscesses of the scalp
- Acne keloidalis nuchae at the nape
- Folliculitis decalvans
- Dissecting cellulitis of the scalp
- Lichen planopilaris and frontal fibrosing alopecia
- Central centrifugal cicatricial alopecia (CCCA)
- Scalp biopsy for suspected scarring alopecia
- Scalp hyperhidrosis (excessive sweating of the scalp)
- Pilar (trichilemmal) cyst of the scalp
Honestly
In the scarring conditions the aim of treatment is to stop the inflammation, not to restore hair from areas that have already scarred — hair lost there does not come back, and that is said at the first visit rather than later. Steroid used freely on the scalp thins the skin, so it is prescribed on a defined ladder and reviewed; a sample is taken before starting long antifungal or antibiotic courses; and no laser, peel or needling is performed over a scalp that is actively infected or inflamed.