Scalp conditions in children can be caused by parasitic infestations or skin disorders like eczema, dermatitis and fungal infections. These conditions result in dry, flaky scalp, along with inflamed red spots and sores. Following are the causes and treatment options for scalp problems in children.
Scalp problems and diseases affect a majority of children around the world, especially those in schools and child care centers. The scalp has a high density of hair follicles and secretes a lot of sebum. The warm, dark environment of the scalp can lead to a number of superficial and parasitic infections. Moreover, exposure to the pollution, dust and harsh chemicals can wreak havoc on the child’s delicate scalp skin, leading to problems like dryness, flaking and itchy scalp.
These scalp conditions can affect the head from the neck to the ears, and sometimes up to the forehead. The symptoms associated with scalp disorders can be unpleasant, especially for school-going children. Problems like dandruff can lead to extreme itching and white flakes on the dark uniform, causing the child a lot of embarrassment and ridicule at school. To avoid this, it is important to find out the reason for the scalp condition, and provide appropriate treatment.
Scalp Problems in Children
The occurrence of these scalp conditions in children can be attributed to a variety of reasons. While most of them are fairly trivial in nature, certain scalp conditions might also be the result of an underlying medical problem. Here are some of the common scalp problems that can be seen in children.
Also known as infantile seborrheic dermatitis or milk crust, cradle cap is an extremely common scalp condition in infants. Usually found in children after birth till about 12 months, cradle cap is a yellowish, patchy, greasy and scaly skin rash affecting newborn children. It is important to note that this condition is not caused by hygiene problems or bacterial infections. It is a non-contagious, inflammatory condition which may be caused by the intake of certain antibiotics during pregnancy or due to biotin insufficiency.
Treating Cradle Cap: The skin rash caused by cradle cap is not itchy, and will often clear up on its own without treatment. However, applying olive oil or mineral oil can speed up the healing process. Vaseline or hydrocortisone cream may also resolve the problem. In case the cradle cap is severe, and is accompanied by cracked, bleeding skin that may result in bacterial growth, it is important to consult a pediatrician. Medical intervention will also be needed in case the rash turns red and starts spreading to other body parts, including the ears and mouth.
Eczema, also termed as atopic dermatitis, is a common scalp condition that affects around ten percent of babies and older children. The word ‘atopic’ stems from the conditions that are caused by environmental allergens like pollen or dust, while ‘dermatitis’ stands for inflamed, red skin. The excessive itching can lead to scratching and secondary skin infections. Usually hereditary factors like parents with allergies, is a major cause for eczema in kids. It is characterized by itchy red skin, and small bumps on the scalp, face, neck and hands. Eczema flare-ups can be seen in the first year of the child. It continues till the age of five or six, after which the condition might improve.
Treating Scalp Eczema: The triggers for scalp eczema in children include dry skin, irritants, sweat, infections, and allergens like pollen, dander and dust. Food allergies can also lead to eczema flare-ups. Removing these eczema triggers from the child’s environment will help in avoiding the rashes. If your child has scalp eczema, then avoid giving him or her hot baths. Instead, use a mild shampoo to wash the hair, and apply cortisone cream prescribed by the dermatologist. Keep the child’s nails short so that the scratching does not damage the skin.
Characterized by thick, scaly, gray and silver patches of plaque on the scalp, psoriasis is a skin disorder that is caused by an abnormality in the immune system. This skin condition causes the cells to multiply faster than normal, and appear as patches on the skin. Unlike children with healthy scalp, where there is new skin cell growth every twenty eight to thirty days, children with scalp psoriasis will have new cell growth after every three to four days. The increased blood flow makes the skin red and inflamed. This can be accompanied by scalp dryness, itching, and a burning sensation.
Treating Scalp Psoriasis: There is no treatment for scalp psoriasis. However, the symptoms like flaky skin can be cured with topical treatments that include medicated shampoos, creams and gels. These may contain coal tar, salicylic acid and steroids. These topical medications have to be applied directly to the scalp. It is best to consult a health care practitioner when using any medicated shampoos or creams on children younger than twelve months, or when there is a suspected allergic reaction. Keep the child’s scalp clean and hydrated all the time to prevent scalp dryness.
Scalp ringworm, also known as tinea capitis, is a fungal infection that affects the scalp. Along with the characteristic inflamed red spots or rings, patches of hair loss can also be seen. The infection is passed on to children by direct contact with the infected people or with contaminated objects such as combs and pillows. In certain cases, the fungus is passed on from infected cats and dogs, or even from the soil. While anyone can contract the infection, it is most frequently observed in children between the age of 3 to 7 years.
Based on the type of fungus that affects the scalp, a child may have varying symptoms of the infection. A black dot with patches of hair loss is caused by Trichophyton organism, while gray patches of hair loss is due to the Microsporum organism. If the ringworm infection is caused by fungi from animals or soil, the common symptoms are pustules or elevated, soft swellings, also known as kerion. These swellings can drain pus, and are often accompanied by symptoms like pain, itching, and enlarged lymph nodes.
Treating Scalp Ringworm: To treat the scalp ringworm, a pediatrician might recommend oral antifungal medication or antifungal shampoos. Ringworm is mildly contagious, and may spread from one person to another when there is close contact. If the infected area looks scaly and crusty even after two weeks of treatment, then it is best to consult the doctor.
Scabies are caused by the Sarcoptes scabiei mite burrowing into the skin. This results in tiny, itchy red bumps and zigzag-shaped burrows along the inner wrists, elbows, knees and underarms. Sores caused by scratching and secondary bacterial infections are also quite common. Although it is mainly observed in the hands and legs, in certain cases, the scabies rash can be seen on the scalp as well.
Treating Scalp Scabies: To treat scalp scabies, five percent permethrin cream or lotion has to be applied on the scalp and the hairline. It is also applied on the entire body from the neck downwards. To control the itching, antihistamines are recommended. Secondary bacterial infections caused by scabies are treated with antibiotics.
Dandruff (Pityriasis Capitis)
A common scalp condition in children, dandruff is caused by the overgrowth of the Malassezia fungus in the scalp. An increasing turnover of new cells on the scalp or infections like scalp eczema can result in dandruff. In children, dandruff can be caused by hormonal changes during puberty, improper scalp care, dry weather, unhealthy diet, stress and lack of sleep. The common signs of dandruff are white or gray flakes along with itching. When the dandruff is severe and is accompanied by greasy, thick, and yellowish scales, it is caused by seborrhoeic dermatitis.
Treating Dandruff: To treat mild cases of dandruff, over the counter shampoos like tar based or selenium sulfide, sulfur and zinc-based shampoos can be used. In case of severe dandruff, the doctor may recommend prescription dandruff or antifungal shampoos. Keeping the child’s scalp clean by shampooing regularly, can eliminate the dandruff problem.
Head Lice (Pediculosis Capitis)
Head lice are tiny, parasitic insects that live on the scalp, and feed on human blood. The bites and saliva of the lice can cause itching and scalp infections. The infestation affects children all over the world, especially in the age group of three to twelve years. The eggs of the lice, also known as nits, cling to the hair shafts, and are often visible on close examination. These parasitic insects have no wings, and can pass on from one child to another by close contact in schools and child care centers. Sharing combs, hats and bedding of an infected person can lead to the spread of head lice.
Treating Head Lice: Anti-lice medications and shampoos containing 1% permethrin, drives the lice away, and controls the itching. Apply the shampoo on damp hair and keep it on for around ten minutes. Wash off with lukewarm water. You can also remove the head lice with a special nit comb. These metal or plastic combs have fine teeth to remove the nits and the lice. Wash the clothes and bedding of your child’s room in hot water, and vacuum the entire room. If the nits and lice return, or the sores caused by scratching become infected, then seek medical intervention.
Superficial or deep inflammation of the hair follicles of the scalp is known as scalp folliculitis or barber’s itch. The scalp condition is characterized by small, pus-filled, reddish bumps around the hair follicles. The scalp is sensitive to touch, and extremely itchy. Improper scalp care, excessive sweating and a dirty scalp can lead to clogging of the scalp pores and inflammation of the hair follicles. Sometimes, tightly braiding the hair, scratching the scalp too much, or using pointed and rough combs can damage the scalp follicles and lead to folliculitis infection. Infections caused by the Staphylococcus aureus bacteria is also one of the major causes of scalp folliculitis.
Treating Scalp Folliculitis: Antifungal shampoos containing ketoconazole or salicylic acid can help in controlling scalp folliculitis. Wash the child’s scalp regularly, and avoid tight braids, especially at night while sleeping. For chronic cases of scalp folliculitis, antibiotic medications and mild steroids are prescribed by the dermatologist.
A majority of these scalp conditions in children can be prevented with daily hair washing and brushing of the hair. Keep your children healthy and provide them with a balanced diet to avoid health problems caused by an unhealthy diet. If your child continues to suffer from chronic scalp problems, then it is best to consult a pediatrician right away.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.