About the Procedure
Humans lose around 100 hairs every day. For most people, this doesn’t become a problem because other hair follicles are entering the hair growth phase and growing new hair. Hair loss occurs when follicles begin to spend more time in the resting phase or become fully dormant. Other scalp issues can affect the hair, as well, including dandruff and scalp psoriasis. Dr. Shah and dermatology providers at Signature Plastic Surgery and Dermatology can help with your hair loss issues.
What is scalp psoriasis?
Scalp psoriasis is simply psoriasis that affects the scalp. About half of the 7.5 million Americans with psoriasis also have it on their scalp. Like psoriasis anywhere on the body, scalp psoriasis creates raised, reddish, scaly patches of skin. It can develop in patches or across the entire scalp. It can spread down the back of the neck and behind or inside the ears.
What causes scalp psoriasis?
As with the other forms of psoriasis, the cause is unknown. It is an immune system reaction that causes skin inflammation. Research has shown that people with psoriasis have an incorrect response from their immune system. This causes skin cells to grow too quickly, with dead cells building up into patches. Scalp psoriasis has a genetic predisposition.
What are the symptoms of scalp psoriasis?
The form of psoriasis can be mild and virtually unnoticeable. But in severe cases, it causes thick, crusted sores. These can itch intensely and affect sleep and everyday life. Outbreaks can endure. Although the condition itself does not cause hair loss, scratching can lead to skin infections and hair loss. The stress that accompanies the condition can also contribute to hair loss. These are the general symptoms:
- Scaly, red, bumpy patches
- Dandruff-like flaking
- Silvery-white scales
- Dry scalp
- Burning or soreness
- Hair loss
How can a dermatologist treat scalp psoriasis?
Although there is no cure for psoriasis of any kind, our dermatologist can help you manage your scalp psoriasis. While there are over-the-counter options, dermatology providers at Signature Plastic Surgery and Dermatology can provide much stronger prescription products.
Is there a cure for scalp psoriasis?
There is no cure for any form of psoriasis. However, our providers with expertise with dermatology can help you manage your condition as well as possible.
What is dandruff?
Dandruff is a chronic scalp condition where the skin of the scalp flakes. Dandruff is not contagious and it is not a sign of another condition. It can be managed.
What causes dandruff?
There are various potential causes of dandruff.
- Irritated, oily skin (seborrheic dermatitis) — This is one of the most frequent causes of dandruff, where red, greasy skin is covered with flaky white or yellow scales.
- Infrequent shampooing — If the hair isn’t washed frequently, oils and skin cells on the scalp build-up, causing dandruff.
- Malassezia — This yeast-like fungus lives on the scalps of most people, but in some cases, it irritates the scalp and causes more skin cells to grow. These extra cells die and fall off.
- Dry skin — Unlike the larger, oilier scales with the above causes of dandruff, having a dry scalp usually creates smaller flakes. People with this type of dandruff usually have dry skin on other areas of the body, too.
- Contact dermatitis — Using certain hair care products or dyes can cause an allergic reaction, contact dermatitis, that creates red, itchy, scaly areas on the scalp.
What are the symptoms of dandruff?
Symptoms are easy to spot: white, oily-looking flakes of dead skin on the hair and shoulders. Some people also have an itchy, scaly scalp. For many people with dandruff, indoor heating exacerbates the problem during winter and it improves during the spring and summer.
How can a dermatologist treat dandruff?
While most cases of dandruff respond well to dandruff shampoo, dermatology providers can provide additional treatments when this isn’t enough. This is especially the case if your dandruff is due to seborrheic dermatitis, psoriasis, fungal infections, or eczema.
What is alopecia?
Alopecia simply means hair loss, either partial or complete. It has various causes and can usually be improved. If treatments to return hair follicles to the growth phase don’t work, Dr. Shah also offers hair transplantation for his patients.
What causes alopecia?
There are different causes for hair loss. Each has a different definition.
- Androgenic alopecia — This is male or female pattern baldness. It is the most common form and is hereditary.
- Telogen effluvium — This is sudden hair loss that is usually linked to trauma or shock. It can occur in women after childbirth. This is temporary.
- Anagen effluvium — Hair loss associated with chemotherapy.
- Alopecia areata — This form of alopecia occurs when your body’s immune system attacks the hair follicles. It creates patchy hair loss.
- Alopecia totalis — This is total loss of scalp hair. Like areata, totalis is also caused by immune system attack.
- Scarring alopecia — In this rare form, scar tissue replaces hair follicles so the hair lost cannot grow back.
What are the early signs of alopecia?
It’s important to catch alopecia/hair loss in the early stages because hair follicles that have only recently become dormant have a much better chance of returning to growth phase. These are some signs:
- Gradual thinning on the top of the head. Men tend to lose hair as it recedes from the forehead. Women retain their hairline, but their part broadens.
- Circular or patchy bald spots. These are coin-sized balding spots. The skin may become itchy or painful before the hair falls out.
- Sudden loosening of hair. This is usually a response to emotional shock. Handfuls of hair may come out with combing or washing your hair.
- Full-body hair loss. This is usually a response to medical treatments. The hair will usually return back.
How can a dermatologist treat alopecia?
Hair loss can be effectively treated, or at least slowed. It’s important to see dermatology providers at Signature Plastic Surgery and Dermatology when you see early signs of hair thinning.
If immune system attacks are behind your hair loss, such as with alopecia areata, she can prescribe drugs that reduce inflammation and suppress your immune system. She may also recommend changing medications that may cause hair loss.
Finasteride is an FDA-approved prescription drug (brand named Propecia) for men. It has shown success in re-starting hair growth in some men, or at least for slowing hair thinning.
- Hair transplantation
Dr. Shah offers both follicular unit extraction (FUE), where individual hair follicles are harvested from healthy growing areas (usually the back of the scalp) and are transplanted back to the thinning areas, follicle by follicle.
He also uses follicular unit strip surgery (FUSS), where an entire strip of healthy growing hair is removed from the back of the scalp and is transplanted to balding areas. Both of these procedures have proven effective for reversing hair loss.
Can alopecia be cured, and can my hair grow back?
Some forms of alopecia, such as telogen effluvium caused by stress or trauma, tend to reverse with time, in this case as the trauma is overcome and dealt with. The same is true with alopecia areata, if drugs can return the immune system to normal function so that it stops attacking the hair follicles. Other forms, such as androgenic alopecia, don’t have a cure. In these cases, Dr. Shah can use FUE or FUSS therapy to replace the hair follicles that have become fully dormant.