Scalp eczema: symptoms, treatment and hair loss

What "scalp eczema" usually means

Most scalp eczema is seborrheic dermatitis, a common, long-term condition that causes greasy or dry flakes, redness and itching, often also around the eyebrows, nose and ears (NHS). It's linked to the skin's reaction to a yeast called Malassezia that lives on everyone's skin. Atopic eczema and contact dermatitis, a reaction to a product such as hair dye, can also affect the scalp (NHS).

Symptoms

• White or yellowish flakes, sometimes greasy
• Red or darker, inflamed patches
• Itching or burning
• Flares with stress, cold weather or illness

Treatment

Seborrheic dermatitis is usually controlled rather than cured. Common approaches include antifungal shampoos such as ketoconazole, and shampoos with selenium sulfide, zinc pyrithione, coal tar or salicylic acid, used regularly and left on the scalp for a few minutes before rinsing (NHS). For stronger flares, a doctor may prescribe a short course of a steroid scalp lotion or other treatment. Contact dermatitis improves when the trigger product is identified and avoided.

Does scalp eczema cause hair loss?

Scalp eczema doesn't usually cause permanent hair loss. Heavy scratching and severe inflammation can cause temporary shedding, which typically recovers once the scalp is calm. Because inflammation may worsen how the scalp looks during pattern hair loss, keeping it under control is part of good scalp care.

When to see a doctor

See a doctor or dermatologist if over-the-counter shampoos don't help after a few weeks, if the scalp is weeping, painful or bleeding, or if you notice patches of hair loss. Psoriasis, fungal infections and other conditions can look similar and need different treatment.

Related: hair care tips for thinning hair.

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