An itchy scalp may be indicative of more than just dandruff, especially in the sweaty summer months

“Hot, sweaty conditions, frequent scratching, tugging-twisting of hair, tight pulling hairstyles like ponytails, braids, use of tight hugging hats and helmets, frequent oil massages, head shaving practice, use of oils, comedogenic hair sprays and applications can all cause scalp folliculitis, which is a bacterial or fungal infection of damaged follicles,” informed Dr DM Mahajan, senior consultant dermatologist, Apollo hospital, founder chairman, Dr Mahajan Skin Clinic, Hauz Khas, New Delhi.

While scalp acne refers to pimples on the scalp, resembling face acne, scalp folliculitis refers to the inflammation around the hair follicles due to various infections.

Concurred Dr Nivedita Dadu, dermatologist, founder and chairman, Dadu Medical Centre and said that scalp folliculitis can happen to anyone, regardless of gender or age. “Some other kinds of scalp folliculitis, such as bacterial folliculitis, can erupt when the yeast that is present in the follicles is exasperated due to changes in the season or excess oil secretion. During the summer months, sweat and oil buildup can exacerbate the condition, making it important to take care of your scalp,” Dr Dadu described.

“It can be associated with seborrheic dermatitis (overgrowth of a type of yeast called Malassezia which leaves white flakes on the scalp) which is seen commonly in people from 18 to 50 years of age, in both males and females,” said Dr Vandana Punjabi, dermatologist and trichologist at Khar, and Nanavati Hospital.

Very often, an unhealthy diet, loaded with carbohydrates and sugary foods may increase the risk of scalp folliculitis, Dr Punjabi added. Agreed dietitian Vidhi Chawla, founder, Fisico Diet Clinic and said that diets that are high in sugars and carbohydrates can make your blood sugar levels fluctuate, which drives hormones in your skin to produce more oil which can lead to folliculitis.

Are you using too many products on your hair? (Source: Getty Images/Thinkstock)

“Also, stress and hormonal imbalances can also cause this condition. It is also seen in people who sweat a lot on the scalp and do not wash their hair afterwards. Besides these, the application of products on the scalp such as oil, gel or hair sprays can clog the pores (oil glands) and trigger scalp folliculitis. These also stimulate the sebaceous gland activity that produces the oil promoting bacterial and fungal overgrowth,” described Dr Punjabi.

Diagnosis and treatment

Consult your dermatologist at the earliest so that your scalp can be thoroughly checked with a hand-held imaging instrument called ‘dermatoscope’, Dr Punjabi recommended.

Treatment options include medicated shampoos that contain salicylic acid, ketoconazole, or tea tree oil, said Dr Dadu. “For severe cases, dermatologists may prescribe topical or oral antibiotics. Additionally, avoiding tight hairstyles, keeping the scalp clean and dry, and reducing stress levels can help prevent and manage the condition,” Dr Dadu told indianexpress.com.

Since scalp folliculitis can, sometimes, be quite stubborn and resistant to treatment due to which it may take a longer time to reverse the condition, Dr Rashmi Shetty, cosmetic dermatologist, founder, RA Skin & Aesthetics, said that the target of the treatment is to reduce the secretion of oil in the scalp because this is consumed as fodder by the yeast. “Therefore, the antibiotics are prescribed with the aim of decreasing the secretion of the sebaceous gland. This course of treatment may be recommended for a longer period of 3-6 months and depending on the progress, the dosage of the medication may also be increased. Prior to the treatment, it is advisable to be aware of your
hormone levels and diabetes as such internal issues could also promote scalp folliculitis,” said Dr Shetty.

Prevention

It is important to prevent oil and flaky build-up to prevent recurrence which is common. “Don’t massage a scalp which is covered in dirt and grime with any product or oil. Always keep the scalp clean by washing the hair at regular intervals. Always go for a suitable shampoo for your scalp, preferably the doctor-recommended one to avoid any kind of damage to the hair. Do not use hot water to wash your hair,” Dr Dadu said.

Also, ensure to wash everything that touches your head including pillowcases, hats, helmets, headbands, etc.

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