I often hear from people who are shedding quite dramatically or have noticed that their hair is thinning. Often, scalp issues accompany this. People often describe the scalp that accompanies their dramatic hair loss as red or pink, inflamed, itchy, sore, or painful. I often hear folks describe their scalp in this scenario as “angry.”
But, often they aren’t sure if they should try to treat and address the scalp in the hopes that it will help with their hair loss, or, alternatively, if they should address the hair loss and hope that this helps their scalp. In truth, both strategies can work since often, the two are most definitely related. I will discuss this more in the following article.
Conditions Where The Shedding Or Hair Loss Could Be Causing The Scalp Issues: Sometimes, when you have conditions that cause very drastic and dramatic shedding, the result is severe inflammation and irritation. What you have are a lot of hair follicles going from the growing to the shedding / resting phase all at once. Whereas you would normally have 5 -10% of your hairs switching between the two, with conditions like telogen effluvium (TE) or alopecia areata (AA,) you can have as much as 25% (and sometimes much more) of your follicles changing. As this is happening, it can cause tightness, pain, irritation, and even burning. I’ve also heard of people having bumps or little pimples.
Generally there are two terms that you might hear related to this sort of scalp discomfort. The first is “burning scalp syndrome” and the second is “substance P.” Specialists will generally refer to “burning scalp syndrome” when a patient has severe scalp discomfort that is sometimes (but not always) related to their hair loss. The reasons behind this are not agreed upon. Some think there is a psychological competent and others believe that the cause is a substance that is released during this process called “substance P.” (I lean more toward substance P because nothing made me angrier than being told my hair loss or pain was “all in my head.”)
But even without the semantics, the scalp condition can be quite painful and the hair loss is of course not the result that you want. And whatever the cause, you just want it to stop. Addressing the inflammation directly can often provide some relief. Tea tree oil, emu oil, and aloe can all be quite soothing if you are looking for natural substances. There are also prescription anti inflammatories. And, dandruff type shampoos can help to combat inflammation also, but be careful to avoid products that are too harsh as you’re basically dealing with wounded skin. Also, you want to rotate and dilute your treatments and not use anything which could clog the follicles.
The itching will generally come when the regrowth starts. Tea tree helps with this as well as some over the counter topicals meant to combat itching.
Conditions Where The Scalp Issue Comes Before (And Can Cause) The Hair Or Thinning Issues: Sometimes, what you’re dealing with is an injury or infection to the scalp that came before the hair loss started. Examples are bacterial infections, ringworm, yeast overgrown, and AGA (androgenic alopecia.) With all of these instances, something is irritating the scalp, severe inflammation is happening, and this is in turn affecting the follicles and causing the hair loss.
Lessening the inflammation is important here too. But, you’ll also need to treat whatever is irritating the scalp. Because if you don’t the cycle could keep right on happening. For example, with AGA, you will usually need to address the androgens that are continuing to compromise the scalp and the follicles. Sometimes, successfully treating the scalp will greatly help with the hair loss. And other times, with conditions like AGA, it’s an ongoing battle which is aided by early and appropriate treatment.
Whatever the cause of your scalp and hair loss issues, you don’t have to just suffer through it. I know that it can be very painful and worrisome. And I know it’s frustrating when people insinuate that you are worrying too much and overreacting. At the very least, consider taking action to combat the inflammation and to get your scalp as healthy as possible so that it can support healthy regrowth.