The Hair Specialists · Lincoln, Nebraska
Scalp & Hair Disorders:
Understand the Differences
From everyday dandruff to less familiar causes of hair loss, explore what different conditions mean, where products fit, and when a medical assessment matters.
Start here
Know when to get medical help
Most scalp changes are not emergencies. These situations deserve a different response from trying another cosmetic product.
Breathing or severe allergy symptoms
Call 911 in the United States for difficulty breathing, sudden swelling of the lips, tongue, or throat, or collapse after a product exposure. Do not wait for a salon appointment.
Learn more: NHS: Anaphylaxis
Fever, spreading pain, or swelling
Seek same-day medical advice for a rapidly worsening painful scalp, spreading redness or swelling, or a suspected infection with fever. A tender, boggy swelling with hair loss also needs prompt care.
Learn more: MedlinePlus / National Library of Medicine: Cellulitis · DermNet: Tinea capitis
Persistent loss or a changing lesion
New bald patches, inflamed thinning areas, possible scarring, or a changing, bleeding, or nonhealing spot deserve an examination. Do not wait months for a growth product to resolve these changes.
Learn more: DermNet: Lichen planopilaris · DermNet: Skin cancer
Similar symptoms, different processes
A scalp symptom is a clue, not a diagnosis
Itch, flakes, bumps, and thinning can overlap. These four distinctions make conversations about hair and scalp health more useful.
Skin inflammation
Conditions such as psoriasis or contact dermatitis primarily involve inflamed skin. Visible redness can be less obvious on some skin tones.
Learn more: DermNet: Scalp psoriasis · DermNet: Atopic dermatitis
Increased shedding
Increased shedding can follow an earlier trigger. This is different from a strand snapping along its length.
Learn more: DermNet: Telogen effluvium
Strand breakage
Damage to a hair shaft can leave shorter pieces. Care practices and inherited structural differences can both be relevant.
Learn more: American Academy of Dermatology: 10 hair care habits that can damage your hair · MedlinePlus Genetics / National Library of Medicine: Monilethrix
Follicle scarring
Some diseases permanently injure follicles. Timely medical care aims to limit further damage; cosmetic fullness does not establish disease control.
Learn more: DermNet: Central centrifugal cicatricial alopecia
Skin findings do not always look bright red. Inflammation may appear purple, brown, gray, darker, or lighter than nearby skin. A clinician considers texture, symptoms, and distribution as well as color. Explore hair anatomy and the growth cycle for the underlying structure.
The condition directory
Common concerns. Less familiar conditions.
Browse all 30 entries or narrow the list by category and search term. Open an entry for typical features, overlapping concerns, medical evaluation, and a useful next step. These groups organize information; they do not estimate what you have.
Showing 30 of 30 entries
Scaling & inflammation
6 entriesFlaking and itching can come from several different inflammatory conditions. Similar symptoms do not mean the same treatment will help.
Seborrheic dermatitis & dandruffRecurring scale and scalp irritation
What it is
A recurring inflammatory condition of oil-rich skin. Dandruff is the scalp-flaking form with little obvious inflammation. The condition involves the skin’s response to factors including Malassezia yeast, which normally lives on skin.
What someone may notice
Loose or greasy scale, itching, and irritated patches may involve the scalp, eyebrows, ears, or sides of the nose. Inflammation may look pink, darker, or lighter depending on skin tone. Psoriasis and contact dermatitis can overlap or look similar.
How it is evaluated and managed
A clinician usually assesses the appearance and distribution. Care may combine an antifungal shampoo with treatment for inflammation. A product that helps one person may be too drying or irritating for another.
A useful next step
Use products as labeled. If flaking persists, becomes painful, or accompanies patchy loss, seek an examination instead of repeatedly adding stronger products.
Learn more: DermNet: Seborrhoeic dermatitis
Link to this entryScalp psoriasisThickened plaques and scalp scale
What it is
An inflammatory skin disease that can produce thickened, scaly scalp plaques. Some people have scalp involvement alone; others also have changes elsewhere on the skin or nails.
What someone may notice
Plaques often have clear edges and may extend past the hairline or behind the ears. Scale can look silvery, while affected skin may appear pink, purple, or brown. Scratching and forceful scale removal can contribute to temporary hair loss.
How it is evaluated and managed
Examination helps distinguish psoriasis from seborrheic dermatitis, eczema, and fungal infection. Treatment may include scalp-specific prescription medicines and approaches that loosen scale. More extensive disease sometimes needs treatment beyond the scalp.
A useful next step
Avoid scraping plaques. Tell your clinician about nail changes or joint symptoms, and ask which formulation is practical for your hair texture and routine.
Learn more: DermNet: Scalp psoriasis
Link to this entryAllergic contact dermatitisA delayed reaction to a contact allergen
What it is
A delayed immune reaction to a substance touching the skin. Potential triggers include certain hair dyes, fragrances, preservatives, and ingredients in adhesives or other products.
What someone may notice
Itching, swelling, scaling, or weeping can develop after exposure. The hairline, ears, eyelids, or neck may be affected as well as the scalp. A product used comfortably for years can still become a problem.
How it is evaluated and managed
A dermatologist may use medical patch testing to identify a delayed contact allergy. This is different from simply trying a small amount of product at home. Irritant dermatitis and other eczema can look similar.
A useful next step
Stop using the suspected product and seek advice. Keep its full ingredient list for the appointment. Do not deliberately re-expose yourself to a product that caused a significant reaction.
Learn more: DermNet: Allergic contact dermatitis
Link to this entryIrritant contact dermatitisSkin-barrier injury and irritation
What it is
Inflammation caused when a substance or physical exposure injures the skin barrier. Unlike allergic contact dermatitis, it does not require a specific immune allergy.
What someone may notice
Burning, stinging, soreness, dryness, or cracking may follow harsh chemicals, repeated washing, friction, or an overly aggressive scalp routine. Symptoms may begin quickly or build with repeated exposure.
How it is evaluated and managed
The exposure history is important because there is no single test that proves irritant dermatitis. A clinician considers contact allergy and other causes; allergic and irritant reactions can occur together.
A useful next step
Pause the suspected irritant and avoid layering exfoliants or other harsh treatments onto sore skin. Significant burns, blistering, persistent pain, or worsening symptoms need medical attention. “Tingling” is not proof that a treatment is effective.
Learn more: DermNet: Irritant contact dermatitis
Link to this entryAtopic dermatitis / eczemaA recurring pattern of dry, itchy skin
What it is
A chronic, relapsing form of eczema involving skin-barrier and immune changes. It can involve the scalp as part of a broader pattern of dry, itchy skin.
What someone may notice
Itching, dryness, scale, and inflamed patches may fluctuate over time. Scratching can thicken or injure the skin. The distribution and appearance vary with age and skin tone; scalp flaking alone does not establish this diagnosis.
How it is evaluated and managed
A clinician considers the overall skin history, examination, and possible overlapping contact allergy. Treatment is individualized and may include barrier care and medicines to control inflammation. Persistent disease may warrant a closer review of triggers or another diagnosis.
A useful next step
Choose a gentle routine that is comfortable for your scalp, and discuss persistent symptoms with a clinician. Weeping, increasing pain, or new crusting may need assessment for a complication.
Learn more: DermNet: Atopic dermatitis
Link to this entryPityriasis amiantaceaHeavy scale that binds groups of hairs
What it is
A pattern of thick, tightly attached scalp scale that wraps around groups of hairs. The name describes how the scalp looks; it does not identify a single underlying disease.
What someone may notice
Heavy scale may bind strands into bundles. Psoriasis, seborrheic dermatitis, eczema, and scalp ringworm are among the conditions that can produce this pattern. Infection or hair loss may occur alongside it.
How it is evaluated and managed
An examination looks for the cause beneath the scale. Fungal testing or bacterial sampling may be appropriate, depending on the findings. Care addresses that cause as well as safely loosening the buildup.
A useful next step
Do not rip or scrape firmly attached scale away. Seek medical assessment, especially when there is patchy loss, discharge, pain, or a child is affected. Treating every thick scale as ordinary dandruff can miss the problem.
Learn more: DermNet: Pityriasis amiantacea
Link to this entryInfections & infestations
4 entriesSome concerns involve fungi, bacteria, or parasites. Appropriate identification matters before choosing a product or returning to shared hair services.
Tinea capitis / scalp ringwormFungal infection of scalp hair and folliclesMedical treatment needed
What it is
A fungal infection involving scalp hair and follicles. It is especially important in children, although adults can also develop it. Despite the name, no worm is involved.
What someone may notice
Scaly patches, broken hairs, black-dot stubble, or patchy loss may occur. A kerion is a more inflamed, swollen, sometimes boggy area that may be painful or drain. Severe inflammation can leave scarring.
How it is evaluated and managed
Clinicians may examine hairs or scrapings and arrange fungal testing. Scalp ringworm generally requires prescription medicine taken by mouth; shampoo may be used as an additional measure but does not replace that treatment.
A useful next step
Arrange medical care for suspected scalp ringworm. Avoid sharing brushes or headwear while getting advice. A painful swelling, pus, or fever needs prompt attention. Do not treat an undiagnosed possible fungal rash with a steroid alone.
Learn more: DermNet: Tinea capitis · Centers for Disease Control and Prevention: Treatment of ringworm
Link to this entryScalp folliculitisInflamed follicles, small pustules, or crusts
What it is
Inflammation around scalp hair follicles. Bacteria or yeast can be involved, but not every follicular bump has the same cause or needs the same medicine.
What someone may notice
Small itchy pustules, tenderness, and crusting may occur, often near the hairline. Scratching can make lesions sore. Acne-like bumps, contact reactions, and deeper scarring disorders can look similar at first.
How it is evaluated and managed
The pattern and severity guide evaluation. A clinician may consider a culture or other testing when symptoms persist or recur. Treatment can involve an appropriate wash or prescribed topical or oral medicine, depending on the cause.
A useful next step
Avoid squeezing the bumps. Arrange an examination if they recur, spread, become painful, or accompany hair loss. Deep swollen lumps or draining areas belong in a medical assessment rather than an escalating sequence of scalp scrubs.
Learn more: DermNet: Scalp folliculitis
Link to this entryHead liceLice and eggs attached to scalp hair
What it is
An infestation by insects that live close to the scalp. Head lice spread mainly through direct hair-to-hair contact and are not a sign of poor cleanliness.
What someone may notice
Itching or a crawling sensation may occur, although itching can take time to develop. Nits attach to hair shafts, but dandruff and product particles can be mistaken for them.
How it is evaluated and managed
Finding a live nymph or adult louse is the best way to confirm an active infestation. Appropriate over-the-counter or prescription treatments are available. Product directions matter, including whether and when retreatment is needed.
A useful next step
If you are unsure whether you are seeing lice, get help confirming the finding before treating. Follow the selected treatment’s directions and professional advice rather than combining multiple insecticides or repeatedly treating an unconfirmed infestation.
Learn more: Centers for Disease Control and Prevention: About head lice
Link to this entryPiedraUncommon fungal nodules on hair strands
What it is
An uncommon fungal infection that creates nodules attached to hair shafts. Black and white piedra are caused by different fungi and can affect different body-hair areas.
What someone may notice
Small dark, firm nodules or softer light-colored deposits may be noticed along a strand. There may be little discomfort, although affected hair can break. Deposits can be confused with lice eggs, product residue, or structural defects in the hair.
How it is evaluated and managed
A clinician can examine the hair and use microscopy or fungal culture to establish the cause. Management may include removing affected hair and selecting antifungal treatment appropriate to the infection.
A useful next step
Get persistent attached nodules identified instead of automatically using a lice product. Routine dandruff shampoo and brushing may not address the underlying infection, and forceful removal can worsen breakage.
Learn more: DermNet: Piedra
Link to this entryShedding & hair loss
6 entriesThese conditions affect growth, shedding, or pulling on the hair. More than one cause can be present, and long-standing traction can lead to scarring.
Pattern hair loss / androgenetic alopeciaGradual thinning and progressively finer hairs
What it is
A common, genetically influenced form of gradual hair thinning in which affected follicles produce progressively finer hairs. Different patterns occur in men and women.
What someone may notice
A receding hairline or thinning at the crown is common in male pattern loss. Female pattern loss often produces thinning through the central scalp or a widening part. A sudden change or inflamed scalp suggests that another process also needs consideration.
How it is evaluated and managed
History and scalp examination help distinguish pattern loss from shedding, breakage, or scarring disease. More than one condition can coexist. Treatment choices depend on the diagnosis, medical history, and goals; not everyone responds in the same way.
A useful next step
Seek an assessment before choosing a long-term growth product. Discuss realistic expectations and the continuing care that may be needed. Cosmetic coverage is also an option when someone wants a fuller appearance.
Learn more: DermNet: Male pattern hair loss · DermNet: Female pattern hair loss
Link to this entryTelogen effluviumIncreased shedding after a growth-cycle shift
What it is
Diffuse shedding that occurs when more follicles than usual enter the resting and shedding part of the growth cycle. It is generally a nonscarring process.
What someone may notice
Increased shedding may become noticeable roughly two to four months after a trigger such as illness, childbirth, surgery, substantial weight change, or a medication change. Sometimes a trigger is not obvious. It can coexist with pattern hair loss.
How it is evaluated and managed
A clinician reviews timing, health changes, nutrition, and medicines and decides whether targeted testing is appropriate. The goal is to identify and address a relevant trigger rather than prescribe the same supplement to everyone.
A useful next step
Avoid stopping a prescribed medicine on your own. Persistent or unexplained shedding deserves assessment. Improvement and visible density recovery take time and vary with the cause; a fixed regrowth deadline is not reliable.
Learn more: DermNet: Telogen effluvium
Link to this entryAnagen effluviumDisruption of actively growing hairs
What it is
Hair loss caused by disruption of actively growing hairs. Some cancer treatments and other exposures can injure these rapidly dividing cells.
What someone may notice
Loss can be more abrupt than telogen effluvium and may affect eyebrows, eyelashes, or body hair as well as the scalp. The amount and timing depend on the treatment or exposure.
How it is evaluated and managed
The treating medical team connects the hair change with the treatment history and considers other causes when needed. Many people regrow hair after chemotherapy, but recovery is not identical for every treatment. High-dose radiation to a particular area can cause lasting loss there.
A useful next step
Discuss scalp comfort, hair protection, and any preventive measures with the oncology or prescribing team. Do not interrupt treatment to protect hair. Wigs, scarves, and other coverage can be planned around your preferences and medical care.
Learn more: DermNet: Anagen effluvium · National Cancer Institute: Hair loss and cancer treatment
Link to this entryAlopecia areataImmune-mediated patches or more extensive loss
What it is
An immune-mediated condition in which the body targets hair follicles. It commonly causes patches of hair loss, but its extent and course vary widely.
What someone may notice
Smooth patches may appear on the scalp or other hair-bearing areas. Eyebrows and eyelashes can be involved, and some people develop nail changes. Alopecia totalis refers to complete scalp-hair loss; universalis describes more extensive body-hair loss.
How it is evaluated and managed
A dermatologist examines the pattern and may use magnification or additional testing if the diagnosis is uncertain. Fungal infection, hair pulling, and other causes of patchy loss need to be distinguished. Treatment depends on age, extent, activity, and individual considerations.
A useful next step
Get new bald patches assessed rather than assuming stress is the only cause. Regrowth, recurrence, and response to treatment are variable. Practical coverage and emotional support can be valuable alongside medical care.
Learn more: DermNet: Alopecia areata
Link to this entryTraction alopeciaHair loss associated with repeated tensionCan become scarring
What it is
Hair loss caused by repeated or prolonged pulling on follicles. The location depends on where tension is applied by hairstyles, attachments, or other practices.
What someone may notice
Broken hairs, thinning along areas of tension, tenderness, or small bumps may appear. A style does not need to produce dramatic pain to place repeated stress on hair. Early traction loss and established scarring require different expectations.
How it is evaluated and managed
A clinician reviews styling practices and examines the affected area. Early changes may improve when tension is removed, but long-standing damage can permanently scar follicles. Other hairline disorders can resemble traction and sometimes coexist.
A useful next step
Loosen or stop a style that pulls and discuss attachment methods with your stylist. Continuing to cover thinning with increasingly tight styles can add stress. Seek a dermatologist when loss persists or the skin looks smooth and scarred.
Learn more: DermNet: Traction alopecia
Link to this entryTrichotillomania / hair-pulling disorderRecurrent hair pulling and uneven breakage
What it is
Recurrent hair pulling that can lead to noticeable loss. Pulling may happen with focused awareness or almost automatically, and it is not simply a matter of willpower.
What someone may notice
Areas may contain broken hairs of different lengths. The scalp, eyebrows, eyelashes, or other sites can be involved. The appearance can overlap with fungal infection or other patchy hair-loss conditions.
How it is evaluated and managed
A medical examination helps identify the cause of loss. When hair-pulling disorder is involved, supportive mental-health care and behavioral approaches such as habit-reversal strategies may be part of treatment. Shame or punishment does not provide useful care.
A useful next step
Discuss the pattern in a nonjudgmental way with an appropriate clinician. If hair is also being swallowed, tell the clinician, because this can lead to digestive complications. Cosmetic help can support confidence while the underlying behavior is addressed.
Learn more: DermNet: Trichotillomania
Link to this entryScarring & specialist disorders
8 entriesThese conditions can damage follicles permanently. Seek a dermatologist promptly when hair loss is accompanied by pain, inflammation, pustules, or a changing hairline.
Lichen planopilaris / LPPFollicular inflammation with potential scarringPrompt dermatology assessment
What it is
An inflammatory disorder that attacks hair follicles and can replace them with scar tissue. It is a form of primary cicatricial, or scarring, alopecia.
What someone may notice
Irregular patches of loss may have itching, burning, tenderness, or scale around remaining hairs at their edges. Some people have few symptoms. Follicle openings can disappear in scarred areas, but this is not always easy to judge without magnification.
How it is evaluated and managed
A dermatologist may use scalp magnification and a biopsy from an active area to confirm the diagnosis. The aim of treatment is to reduce inflammation and limit further loss; medication cannot reliably restore follicles already destroyed by scarring.
A useful next step
Arrange prompt dermatology assessment for progressive patches with inflammation. Do not wait for a shampoo or growth serum to solve an active scarring process. Monitoring is important because activity can change over time.
Learn more: DermNet: Lichen planopilaris
Link to this entryFrontal fibrosing alopecia / FFAA changing hairline and possible eyebrow lossPrompt dermatology assessment
What it is
A scarring alopecia that often affects the front and sides of the hairline. Eyebrow loss can occur, sometimes before the scalp change becomes obvious.
What someone may notice
A gradually receding band of hair, isolated remaining hairs, or redness and scale around follicles may be seen. It occurs most often after menopause but can affect other people too. Traction and pattern loss are among the possible look-alikes.
How it is evaluated and managed
Evaluation considers the hairline, eyebrows, symptoms, and scalp findings. A biopsy may help when the diagnosis is uncertain. Treatments aim to slow or stabilize the disease, with response and ongoing management varying between individuals.
A useful next step
Seek assessment when hairline recession is accompanied by eyebrow loss, discomfort, or inflammation. Hair that has been permanently lost to scarring may not regrow. Avoid assuming that every changing hairline is ordinary aging or styling damage.
Learn more: DermNet: Frontal fibrosing alopecia
Link to this entryCentral centrifugal cicatricial alopecia / CCCAScarring loss that often starts at the crownPrompt dermatology assessment
What it is
A scarring disorder that usually starts near the crown and spreads outward. It is especially important in Black women, although people of other backgrounds can be affected.
What someone may notice
Thinning or breakage in the central scalp can appear early. Some people notice tenderness, itching, or burning; others do not. Smooth areas with fewer visible follicular openings can develop as scarring progresses.
How it is evaluated and managed
A dermatologist assesses the distribution and may take a biopsy. The cause is complex and is not explained simply by one hairstyle or product. Treatment focuses on controlling inflammation and preserving follicles that remain.
A useful next step
Get persistent crown thinning assessed, especially if it is uncomfortable or spreading. Discuss gentle care and reduced tension without assigning blame. Products marketed to “wake up” every follicle cannot reverse established scar tissue.
Learn more: DermNet: Central centrifugal cicatricial alopecia
Link to this entryFolliculitis decalvansRecurring pustules, tufting, and scarringPrompt dermatology assessment
What it is
A chronic inflammatory follicle disorder that can produce permanent scarring hair loss. It differs from an occasional uncomplicated scalp pimple.
What someone may notice
Pustules, crusts, tenderness, and expanding areas of loss can occur. Several hairs may emerge together in a tuft. That finding is helpful to clinicians but is not unique to this condition.
How it is evaluated and managed
A dermatologist considers the clinical pattern, bacterial or fungal sampling, and sometimes a biopsy. Treatment may use antimicrobial and anti-inflammatory medicines. The relationship between microbes and the inflammatory response is more complex than simply having an “unclean” scalp.
A useful next step
Seek prompt assessment for recurring pustules at the edge of a thinning or scarred area. The condition can fluctuate and needs follow-up. Reducing active inflammation does not guarantee reversal of hair loss that has already become permanent.
Learn more: DermNet: Folliculitis decalvans
Link to this entryDissecting cellulitis of the scalpDeep inflamed nodules and draining areasMedical assessment needed
What it is
An uncommon inflammatory disorder involving blocked and damaged follicles. Deep inflammation can lead to connected draining areas and scarring hair loss.
What someone may notice
Painful nodules, swollen areas, pustules, or discharge may affect the crown and back of the scalp. Other follicular-occlusion conditions can occur alongside it. Despite the name, this is not simply the same process as an ordinary spreading bacterial skin infection.
How it is evaluated and managed
A dermatologist assesses the pattern, checks for secondary infection when appropriate, and selects treatment according to severity. A draining lesion does not automatically mean that bacteria are the primary cause.
A useful next step
Arrange medical care for painful deep lumps or recurrent drainage. Avoid squeezing or trying to drain them at home. Fever or rapidly worsening painful swelling needs urgent assessment, while longer-term management aims to control inflammation and limit additional damage.
Learn more: DermNet: Dissecting cellulitis of the scalp
Link to this entryDiscoid lupus erythematosus / DLEPersistent plaques, pigment changes, and scarringPrompt dermatology assessment
What it is
A form of chronic cutaneous lupus that can affect the scalp, ears, face, and other skin. On hair-bearing skin it can cause lasting scarring and hair loss.
What someone may notice
Persistent scaly plaques may develop changes in color, thinning of the skin, or visible scarring. Symptoms can be mild, so lack of discomfort does not rule out an active problem.
How it is evaluated and managed
A dermatologist may use a biopsy to confirm the condition and evaluate for other features of lupus. Having discoid lupus does not automatically mean someone has systemic lupus. Management may include sun protection and prescribed anti-inflammatory treatment.
A useful next step
Have persistent scalp plaques with color change or hair loss examined. Do not assume they are only dandruff or a cosmetic pigmentation concern. Early attention can help address disease activity before additional follicles are permanently damaged.
Learn more: DermNet: Discoid lupus erythematosus
Link to this entryErosive pustular dermatosisPersistent crusts and erosions on vulnerable skinPersistent lesions need examination
What it is
An uncommon inflammatory condition most often seen on an older, sun-damaged, thinning or bald scalp. Injury or a procedure may precede the problem.
What someone may notice
Pustules, thick crusts, and raw or moist areas can develop. The appearance can resemble infection or skin cancer, and extensive disease may scar. Infection is not considered the main explanation in every case.
How it is evaluated and managed
Medical evaluation is essential. Swabs or fungal tests may be considered, and a biopsy may be needed to exclude a cancer beneath the crusted area. Treatment is chosen after the clinician has assessed these possibilities.
A useful next step
Do not repeatedly pick crusts or keep treating an unhealed spot as routine dandruff. Arrange dermatology assessment for persistent erosions or crusting, especially on sun-damaged skin. A visible improvement in scale alone does not establish what caused the lesion.
Learn more: DermNet: Erosive pustular dermatosis
Link to this entryFolliculitis keloidalis / acne keloidalis nuchaeBumps and scarring at the back of the scalpCan cause permanent hair loss
What it is
A chronic scarring follicular disorder, usually affecting the back of the scalp and neck. The common name includes “acne,” but it is not ordinary acne vulgaris.
What someone may notice
Itchy or tender bumps and pustules may progress to thickened, raised scar-like areas. It often affects people with tightly curled hair. Very close cutting, shaving, and repeated friction can aggravate the problem.
How it is evaluated and managed
A clinician usually evaluates the location and appearance and considers infection or another follicular disorder. Treatment depends on whether the condition is mainly inflamed bumps, established scarring, or both.
A useful next step
Avoid shaving closely over affected areas and discuss ways to reduce friction. Ask a dermatologist about persistent bumps before large scars develop. Popping lesions or repeatedly cutting into them can add injury and does not treat the underlying inflammation.
Learn more: DermNet: Folliculitis keloidalis
Link to this entryHair structure & growth differences
2 entriesLess familiar disorders may change the strength or growth pattern of a strand. Persistent fragility or unusual childhood hair growth deserves an appropriate medical assessment.
MonilethrixInherited fragility with a beaded hair structure
What it is
A rare inherited hair disorder that makes strands fragile. Under magnification, affected hairs show repeated narrowed areas that create a bead-like appearance.
What someone may notice
Hair may become short, brittle, or sparse during early life, sometimes after apparently normal hair at birth. In milder cases the back of the head is mainly affected. More extensive cases can involve other hair-bearing areas, and some people have small follicular skin bumps or nail changes.
How it is evaluated and managed
A clinician can evaluate the distinctive hair structure and family history and consider genetic assessment when appropriate. Several different genes can be involved, and inheritance patterns are not identical in every family.
A useful next step
Seek assessment for persistent childhood hair fragility or a family pattern of similar hair changes. Avoid assuming that short hair means poor care or a vitamin deficiency. Product claims should not be mistaken for evidence of a genetic cure.
Learn more: MedlinePlus Genetics / National Library of Medicine: Monilethrix
Link to this entryShort anagen syndromeAn unusually short growing phase
What it is
An uncommon hair-growth condition in which the growing phase is shorter than usual. Hair stays relatively short even though the individual strands may otherwise be normal.
What someone may notice
It is often noticed in childhood when hair seems never to need cutting or does not reach an expected length. The hair is not necessarily fragile, and density may be normal. This differs from a strand repeatedly snapping.
How it is evaluated and managed
A dermatologist distinguishes a short growth phase from breakage, shedding disorders, and loose anagen syndrome, in which growing hairs are weakly anchored. Examination and appropriately performed hair tests can help clarify the difference.
A useful next step
Bring the child’s hair-growth history and any family history to a clinician. Evidence for treatment is limited, so do not start an adult growth medication for a child without medical guidance. Longer hair is not a reliable measure of overall health.
Learn more: DermNet: Short anagen syndrome
Link to this entryLumps, growths & sun damage
4 entriesA scalp lump or rough spot is not necessarily a hair disorder. New, changing, bleeding, or nonhealing lesions need a medical examination.
Pilar / trichilemmal cystA firm, keratin-filled lump under the skin
What it is
A usually benign, keratin-filled cyst arising from part of a hair follicle. Pilar cysts commonly occur on the scalp and can run in families.
What someone may notice
A firm, movable lump under the skin is typical. There may be more than one. An inflamed cyst can become painful. People often call these “sebaceous cysts,” but that label does not accurately describe a pilar cyst.
How it is evaluated and managed
A clinician examines the lump and determines whether observation, removal, or further investigation is appropriate. A comfortable, stable cyst may not require removal; changes or symptoms deserve reassessment.
A useful next step
Do not puncture or squeeze a scalp lump yourself. Have a new, enlarging, painful, or otherwise changing lump examined rather than assuming every bump is a harmless cyst. A shampoo cannot remove a cyst wall beneath the skin.
Learn more: DermNet: Trichilemmal cyst
Link to this entrySeborrheic keratosisA benign growth that can resemble other lesions
What it is
A common benign skin growth that becomes more frequent with age. Despite the similar name, it is different from seborrheic dermatitis and is not caused by dandruff.
What someone may notice
A growth may look waxy, rough, raised, or “stuck on,” with colors ranging from skin-toned to dark brown or black. Its appearance can vary substantially. Some lesions become irritated by combing or clothing.
How it is evaluated and managed
A clinician uses examination and sometimes dermoscopy to distinguish the growth from other lesions. If there is uncertainty, a biopsy or removal for analysis may be needed. A description on a website cannot confirm that a dark spot is benign.
A useful next step
Get a new or changing spot checked, especially if it bleeds, changes color, or keeps catching on a comb. Do not use a wart remover or pick at an undiagnosed scalp growth.
Learn more: DermNet: Seborrhoeic keratosis
Link to this entryActinic keratosisA rough, precancerous change in sun-damaged skin
What it is
A precancerous change in sun-damaged skin that may occur on an exposed scalp. It develops after ultraviolet damage and needs to be distinguished from harmless scale or other growths.
What someone may notice
A persistent gritty or rough patch may be easier to feel than see. Lesions may be flat or thickened, and skin-colored, pink, or pigmented. There can be one spot or several.
How it is evaluated and managed
A clinician evaluates the lesion and may use dermoscopy or biopsy if cancer is a concern. Treatment options depend on the spot and the surrounding sun-damaged skin. Not every actinic keratosis progresses, but some develop into squamous cell carcinoma.
A useful next step
Arrange an examination for a persistent rough scalp spot, particularly if it becomes tender, thick, enlarging, or ulcerated. Use appropriate sun protection for exposed skin and discuss ongoing surveillance with your clinician.
Learn more: DermNet: Actinic keratosis
Link to this entrySkin cancers of the scalpChanging, bleeding, or nonhealing scalp lesionsMedical examination needed
What it is
Basal cell carcinoma, squamous cell carcinoma, and melanoma can occur on the scalp. Hair can make a lesion harder to notice, so an unexplained change should not be dismissed as a hair-care problem.
What someone may notice
A growing lump, a changing pigmented spot, repeated bleeding or crusting, or a sore that does not heal can require evaluation. These findings also have noncancerous causes; appearance alone does not tell you which is present.
How it is evaluated and managed
A clinician examines the lesion, often with magnification, and may perform a biopsy. Treatment depends on the exact diagnosis and extent. Earlier assessment is preferable to repeatedly trying a cosmetic or dandruff product.
A useful next step
Book a medical examination for a new, changing, bleeding, or nonhealing lesion. A stylist may notice a spot, but a salon consultation cannot rule out cancer. Avoid attempting removal or chemical treatment yourself.
Learn more: DermNet: Skin cancer
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Try a broader word, a medical abbreviation, or all categories. The absence of a match does not rule out a condition.
This is a broad educational directory, not an exhaustive list of every disease. Systemic illnesses, medications, nutritional problems, and other skin conditions can also affect hair. New, persistent, or unexplained changes deserve an individualized assessment.
Understand the product before the promise
What scalp and hair products can actually do
Start with the problem a product is intended to address. Cleansing, conditioning, treating inflammation, and supporting selected types of hair growth are different goals.
On a smaller screen, scroll the table horizontally to compare all four columns.
| Product category | Where it may fit | What it does not establish | A better question or next step |
|---|---|---|---|
| Medicated dandruff shampoosA defined role | Ingredients such as ketoconazole, selenium sulfide, or zinc pyrithione may help appropriate dandruff or seborrheic-dermatitis care. | They are not interchangeable cures for every itchy scalp, and they do not replace oral treatment for scalp ringworm. | Follow the individual label for frequency and contact time. Consider hair texture and dryness when planning the routine. Learn more: American Academy of Dermatology: How to treat dandruff · Centers for Disease Control and Prevention: Treatment of ringworm |
| Scale-loosening productsA defined role | Ingredients such as salicylic acid can help loosen scale in an appropriate scalp-care plan. | Removing visible flakes does not prove that an underlying inflammatory condition, infection, or lesion has been treated. | Ask what diagnosis the product is intended for. Avoid forceful scraping, especially when scale is firmly attached. Learn more: American Academy of Dermatology: How to treat dandruff · DermNet: Pityriasis amiantacea |
| Prescription anti-inflammatory medicinesDiagnosis first | A clinician may prescribe scalp treatments for diagnosed inflammatory conditions such as psoriasis or eczema. | A steroid alone can make a fungal rash worse. Potency, formulation, and duration are condition-specific. | Use the plan your prescriber gives you. Do not borrow someone else’s prescription or keep treating an uncertain rash. Learn more: DermNet: Scalp psoriasis · DermNet: Atopic dermatitis · Centers for Disease Control and Prevention: Treatment of ringworm |
| Minoxidil and hair-growth medicinesDiagnosis first | Minoxidil can support growth in selected forms of hair loss. The appropriate treatment depends on the cause. | It does not treat lice, remove cysts, or substitute for controlling an active infection or scarring inflammation. | Confirm the diagnosis and suitability first, especially with sudden loss, scalp symptoms, pregnancy, breastfeeding, or use in children. Learn more: American Academy of Dermatology: Hair loss: Diagnosis and treatment |
| Conditioners and gentle stylingStrand care | Conditioning and lower-friction handling help reduce avoidable damage to the hair you have. | A smoother strand is a cosmetic improvement, not evidence that an inflammatory follicle disease has resolved. | Reduce excessive heat and pulling. Match detangling methods to hair texture and stop styles that cause tension. Learn more: American Academy of Dermatology: 10 hair care habits that can damage your hair |
| Essential oils and botanical blendsCheck the claim | Some people enjoy these products cosmetically, but suitability depends on the formulation and individual skin. | Plant origin does not rule out allergic contact dermatitis. One ingredient’s reputation does not establish a blend as a treatment for a diagnosed disorder. | Avoid using concentrated oils on irritated skin or deliberately re-testing a product that caused a reaction. Discuss persistent symptoms with a clinician. Learn more: DermNet: Allergic contact dermatitis to essential oils |
| Biotin and “hair” supplementsCheck the claim | A confirmed nutrient deficiency deserves an appropriate medical or nutritional plan. | Biotin is not a universal hair-loss treatment. Evidence for routine hair benefits is limited, and supplemental biotin can distort some laboratory tests. | Tell your clinician and laboratory about supplements. Ask whether testing or supplementation is actually indicated rather than assuming that more is better. Learn more: NIH Office of Dietary Supplements: Biotin: Fact sheet for consumers |
| Laser and light devicesCheck the claim | Evaluate the evidence and labeling for the exact device, intended use, and hair-loss condition. | “FDA registered” is not equivalent to cleared or approved, and none of those terms guarantees an individual result. | Ask for the specific regulatory record, realistic benefit, time commitment, and a clinician’s view of suitability for your diagnosis. Learn more: U.S. Food and Drug Administration: Is it really FDA approved? |
| Dyes, relaxers, and attachment adhesivesCosmetic products | These products can serve styling or attachment goals when appropriate for the person and scalp. | They can also cause irritation or contact allergy. Previous tolerance and a “hypoallergenic” label do not guarantee future tolerance. | Keep ingredient information, follow directions, and disclose prior reactions before a service. Get an inflamed scalp assessed before adding new chemical or adhesive exposure. Learn more: U.S. Food and Drug Administration: Hair dyes · DermNet: Allergic contact dermatitis · U.S. Food and Drug Administration: Hypoallergenic cosmetics |
Learn more: U.S. Food and Drug Administration: Hypoallergenic cosmetics · U.S. Food and Drug Administration: Is it really FDA approved? · DermNet: Allergic contact dermatitis to essential oils
Interactive learning
Myth or fact?
Put your scalp-care knowledge to the test.
Work through 16 statements about disorders, ingredients, and hair-care claims. Each answer includes an explanation and a source.
This is a knowledge quiz, not a symptom checker. Your score does not measure scalp health, disease risk, or suitability for a treatment.
Prefer to browse? Read every myth and fact below.
16 questions · learn at your own pace
A little clarity goes a long way.
Choose Myth or Fact, read the explanation, then continue. You can review previous answers and retry missed questions when you finish.
Quiz complete
Here is what you learned
This reflects answers to the learning quiz only. It provides no assessment of your own scalp or hair.
Keep the facts close
The myth-busting library
Open any statement to see whether it is a myth or a fact, why the distinction matters, and where to read more.
ConditionsDandruff always means someone is not washing enough.
Seborrheic dermatitis involves skin inflammation and a response to factors including naturally occurring yeast. Washing habits can affect scale, but flakes are not a dependable measure of personal cleanliness.
Learn more: DermNet: Seborrhoeic dermatitis
ProductsShampoo alone usually cures scalp ringworm.
Scalp ringworm involves hair and follicles and generally needs a prescription antifungal taken by mouth. A clinician may add shampoo, but it does not replace the required treatment.
Learn more: Centers for Disease Control and Prevention: Treatment of ringworm
ConditionsPeople with clean hair can get head lice.
Head lice mainly spread through direct hair-to-hair contact. They are not caused by poor hygiene. Confirming an active infestation helps avoid unnecessary treatment.
Learn more: Centers for Disease Control and Prevention: About head lice
ConditionsSome inflammatory scalp disorders can cause permanent hair loss.
Scarring alopecias can destroy follicles. Treatment often aims to control disease activity and preserve remaining hair, which is why timely evaluation matters.
Learn more: DermNet: Lichen planopilaris
ProductsBiotin supplements reliably regrow hair in everyone.
NIH notes limited scientific evidence for general hair benefits. A deficiency is different from routine supplementation, and excess supplemental biotin can interfere with some laboratory test results.
Learn more: NIH Office of Dietary Supplements: Biotin: Fact sheet for consumers
ProductsA natural essential oil can still cause a skin allergy.
Essential oils contain chemicals that can trigger allergic contact dermatitis. “Natural” describes origin, not an assurance that a product will suit every scalp.
Learn more: DermNet: Allergic contact dermatitis to essential oils
Hair careGentler handling can reduce avoidable hair breakage.
Conditioning, careful detangling, and reducing excessive heat or mechanical damage can help protect strands. This does not establish or treat every cause of shedding from the follicle.
Learn more: American Academy of Dermatology: 10 hair care habits that can damage your hair
ConditionsTwo people with scalp flakes may need different treatments.
Flaking can accompany dandruff, psoriasis, eczema, or infection. Identifying the cause matters more than choosing a product because a friend has similar-looking flakes.
Learn more: American Academy of Dermatology: How to treat dandruff · DermNet: Pityriasis amiantacea
ConditionsShedding related to an illness can appear months after the illness.
Telogen effluvium often becomes apparent about two to four months after a trigger. That delay is one reason a clinician asks about events before the shedding began.
Learn more: DermNet: Telogen effluvium
ProductsA steroid cream is a safe first choice for every unexplained scalp rash.
Steroids may help certain diagnosed inflammatory conditions, but they can worsen an unrecognized fungal infection. Get an uncertain, persistent, or hair-loss-associated rash assessed.
Learn more: Centers for Disease Control and Prevention: Treatment of ringworm
ProductsA hypoallergenic label guarantees that a cosmetic cannot cause an allergy.
The FDA has no federal definition or standard governing this cosmetic term. A label does not replace knowing which ingredients you personally need to avoid.
Learn more: U.S. Food and Drug Administration: Hypoallergenic cosmetics
ProductsAn FDA-registered device is automatically FDA-approved.
Registration and listing do not establish approval. Clearance and approval are different regulatory pathways, and any claim should be checked for the specific device and intended use.
Learn more: U.S. Food and Drug Administration: Is it really FDA approved?
Hair careBurning from a scalp product proves that it is working.
Burning can be a sign of irritation. Do not use discomfort as a measure of effectiveness or keep applying a product that is causing a reaction.
Learn more: DermNet: Irritant contact dermatitis
ConditionsOne person can have more than one reason for thinning hair.
For example, increased shedding after childbirth can occur alongside hereditary thinning. A useful assessment considers overlapping causes rather than forcing every change into one label.
Learn more: American Academy of Dermatology: Hair loss: Diagnosis and treatment
Hair careLong-standing tension on hair can eventually cause scarring.
Early traction-related loss may improve after tension is removed. Repeated, prolonged injury can damage follicles permanently, so a painful or pulling style deserves attention.
Learn more: DermNet: Traction alopecia
ProductsUsing a hair dye safely before means you cannot react to it later.
Sensitization can develop with repeated exposure, and formulations can change. Follow the label’s allergy-test directions before each use; even a negative test does not guarantee that a reaction will not occur.
Learn more: U.S. Food and Drug Administration: Hair dyes
Turn information into a useful conversation
Prepare for a medical assessment
A useful consultation connects the timeline, examination, and any necessary testing. No single test or product explains every scalp problem.
- Describe the timeline.Note when the change began, whether it was sudden or gradual, and relevant illnesses, medicines, supplements, or styling changes.
- Examine the pattern.A clinician looks at the scalp, hair, and sometimes other skin or nails. Magnification can reveal details that are hard to see at home.
- Choose targeted tests.Depending on the findings, fungal tests, allergy patch testing, blood work, or a biopsy may be useful. Not everyone needs every test.
Learn more: American Academy of Dermatology: Hair loss: Diagnosis and treatment · DermNet: Tinea capitis · DermNet: Allergic contact dermatitis
Questions worth taking with you
Select the questions you want to bring, then copy your list.
A clearer vocabulary
Terms you may hear at an appointment
- Alopecia
- A general word for hair loss; it does not identify the cause.
- Scarring / cicatricial alopecia
- Hair loss in which follicles are damaged and replaced by scar tissue.
- Nonscarring alopecia
- Hair loss without destruction of follicles by scarring; this does not guarantee regrowth.
- Follicle
- The structure within the skin that produces a hair.
- Hair shaft
- The strand itself. Shaft breakage and shedding from a follicle are different processes.
- Miniaturization
- Progressive production of finer hairs, as occurs in pattern hair loss.
- Pustule
- A small pus-containing bump; its appearance alone does not identify the cause.
- Plaque
- A raised or thickened area of skin, sometimes with visible scale.
- Dermoscopy / trichoscopy
- Examination of skin or hair using a magnifying device, often with special lighting.
- Biopsy
- Removal of a small tissue sample for laboratory examination.
- Patch testing
- Clinician-directed testing to investigate delayed contact allergy.
- Kerion
- A strongly inflamed, swollen form of scalp ringworm that needs medical treatment.
These plain-language definitions accompany the condition explanations and their linked clinical references above.
Practical questions
A few more things people want to know
Can I identify a disorder by matching pictures or symptoms?
Descriptions help you learn the vocabulary, but overlapping conditions can look alike. A clinician may need magnification or testing to tell them apart. Use this directory to prepare questions rather than diagnose yourself.
Learn more: American Academy of Dermatology: Hair loss: Diagnosis and treatment
When should a child’s scalp be examined?
Arrange an assessment for new patchy loss, broken hairs with scale, an inflamed swelling, or persistent unusual hair growth. Scalp ringworm is an important possibility in children and needs appropriate treatment. Short or fragile hair can also have a different explanation. Adult hair-growth products are not a substitute for a pediatric assessment.
Learn more: DermNet: Tinea capitis · DermNet: Short anagen syndrome
Is every scalp disorder contagious?
No. Different disorders have different causes. Head lice can spread through close hair contact, and scalp ringworm is a transmissible fungal infection. Pattern hair loss, for example, is genetically influenced rather than an infection. Ask a clinician about precautions for a confirmed diagnosis instead of assuming that anyone with flakes or thinning poses a risk.
Learn more: Centers for Disease Control and Prevention: About head lice · DermNet: Tinea capitis · DermNet: Male pattern hair loss
Can a painless problem still need attention?
Yes. Some scarring disorders can progress with few symptoms. A changing, bleeding, or nonhealing skin lesion also deserves an examination even when it does not hurt. Pain is one useful clue, but it is not a requirement for seeking care.
Learn more: DermNet: Central centrifugal cicatricial alopecia · DermNet: Skin cancer
Should I change everything in my routine at once?
Bring product and ingredient lists to your appointment. A clinician can help distinguish irritation from allergy and identify useful changes. Introducing several products at once can complicate the exposure history. Significant reactions deserve care rather than repeated experiments.
Learn more: DermNet: Allergic contact dermatitis · DermNet: Allergic contact dermatitis to essential oils
What should I bring to a hair or scalp appointment?
Bring a timeline, medicine and supplement list, relevant health or styling changes, and product ingredients. Photographs may help describe a changing area. Mention eyebrow, eyelash, skin, or nail changes too. Ask your clinician about diagnosis and treatment, and your hair professional about cosmetic coverage and maintenance.
Learn more: American Academy of Dermatology: Hair loss: Diagnosis and treatment · U.S. Food and Drug Administration: Hair dyes
Continue learning
Build a fuller picture of hair health
About this resource
Clear sourcing. Practical education.
Published by The Hair Specialists for general education. This page draws on condition-specific resources from DermNet, the American Academy of Dermatology, the CDC, the FDA, NIH resources, and the NHS. Sources were checked on September 16, 2026.
Each condition and product topic links to supporting information. Clinical knowledge and product labeling can change, and care must account for the individual. This guide does not provide a diagnosis, prescribe treatment, or promise regrowth.
The Hair Specialists provides commercial hair and scalp services. The educational sections discuss product categories without ranking or endorsing a particular brand.
Browse all 43 references
- 10 hair care habits that can damage your hairAmerican Academy of Dermatology
- Hair loss: Diagnosis and treatmentAmerican Academy of Dermatology
- How to treat dandruffAmerican Academy of Dermatology
- About head liceCenters for Disease Control and Prevention
- Treatment of ringwormCenters for Disease Control and Prevention
- Actinic keratosisDermNet
- Allergic contact dermatitisDermNet
- Allergic contact dermatitis to essential oilsDermNet
- Alopecia areataDermNet
- Anagen effluviumDermNet
- Atopic dermatitisDermNet
- Central centrifugal cicatricial alopeciaDermNet
- Discoid lupus erythematosusDermNet
- Dissecting cellulitis of the scalpDermNet
- Erosive pustular dermatosisDermNet
- Female pattern hair lossDermNet
- Folliculitis decalvansDermNet
- Folliculitis keloidalisDermNet
- Frontal fibrosing alopeciaDermNet
- Irritant contact dermatitisDermNet
- Lichen planopilarisDermNet
- Male pattern hair lossDermNet
- PiedraDermNet
- Pityriasis amiantaceaDermNet
- Scalp folliculitisDermNet
- Scalp psoriasisDermNet
- Seborrhoeic dermatitisDermNet
- Seborrhoeic keratosisDermNet
- Short anagen syndromeDermNet
- Skin cancerDermNet
- Telogen effluviumDermNet
- Tinea capitisDermNet
- Traction alopeciaDermNet
- Trichilemmal cystDermNet
- TrichotillomaniaDermNet
- CellulitisMedlinePlus / National Library of Medicine
- MonilethrixMedlinePlus Genetics / National Library of Medicine
- AnaphylaxisNHS
- Biotin: Fact sheet for consumersNIH Office of Dietary Supplements
- Hair loss and cancer treatmentNational Cancer Institute
- Hair dyesU.S. Food and Drug Administration
- Hypoallergenic cosmeticsU.S. Food and Drug Administration
- Is it really FDA approved?U.S. Food and Drug Administration
Keep this guide as a starting point for questions. For diagnosis or medical treatment, consult a qualified healthcare professional.