What is it? | "Dry Scalp"


Monday, January 18th, 2010

by 2 comments

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In the Caribbean, we are familiar with ‘dry scalp’, a term that is used to explain almost any scalp condition that involves powdery flakes – on the scalp, in the hair, on someone’s back and on their clothing, which usually serves as a source of embarrassment. Some also use this state as an indication to shampoo their hair.

The term ‘dry scalp’ is also used to refer to another condition, also called dandruff – thick patches of scale that are caked to the scalp, that may also be associated with acne-like bumps on the head.

In it’s mildest form, ‘dry scalp’ is harmless, although it can do a number on your social life. 

Dr. Patricia Yap, a dermatologist who practices in Jamaica and specializes in black skin, states that:

The medical term for ‘dry scalp’ is Seborrheic Eczema/ Dermatitis. It is a condition that is usually accompanied by itching, redness or whitening of the scalp and face. Other parts of the body can also become involved, such as the hairline, eyebrows, and the sides of the nose, behind and in the ears, in the middle of the chest and back and in the groin. These areas have the highest concentration of sebaceous (oil) glands. It can also be found in infants and when present during infancy, is called cradle cap when present on the scalp but can affect the entire body of the enfant

Seborrheic eczema is a subdivision of eczema and is based solely on clinical grounds. The term “seborrheic” is thought to be misleading because seborrhoea (a medical term applied to describe an accumulation on the skin of the normal sebaceous secretion mixed with dirt and forming scales or a distinct incrustation) is not always present and is not required to make a diagnosis.

It has been proven that pityrosporum, a type of yeast, plays an active role in Seborrheic eczema. These yeasts are oil-loving organisms, (lipophilic) and are normally found on the skin in areas where oil (sebaceous) glands are abundant. 

Findings

In her Jamaican practice, Dr. Yap has found that Seborrheic eczema:

- Exists in infants

- Is commonest in young adults, females more so than males

- Is common in patients with Parkinson’s disease and immuno-suppression.

Symptoms

Large quantities of these organisms can give rise to the following:

1. Inflammation, which results in redness, scaly or dry patches on skin, especially after washing face.

2. Itching and burning of the face when hot or after face is washed.

3. Hair loss when combing or even tugging on hair. This worsens after the hair is chemically processed, as often during chemical treatments, there is excessive burning, which causes acute damage to the scalp.

4. Uneven skin tone – whitening or darkening of the areas involved, especially those on the face. 

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Dr. Yap found it interesting that, in the the Jamaican culture, it is not uncommon for hairdressers to suggest oiling of the scalp for effective treatment of this condition. While oiling of the scalp makes the flakes less obvious (masking the flakes), it worsens the condition as the presence of this oil provides a rich breeding ground for the reproduction of the Pityrosporum yeasts, and so they remain. 

Some factors she highlights that contribute to the high incidence of Seborrheic eczema in Jamaica are:

1. Genetic

This condition is hereditary, i.e. the patient has a first degree relative e.g. a mother, father, daughter or son, with this condition. 

2. Cultural Practices

Because of certain hair styles and processes, it is not uncommon for many women to wash their hair no more than twice a month. This natural oil buildup, coupled with oiling of the scalp provides an ideal environment for multiplication of these yeasts. 

3. Environmental

Heat worsens this condition, and the tropical climate of Jamaica provides the ideal temperature for growth of these yeasts, which grow best between 27 and 30 degrees Celsius - the temperature of Jamaica in summer when the condition has been found to be most prevalent. 

4. Stress

During stress, oil glands are more active. It is then perhaps as a result of the increased production of oil, the yeasts multiply and conquer. It is then no coincidence that individuals who are often under stress, for example police officers, lawyers, accountants and students who are studying for exams for example, often are affected by this condition. 

5. Hormonal

Seborrheic eczema has been shown to be more active near menstruation as well as during pregnancy. 

6. The overuse of harsh cleansing soaps like blue soap, Protex and Lifebuoy.

The pH of the skin is about 5.5, which is the optimal pH needed for the skin to fight off infection, bacteria, yeasts and potential viruses. 

Using harsh soaps, which are alkaline in nature, alters the pH of the skin, leaving it susceptible to the invasion of the yeasts that perpetuate this condition.

The use of antibacterial soaps kill the normal bacterial flora needed to fight the growth of the yeast.

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In my view, many of Dr. Yap’s findings may be applied to the wider Caribbean, and possibly to other areas of the world where such conditions and/ or practices, as listed above, are found.

Seborrheic Eczema/ Dermatitis is a treatable condition, you do not have to live with its symptoms for the rest of your life.

When present on the scalp in it’s mildest form, this condition can be rectified by washing hair regularly, at least 2-3 times a week – not necessarily everyday because then you may develop other issues, especially if your hair is naturally dry. 

For other acute forms, or if for some reason you are unable to wash your hair that regularly, seek the advice of a dermatologist. Seborrheic Eczema/ Dermatitis shows up very differently in darker skins than it does in lighter skins, so if you fall in the former category, it would be in your best interest to seek the advice of a dermatologists who specializes in black skin.

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Source, (Reproduced with permission):

Pamphlet: “This Thing called Dry, Itchy, Scalp”, Dr. Patricia Yap -  MBBS, Dip. Derm.; F.A.A.D

Presentation: “Seborrheic Dermatitis: The Jamaican Experience”, – Dr. Patricia Yap -  MBBS, Dip. Derm.; F.A.A.D

Dr. Yap is a dermatologist practicing in Jamaica. She is a member of the Dermatology Association of Jamaica and a Fellow of the American Academy of Dermatology.  She runs her own practice at:

Apex Skin and Laser Centre
2A Molynes Road
Kingston 10
Jamaica W.I.

 

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  1. Deboah Gayle says:

    I have to say this was a very helpful read. I have been suffering from this condition and it is great to know that i don’t have to live with it forever. I have tired alot shampoo’s and stuff and have had some luck but the results don’t last long. I guess I need to see the dermatoligist now. keep these insiteful readings coming.

    [Reply]

    Supernova Reply:

    Thanks for reading Deboah.
    Indeed “Dry Scalp” is a condition that is at the very least manageable, but treatable when adequate steps are taken. We look forward to hearing more from you!

    [Reply]

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