Dermatologist-Approved Tips For Your Most Common Hair and Scalp Issues

As a professional hairstylist, I’m often asked about cures for hair loss, bald spots and lack of growth. The reality is that sometimes, we do things that need to be remedied in a dermatologist’s office instead of the salon chair. A dermatologist is a doctor who specializes in the treatment of skin, hair, nail and mucous membranes (e.g. lining inside the mouth, nose and eyelids.).

These experts are able to diagnose scalp conditions, prescribe medications and perform procedures that can assist in our hair, skin and nail journeys!  We spoke to NYC-based dermatologist, Dr. Fran E. Cook-Bolden, MD, and got answers to your most pressing questions about Black hair. Let’s get started:

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Dry Scalp  

Definition: the loss of moisture to the scalp, characterized by small white flakes  

What causes our scalps to become dry?  

Anything that can cause dry skin on the body can cause dry skin on the scalp. This includes soap, medicated shampoos, detergents, cold weather, product build up, hard water and diet (example: caffeine).  In addition, products applied to the hair that are gel formulations tend to contribute to greater dryness and build up as compared to creams, lotions and more hydrating gels.  

Are there certain foods/drinks we should avoid to combat dry scalp issues?

It’s recommended that you avoid inflammatory foods, such as processed foods, sugar, gluten, dairy, soy, peanuts and alcohol, to name a few. Fill your diet with anti-fungal foods, such as garlic, apple cider vinegar, bananas, avocado, flaxseed, ginger and coconut oil.    

Any product recommendations or natural remedies for dry scalp?

Apple cider vinegar rinses help restore the pH on your scalp and remove build up left behind by shampoos, conditioners and other hair products. Use natural oils such as argan oil, coconut oil, extra virgin olive oil, jojoba oil, etc. to gently massage the scalp and natural hair masks like yogurt, honey, banana and avocado to hydrate and bring moisture. 

Itchy Scalp 

What are common causes?  

Dry scalp, dandruff, irritation/ allergic reaction to something applied to the scalp are often common causes. Additionally, autoimmune diseases such as lupus, thyroid disease, anemia, infections and infestations caused by bacteria, ringworm, yeast and lice (uncommon in curly and textured hair) also cause itchy scalp.  

How can we recognize the difference between an “itchy scalp” and irritation?

You can recognize a scalp irritation by taking a close look at products you use and identifying any symptoms associated with use of that product. If whenever you use it, you experience swelling, redness, burning sensation, then that’s an indication that the scalp is irritated and you should discontinue use.

Any product recommendations or natural remedies for an itchy scalp?  

The same remedies used for dry scalp can be used for itchy scalp. However, in the event of medical problems, such as allergic reactions, infections, seborrheic dermatitis, etc., it’s important to see a board-certified dermatologist and your primary care physician as needed.    

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Thinning Hair

What is the difference between “thinning hair” and “hair loss?”

Thinning hair is one of many manifestations of hair loss and is usually temporary. Hair loss may be caused by a number of factors, including medical conditions, medical treatment, medications and radiation therapy to the scalp.

Telogen effluvium is also a type of hair loss that can be triggered by for several months after an intense emotional or physical shock such as death of a loved one, long periods without sleep, sudden and excessive weight loss, intense exercise, divorce, a severe illness, high fever, giving birth or a surgical procedure. 

What are common causes of thinning hair?

Practices that can lead to hair thinning are excessive manipulation that includes, but is not limited to, excessive pulling and twisting of the hair and excessive use of products, heat and chemicals.    

Hair Loss/ Scalp Conditions

From your experience, what is the top non-hereditary scalp concern that comes into your office?

It is a close tie between Seborrheic Dermatitis (often referred to as dry scalp, itchy scalp or dandruff) and Traumatic Alopecia from styling practices and use of chemicals and products.

Seborrheic dermatitis is very common and when mild, can often be successfully treated at home by avoiding overuse of products, washing more frequently and with the use of over-the-counter products that contain ingredients such as selenium sulfide, zinc and ketoconazole.

However, if hair loss is extensive, the threat of permanent hair can be a devastating prospect and one should seek the guidance of a dermatologist.  

What is alopecia?

The word “alopecia” refers to hair loss and is experienced by everyone at some level, even if minimal. Harmful forms of alopecia include traction alopecia, from excessive hairstyling or hairstyles that pull your hair tight, such as ponytails, braids and cornrows. 

How can women avoid obtaining alopecia or traction alopecia?  

Traction (or pulling) alopecia should be avoided to prevent eventual permanent hair loss. This is achieved by avoiding excessive pulling and tightness overall during styling and with hairstyles, and by alternating your hairstyles and the direction of pulling forces if there is pulling.  

Are hormone shots an option for anyone experiencing hair loss? If so, what makes a person a good candidate?

Cortisone injections by an experienced dermatologist can be very helpful. These injections can help stimulate hair growth and reduce/clear the inflammation that surround the hair follicle. Most patients can benefit from these injections and the dermatologist will evaluate you to determine if you are eligible based on your history, physical examination and associated factors. For a favorable response, there should be a presence of some hair follicles in the area being treated and the lack of evidence of a chronic related condition.  

Product Ingredients/ Medications:  

What are some common ingredients found in products or OTC medication that may contribute to our scalp concerns?  

Ingredients to avoid are shampoos with Sodium laureth sulfate (SLS), Ammonium laureth sulfate, Formaldehyde, as well as hair gels and sprays, especially those that contain high amounts of Alcohol.  Also, there’s a long list of oral medications that cause hair loss. A few of these are commonly found in our medicine cabinets and include drugs to treat and prevent stomach ulcers, indigestion and weight loss. 

Does caffeine help promote growth?

Some shampoos and conditioning treatments use caffeine as an active ingredient to reduce hair loss. Claims state that the caffeine can help prevent hair loss, extend the life cycle of the hair and encourage regrowth. Although caffeine can stimulate the nerves when consumed in a beverage, there is no scientific evidence to suggest that drinking caffeinated beverages or applying topical caffeine treatments improve growth.  

When do you recommend clients with scalp issues graduate from seeking the help of a professional hairstylist to coming to see a dermatologist?

After almost 30 years of treating thousands with hair concerns and loss, I recommend the team approach. I have researched and sought out stylists who are highly trained and recommend seeing both at the same time. The knowledge is synergistic and the care and treatment can be complimentary. I immediately investigate if the patient has a regular hairstylist with whom they are comfortable and can also make a recommendation. It’s important that the dermatologist and the stylist are on the same page.

If you’re in the NYC area and have more questions about hair loss, book an appointment with Dr. Bolden here!