Our scalps: not sexy. But our hair? Our hair is intertwined with our identities, our expressions, and our personalities. In comparison to the scalp, hair is very sexy — but the scalp demands our attention because it’s the lifeline to our mane attraction.
Neglect it, and your hair may fall prey to such issues as thinning, shedding, and loss of hair strength or luster — which makes sense, says certified trichologist Bridgette Hill, aka The Scalp Therapist, who splits her time between Palm Beach, Florida, and New York City.
“Simply put, our hair formation and growth begins below the skin. By the time the hair protrudes from the hair follicle it has already been formed,” she says, adding, “I’m often quoted as saying, ‘Scalp care is hair care that begins with health care.’ Scalp care as a preventive measure can completely alter or mitigate some of the extreme issues with follicles that create hair loss.” Here, what you need to know to keep your scalp and hair happy.
What Does the Scalp Do?
Your scalp is more essential than you can imagine. Composed of five layers — including the dermis and epidermis — the scalp contains hair follicles, little structures comprised of layers of cells that work together to support and form the hair shaft through keratinization. Those follicles, found in the dermis, act as the synthesizers and anchors for your hair.
Genetics, nutrients, minerals, and proteins regulate our follicle’s growth cycle, fueling the formation of hair. How strong your mane is depends largely on the quality of the tissues, cells, and blood that fuel the follicle. “The health of our hair follicles determines the quality of the proteinized keratin that protrudes from the scalp to create what we call our hair,” Hill says.
What Affects Hair Health?
Not surprisingly, genetics play the largest role in determining scalp and hair health, but other factors influence the environment as well. “If you suffer from deficiencies in vitamins, minerals, and/or nutrients, have declining health, regularly take toxic medications, or have high cortisol levels due to stress, the hair follicle may be negatively affected and lead to dry, brittle hair, thinning, shedding, or scalp issues,” says Hill.
At a time when the body undergoes extreme hormonal changes (menopause), the overproduction or underproduction of certain hormones affects keratinization, which may lead to hair shedding, thinning, and a problematic scalp. Additionally, buildup on the scalp can wreak havoc. An abundance of dead skin cells, sebum, sweat, and environmental stressors (pollution, dirt, smoke, etc.) can clog hair follicles, causing folliculitis, an inflammation of the follicle that can lead to flaking, infection, permanent hair loss, and scarring. Even your hairstyling habits can play a role: Overuse of styling products — especially silicone-based formulas or dry shampoos — can leave behind follicle-blocking residue, and overzealous washing can strip the scalp of important natural oils and cause a pH imbalance.
The Scalp Ages, Too
No body part is left untouched by the passage of time, including the scalp. “Because the scalp is made up of the skin and other connective tissues in our body, it ages just the same as our bodies do,” says Hill. Over time, cellular activity within the hair follicle slows, causing hair regeneration to wane and our crowning glory to thin. Hormone-driven miniaturization, the shrinking of hair follicles — and therefore decrease of hair shaft diameter and length — occurs thanks to an age-related increase in androgen hormones. And a 2016 study found that hair follicle stem cells damaged by aging convert themselves into skin, eventually causing hair follicles to shrink and disappear.
That Flake May Not Be What You Think
While aging definitely impacts our scalps, sometimes we may be unaware there’s a problem. But, when we do become aware our scalps are in peril, we typically feel tightness and/or itchiness and witness flaking. Yet not every flake is the result of a single cause. “Because scalp health is affected by a combination of factors, it’s often challenging to isolate one particular cause. Each factor may or may not serve as a trigger to create the onset of the abnormal scalp condition,” warns Hill.
Dandruff affects up to 50 percent of the population and typically results from excess sebum; diets low in B vitamins, zinc, and some fats; stress; an overgrowth of yeast; hormones; and/or immune deficiencies. Seborrheic dermatitis, a chronic condition that produces itchiness and oily, yellow scaly skin that may occur with dandruff, crops up on the scalp as well as other oil-prone areas (think: eyelids and forehead), and can be triggered by an overgrowth of yeast, a poor diet, stress and/or dry winter weather. Psoriasis of the scalp causes pink, inflamed skin covered with silvery scales that are prone to bleeding if scratched or removed, and is caused by bacterial or viral infections, dry air, stress, excess alcohol consumption, injuries to the skin, and/or a compromised immune system.
Which Treatment Do You Need?
If you have a scalp issue, knowing what plagues it will help you with treatment. If you’re suffering from chronic conditions, Hill recommends using minimal heat when styling your hair as well as a low-tension styling routine (think: no pulling with a brush or wearing tight ponytails) to give the follicles a break. She suggests seeking a medical professional’s advice if you notice scaling, inflammation, or constant itchiness as the professional will be able to prescribe topical and/or oral medicine. Treatment for seborrheic dermatitis can include either over-the-counter or prescribed anti-inflammatory and antiseptic prescriptions, as well as frequent shampooing with medicated shampoo. Psoriasis is trickier; the condition requires medically supervised care in which you might use topical and/or oral prescriptions plus medicated shampoo.
“The unfortunate reality of severe scalp issues is that some of the proven active ingredients in the treatments may have adverse affects on the hair fabric,” Hill says. She points to a certified trichologist, who bridges the gap between cosmetologist and medical professional, for assistance in understanding ingestibles, topicals, and scalp therapies that can offer scalp relief as well as maintain the integrity of your hair. “Keep in mind that some scalp disorders are highly contagious and cannot be serviced in a salon setting until you’ve been cleared by a medical professional,” she adds.
What can you introduce into your routine to satisfy your scalp environment? Hill says to think of your scalp like your face: “It requires the same needs: exfoliation, cleansing, and moisturizing.” Here, she shares four of her top scalp care musts.
Enjoy a Weekly Scalp Massage: Once a week, pretreat hair before shampooing with scalp-stimulating oils containing peppermint, tea tree, and/or citrus, which will enhance circulation while decongesting the scalp. Massage the oil into your scalp, starting at the nape of the neck, using both hands and working your fingers up the head to the crown. Then work from the base of the ear to top of the head on both sides. “Spend three to five minutes massaging the appropriate oil into the scalp to soften skin cells, exfoliate, and remove debris to encourage blood flow,” says Hill. Then shampoo.
Get Your Vitamins: Using supplements in addition to eating a diet rich in vitamins can positively impact your scalp. Vitamins like A (to stimulate sebum production for necessary moisture), B (to create red blood cells, which carry oxygen and nutrients to the scalp), and D (low levels have been linked to alopecia) can help supply necessary nourishment to the hair follicles. “Because scalp issues can result from vitamin deficiencies, it’s important to check with your medical practitioner, who can take a blood test to determine if you’re deficient in, say, iron or vitamin D,” Hill says.
Take a Break: Hill recommends extending the time between chemical services like haircolor or keratin treatments to give your scalp the time it needs to regulate itself. “If gray coverage is a priority and you can’t wait as long between services, apply a soothing scalp treatment the day before your color appointment,” she suggests. She points to oils rich in lipids and fatty acids, like shea butter, coconut oil, and olive oil, as appropriate soothers before hair color.
Ease Tension: “Avoid putting too much tension on the same area day in and day out,” Hill says. If you wear your hair up, she recommends switching your bun or ponytail’s position — one day high, the next day low. “You might also want to rethink the brush you use to blow-dry your hair,” she says. Sensitive scalps don’t respond well to abrasive bristles, like those found on a metal brush. Instead, pick a boar bristle brush, one that has a mix of plastic and boar hair bristles, or a high-quality rubber brush.