Ask Dr. Newsome
1) I’ve been transitioning to natural and have been trying many different oils and hair regimes such as co-washes. I’ve noticed my scalp gets tender in areas and even pimple-like bumps appear. Why may this be happening?
This is a great question. I have seen a lot of patients who have decided to make the choice to transition back to natural. I think it is great but there are things to be aware of. Many people who begin a transition are typically wearing hair styles and using products which they likely were not using before with chemically straightened/chemically processed hair.
Natural oils and creams are great but patients need to be aware of the ingredients that can be found in their hair styling products. The pimple like bumps could be follicullitis (inflammation of the hair follicle) caused by a product and/or ingredient irritating the scalp. The type of product being used is important but you must also be mindful of how the product is being applied. For instance, applying products against the direction of hair growth can make matters worse. Similarly, build-up of hair products could lead to irritation. A lot of people with curly or transitioning hair are starting to co-wash (conditioner wash) instead of shampoo. This method can help retain needed hair moisture, however, not all hair types can handle the amount of product build-up this hair regime produces. Depending on the individual, co-washing can lead to accumulated product build-up resulting in not only bumps, but itching and scaling scalps. I recommend using a clarifying shampoo at minimum a couple times a month to help prevent these symptoms.
Individuals should take into consideration the type of hair style they choose to wear. It is recommended that hair styles be loose and not worn in the same style for an excess period of time. Doing so may cause tension on the hair resulting in tenderness, bumps and even hair loss.
Often times other medical conditions including bacterial, fungal, and scarring alopecia can present with tender scalps and bumps. If styling products and hair styles do not seem to be the issue, your scalp might need further evaluation by a physician to ensure nothing else is going on that may lead to permanent hair loss and scalp issues.
2) I’ve been experiencing dry scalp flakes but my scalp feels oily and not dry. Should I be concerned and how do I stop the flakes?
This is a common condition called Seborrheic Dermatitis, also known as cradle cap in babies. People typically experience scaling (the white flakes), itching, and redness. Patients can also have it on their face and ears. The exact cause is not known but it is linked to over active oil glands and an inflammatory reaction to a common yeast (that lives on everyone). When there is not much redness and just scaling it is called pityriasis capitis or dandruff. It is not just dry scalp as such, just adding oils and creams won’t help. If patients want to try at home treatment initially, I typically recommend using any anti-dandruff shampoo with zinc pyrithione. Hair should be washed at least once a week with it (optimally 3 times a week) and allowing shampoo to sit for at least five minutes before rinsing. If there is a lot of redness and itching or the over the counter shampoo is not working, there is a prescription anti-fungal shampoo that is available as well as solutions and oils with corticosteroids that can help.
There are some natural anti-fungal ingredients such as coconut oil and apple cider vinegar that patients will bring up from time to time. I personally do not have much first hand experience to speak to its effectiveness but I do not see any problems with trying them. I would encourage individuals to be careful when using coconut oil because it may clog up hair follicles on surrounding skin and cause acne. It’s important to understand this is a chronic condition meaning that it may be something you will have to manage life-long.
**It is best to have your scalp evaluated by your dermatologist for proper diagnosis and treatment.
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