Scalp Problems

What is dandruff?

Dandruff is a common scalp condition characterised by flaking and sometimes an itchy scalp. It involves the shedding of dead skin cells from the scalp at a faster rate than normal. Dandruff is not contagious or serious but can be embarrassing and sometimes difficult to treat. The severity of dandruff can vary significantly from person to person.

As dermatologists in Singapore, we understand the impact that dandruff can have on scalp health and overall confidence. Beyond visible flakes, dandruff can cause one to be self-conscious, leading to avoidance of wearing dark-coloured clothes, itch, and irritation.

What causes dandruff?

It is important to identify the underlying cause of dandruff. Dandruff can be influenced by several factors, including dry skin, sensitivity to hair products, and the growth of a specific type of yeast that lives on the scalp, known as Malassezia.

What are the symptoms of dandruff?

Dandruff is a common scalp condition characterised by several noticeable symptoms. Here are the primary signs of dandruff:

• White and dry flakes: eczema-prone individuals or those with psoriasis may experience white or light yellow flakes of “dead skin” that fall from the scalp. These flakes are often seen on the hair shaft and shoulders.
• Yellow and greasy flakes: people with oily scalps will have yellow and greasy flakes due to excessive oil production and an overgrowth of the Malassezia yeast.
• Scales are freely mobile along the hair shaft: dandruff scales are freely mobile on the hair shaft. If the scales are immobile and adherent to the hair shaft, one needs to consider the possibility of a nit infestation instead.
• Itchy scalp: many people with dandruff experience an itchy scalp, which can vary in intensity.
• Scalp redness and scabbing: some individuals may notice mild redness or scabbing on their scalp due to inflammation and scratching.

Who is at risk of dandruff?

In Singapore, where the climate is typically hot and humid, the risk factors for dandruff can be slightly different from those in cooler, drier climates. However, the following groups of people are generally more at risk of developing dandruff:

• People with oily skin: individuals with naturally oily skin and scalp are more prone to developing dandruff. This is because the yeast-like fungus that contributes to dandruff, Malassezia, thrives in oily environments.
• Adolescents and young adults: dandruff is often observed starting in adolescence and throughout adulthood, likely due to hormonal changes that increase oil production in the skin and scalp.
• People with certain skin conditions: individuals with skin conditions such as psoriasis, eczema, or seborrhoeic dermatitis are at a higher risk of developing dandruff.
• Stress and poor diet: high-stress levels and a poor diet can exacerbate dandruff in some individuals, affecting overall skin health and immunity.
• Men more than women: men are more frequently affected by dandruff, possibly due to higher sebum production.

What are the treatment options for dandruff?

Fortunately, effective treatment options for dandruff are available:

• Medicated shampoos: look out for shampoos containing active ingredients, including zinc pyrithionine, ketoconazole, ciclopirox, or selenium sulfide, which are designed to combat the malassezia yeast — a common contributor to dandruff. Ingredients such as salicylic acid and coal tar may also be beneficial, helping to normalise scalp cell turnover and reduce flakiness.
• Scalp hygiene: maintaining good scalp hygiene in Singapore’s humid environment is paramount. You might need to wash your hair more frequently than in cooler climates. Consider supplementing your anti-dandruff shampoos with moisturising shampoos, as the latter sometimes causes excessive dryness of the scalp.

If these options don’t work out for you, consider seeking professional help to ascertain the exact cause of the dandruff. Personalised care with Dr Evelyn at Lumine Dermatology & Laser Clinic can make a difference. Prescription-grade topicals or even a short course of oral antifungals can be tailored to your specific diagnosis.

What is an oily scalp?

An oily scalp occurs when the sebaceous glands produce excessive amounts of sebum, the natural oil that moisturises and protects both the scalp and hair. While sebum is essential for healthy hair, too much can lead to a greasy scalp. This excess oil can also attract and hold onto dirt, pollutants, and product residues.

Living in Singapore's tropical climate comes with its perks, but for many, it also means dealing with oily scalp issues exacerbated by the high humidity levels. At Lumine Dermatology & Laser Clinic, we are here to guide you through managing an oily scalp with a dermatologist-approved approach, ensuring your hair and scalp remain healthy and balanced despite the humidity.

What causes an oily scalp?

Several factors can contribute to an oily scalp, including genetics, hormonal imbalances, use of inappropriate hair care products, stress, and diet. The scalp contains sebaceous glands that produce sebum, a natural oil that helps keep hair and skin moisturised. However, environmental conditions like Singapore’s relentless humidity can trigger these glands into overdrive, making it a challenge to keep the scalp feeling fresh and clean. As a result, people with an oily scalp may find that their hair looks greasy soon after shampooing their scalp.

What are the symptoms of an oily scalp?

Here are some common symptoms of an oily scalp:

• Greasy or shiny hair: hair can appear greasy or oily just a few hours after washing.
• Limp hair: excess oil can weigh hair down, making it look flat and limp without volume.
• Itchy scalp: while not always present, an oily scalp can sometimes lead to itching due to the build-up of oil and the potential increase in yeast activity.
• Dandruff or scalp flakes: an oily scalp is often accompanied by dandruff. The flakes can be oily and yellowish, unlike the dry white flakes typically seen with a dry scalp.
• Scalp acne: the excess oil can clog hair follicles, leading to itchy or painful pimple-like bumps on the scalp.

Who is at risk of an oily scalp?

Certain factors can increase the likelihood of developing an oily scalp in hot and humid climate. Here are some groups of people who might be more at risk of developing an oily scalp:

• Adolescents and young adults: hormonal changes during puberty often increase sebum production, leading to an oily scalp. This continues to be a factor in young adulthood.
• Individuals with fine hair: people with finer hair may appear to have an oily scalp because their hair is less able to absorb and distribute the sebum away from the scalp.
• Men more than women: men are more prone to having an oily scalp because they tend to produce more sebum, a trait influenced by male hormones.
• People with high-stress levels: stress can influence hormone levels, potentially increasing sebum production and contributing to an oily scalp.
• Genetic predisposition: genetics can play a significant role in sebum production. If oily skin or hair runs in the family, individuals from such families may be likelier to have an oily scalp.
• Poor hair care practices: overwashing hair or using harsh products can strip the scalp of its natural oils, prompting it to produce even more sebum. Conversely, inadequate washing can allow oil to build up.

What are the treatment options for an oily scalp?

Here are some effective strategies for managing an oily scalp:

• Regular washing: in our humid environment, washing your hair more frequently can help manage oiliness by removing excess sebum, sweat, and impurities that accumulate on the skin.
• Choosing the right products: incorporate lightweight, oil-free hair care products into your routine. When selecting a shampoo for oily scalp, look out for the following ingredients: salicylic acid (gentle exfoliative properties and anti-inflammatory), tea tree oil (antibacterial, antifungal, and anti-inflammatory), ketoconazole (antifungal), zinc pyrithionine (antifungal), and selenium sulfide (antifungal).
• Avoiding heavy products: avoid heavy styling products and those containing silicones, which can lead to buildup and further aggravate scalp oiliness.

Seek professional advice from a dermatologist if you struggle to manage an oily scalp despite trying various home remedies and over-the-counter products. We can assess your scalp condition, recommend suitable treatments, and provide personalised advice tailored to your needs.

What is scalp folliculitis?

Are you struggling with itchy or sore bumps on the scalp, exacerbated by humid climate? You are not alone and might be suffering from scalp folliculitis. This condition occurs when hair follicles become inflamed or infected, usually due to bacteria or yeast.

What causes scalp folliculitis?

Excessive sweating, increased oil production, and even friction from wearing hats or helmets—common issues in our tropical climate—can contribute to its onset. In Singapore's humid climate, sweat and oil production can further contribute to the development of scalp folliculitis. Moreover, individuals with a tendency toward acne may notice similar breakout patterns on their scalp.

What are the symptoms of scalp folliculitis?

Here are the common symptoms associated with scalp folliculitis:

• Small red bumps: the most noticeable symptom is the appearance of small, red, pimple-like bumps on the scalp. These bumps may be scattered or clustered.
• Itching or tenderness: the affected scalp area may feel itchy or tender to the touch.
• Pus-filled blisters: some bumps may develop into pustules or blisters that contain pus, which can crust over when they rupture or dry up.
• Pain: in more severe cases, the bumps can become painful.
• Hair loss: chronic or severe folliculitis can damage the hair follicles, resulting in temporary or permanent hair loss in the affected areas.
• Scaling and crusting: as the lesions heal, they may be accompanied by scaling or the formation of a crust over the site of the infection.

Who is at risk of scalp folliculitis?

Scalp folliculitis can affect anyone, but certain factors can increase the risk of developing this condition.

• Poor hygiene: inadequate washing and cleansing of the scalp can contribute to the development of folliculitis by allowing bacteria or fungi to accumulate.
• Oily scalp: people with excessively oily scalps are more prone to developing scalp folliculitis because the excess sebum can provide a breeding ground for bacteria.
• Frequent use of hair products: heavy use of hair products such as oils, gels, and sprays can clog hair follicles and increase the risk of infection.
• Damaged hair follicles: physical injury to the scalp, such as from scratching, wearing tight hats or helmets, or frequent hair styling, can damage hair follicles and make them more susceptible to infection.
• Damp and sweaty conditions: environments that encourage sweating, such as wearing a hat or helmet for long periods, especially in hot and humid conditions, can promote folliculitis.
• Pre-existing dermatological conditions: people with dermatological conditions like acne are at higher risk.

If these symptoms are observed, it is advisable to seek medical attention. A dermatologist can confirm the diagnosis, often just by looking at the scalp, and may prescribe topical or oral antibiotics, antifungals, or other treatments depending on the severity and underlying cause of the folliculitis.

What are the treatment options for scalp folliculitis?

Effective management and prevention strategies for scalp folliculitis include:

• Scalp hygiene: scalp hygiene is essential for controlling folliculitis. Good scalp hygiene involves using gentle, non-comedogenic shampoos. These products help reduce oil and product buildup without irritating the scalp.
• Avoiding irritation: it is crucial to minimise friction from headgear and to resist the urge to scratch or pick at the bumps. Though tempting, picking can worsen inflammation and introduce new bacteria to the area.
• Choosing the right products: we recommend shampoos with antibacterial and antifungal properties to address the root causes of folliculitis. For those with more sensitive scalps, selecting a product can be a delicate balance, which is where professional guidance becomes invaluable.

Lumine Dermatology & Laser Clinic offers specialised care for cases that persist despite over-the-counter treatments. Depending on the severity, we may prescribe topical or oral medications to reduce inflammation and combat infection. In cases where scarring is a concern, steroid injections could be considered part of a comprehensive treatment plan.