A woman is doing her hair cut at a barber store

How do you know if you have poor scalp health?


The skincare industry is booming, but many often overlook the fact that the skin on your scalp is also an essential part of the human skin, and plays a very important role in our lives.

Physically, the scalp acts as a barrier to protect our body from physical trauma and foriegn irritation such as potential microorganisms that can cause infection. Aesthetically, the scalp serves as an area where hair can grow, and also aids in heat conservation.

woman getting her hair shampoo
Photo by cottonbro on Pexels.com

The scalp skin is constantly adapting, shedding, and growing new skin cells. A healthy scalp has a normal pH of 4.5 +/- 0.5 , normal oil production and normal thickness of the epidermis and dermis layer.

For individuals with scalp troubles, the symptoms depend on the exact condition but generally include redness,  hair loss and breakages, itchiness, scaly patches, excessive oiliness, flakes, pain and bleeding.

Compared to the skin in other parts of the body, scalp skin has a greater concentration of oil glands. The main function of sebum is to protect the hair and scalp from moisture loss. However, this also creates a moist and warm environment that is prone to fungal infection.

Dandruff and seborrheic dermatitis

Dandruff on a woman's shoulder

Malassezia fungus is a normal human skin flora which thrives on areas of the skin that have more oil glands, including the face, scalp, and upper trunk. In oily scalp conditions, they can also cause or exacerbate skin diseases, such as dandruff and seborrheic dermatitis. These are not contagious but can be embarrassing.  


Finding ringworm

‘Ringworm infection of the scalp’, also called tinea capitis, is another fungal infection that usually happens amongst children, but occasionally adults get it too.

Despite its name, it has nothing to do with worms. It occurs in moist and sweaty skin that fungi thrive on.

This infection spreads easily and most people get a rash that can be painful and scaly. Sometimes, patchy hair loss, broken hairs, and black dots can also occur.


Psoriasis on a woman

Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales. The scalp skin is affected in about 50% of cases. Psoriasis is not contagious but can run in the family, and people with psoriasis have increased production of skin cells.

Skin cells are normally made and replaced every 3 to 4 weeks, but in psoriasis, this process only takes about 3 to 7 days.

The resulting build-up of skin cells is what creates the patches associated with psoriasis. It is also quite common to develop pain and swelling in the joints and connective tissue, known as psoriatic arthritis.

Contact Dermatitis

Contact dermatitis is a type of eczema triggered by contact with particular substances. Eczema is the name for a group of conditions that cause the skin to become dry and irritated. Contact dermatitis on the scalp is caused by a reaction to the chemicals in some shampoos, hair dyes and hair grooming products.

It may be that you are allergic to those ingredients or that they just irritate your skin. Some of the scalp skin irritants include metals from hair clips (nickel, cobalt), sulphates (Sodium and Ammonium Laureth Sulfate i,e. SLS and ALS), chemical fragrance mix, formaldehyde and ingredients in hair dye. Contact dermatitis usually improves or clears up if the substance causing the problem is identified and avoided. 


Folliculitis occurs due to inflammation of the hair follicle, mostly appearing like pus-containing bumps similar to acne and may feel sore on the scalp. They are usually caused by bacteria or irritation from shaving, certain hair products and sweating.

Hair loss

Regardless of the cause, hair loss can be really distressing to some. 

The causes cover a wide range, including but not limited to stress, medical conditions, medications, inflammation, hormonal abnormalities and hair fragility.

Often, it can be due to a combination of factors. Some medical conditions that can contribute to hair loss are anaemia, vitamin deficiency, abnormal thyroid function and irregular hormone levels. Besides, physical and emotional stress such as the passing on of a loved one or illness can cause massive shedding months after the incident.

A bunch of long brown hair

Let’s not forget that years of bleaching, dyeing, straightening, perming and tight hairstyles can also catch up on us.

Take home message

A healthy scalp is something that many of us often take for granted. In fact, individuals affected by scalp troubles can experience significant distress. On a brighter note, though not all are curable, most of the time the symptoms and frequency of flare-ups can be controlled.

The healthier the scalp, the healthier the hair will be.

On the whole, efforts to create a healthy scalp revolve around improving the structural and functional integrity of scalp skin and hair follicles. This can involve lifestyle changes, topical, and/or systemic treatments. If you have a scalp condition and you have concerns over your physical and mental wellbeing, consider speaking to your doctor or healthcare team. They can offer advice and further treatment if necessary.

Dr. Jia Rou
Dr. Jia Rou

Dr. Jia Rou is from Selangor, Malaysia who has completed her 2 years of compulsory postgraduate training and is currently in a specialty training programme. She has a soft spot for older patients and a meticulous love for details. She is a coffee lover and enjoys cooking.

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