All disorders which lead to hair loss (and greying hair) cause inflammation, whether visible or not. Scalp inflammation symptoms include:

  • itch
  • flakes of dandruff
  • red patches
  • flakey patches
  • thick scales of scalp with embedded hairs
  • scabs

The possible causes of these symptoms are:

  • seborrhoeic dermatitis – an inflammation caused by a reaction to the fungus Malassezia. We all have this fungus on our skin but only a few of us develop the inflammation
  • psoriasis – a scaley rash that runs in families
  • tinea capitis AKA ringworm – either from pets or people. Less common and may be missed
  • the scarring alopecias. These commonly misdiagnosed conditions can present with itch and inflammation


By far the most common cause of these symptoms is seborrhoea dermatitis. Treatment involves:

  • reducing the numbers of Malassezia fungus on the scalp. This is how anti dandruff shampoos work. Active ingredients include ketoconazole (Nizoral, Sebizole), zinc pyrithione (Head and Shoulders, American Crew), selenium sulphide (Selsun) and climbazole (Clear)
  • reduce the inflammation with steroid lotions
  • use gentle detergents to reduce stress on the scalp barrier layer
  • remove scale with exfoliants like salicylic acid and coal tar
  • diet is important. Cutting down on processed carbohydrates will reduce scalp oil production and Malassezia fungal numbers

Different combinations work for different people.