Itchy Scalp? The Microbiome May be the Cause

An itchy scalp, or scalp pruritus, is a common problem that can lead to symptoms such as frequent scratching or discomfort, scabbed or flaking skin, or redness on the scalp. 

In this article, we’ll cover everything you need to know about itchy scalp and its links to the scalp microbiome, including excerpts from accredited dermatologist, Dr. Teo Wan Lin. We’ll also cover how the scalp microbiome can lead to various hair conditions, and how to keep the scalp microbiome healthy.

What causes itchy scalp?

The cause of an itchy scalp is inflammation. Is it possible that itchy scalp leads to hair loss? The short answer is no. But the long answer is that if your itchy scalp is due to an underlying scalp condition such as seborrheic dermatitis, this can in the medium to long term, disrupt your hair cycle and cause more hair to fall our faster, and hair to grow at a slower rate due to the underlying inflammation. Associated scalp symptoms can include redness, sensitivity. Some individuals experience pain when they’re tying up their hair. All that has to do with increased activity of the immune cells around the area where there is inflammation.

Seborrheic dermatitis

The commonest cause of scalp inflammation in this part of the world, in tropical Singapore, is seborrheic dermatitis. Seborrheic dermatitis is due to an overgrowth of yeast organisms that are otherwise normal commensals, meaning that they are part of the healthy scalp microbiome. What happens in seborrheic dermatitis is that the scalp inflammation leads to symptoms of itch, flaking, redness, sensitivity.

Over a period of several months, or years, this can cause disruption in the hair cycle. 90% of our hair should be in the growing phase known as the anagen phase. When there is active inflammation such as in the case of seborrheic dermatitis, psoriasis, or eczema, the hair cycle may be disrupted and as a result, more hairs may enter into the telogen phase. This expedites the hair cycle process, leading to more hair that is falling out, and comparatively, less hair that is growing back to compensate for the amount of hair that’s falling out. 

The Copper Peptide Hair Regrowth Serum contains Copper tripeptide, a novel molecule that stimulates hair growth. Copper tripeptide is a potent antioxidant with minimal to zero risk of scalp irritation. It helps to maintain healthy, immunological function of the scalp, promoting beneficial scalp microbiome.

What is the scalp microbiome? 

The scalp is one of the thickest parts of the skin on the body, with on average about 100,000 hairs growing on it at a given time. It high production of vitamin-rich sebum (oil) and an unusually humid environment, which gives rise to microbes and microorganisms that aren’t found on any other part of the body. 

A microbiome is a community of microorganisms that exist in one habitat, like your gut, skin and scalp. In order for a microbiome to function efficiently, it must maintain a balance of diverse microorganisms, with each contributing to the productivity of the habitat. The scalp microbiome is the balance of healthy microorganisms that work together and contribute to our scalp health. Just like our skin microbiome, if the delicate microbiome is thrown off balance, skin conditions can develop, causing symptoms of flaking, itching, and irritation.

How does the scalp microbiome affect hair conditions?

Research in the scalp microbiome has intensified in the last 3 years. In 2017 in a paper submitted to Experimental Dermatology, a group of researchers stated that there was a difference in the scalp microbiome in terms of the bacterial and yeast flora in individuals who suffered from dandruff, also known as seborrheic dermatitis, compared to individuals with healthy scalps. What that really means that there is a definite role in the balance that microorganisms play in our skin, and now our scalp, in order to maintain scalp homeostasis. Homeostasis is the state of balance that is required for our organs to function at their optimal states.

A disturbance in the scalp microbiome can be influenced by the environment, one’s personal genetics as well as hormonally influenced oil production on the scalp. In this situation, we should zoom in on the specific problems that are brought about by the imbalances of the microorganisms living on one’s scalp.

Dandruff

Dandruff is one of the most common scalp complaints. Flaking on the scalp and white scales found on one’s clothes are one of the first symptoms of dandruff. The term dandruff is lay speak for any form of scalp inflammation that causes the cell turnover rate on the scalp to increase abnormally. There are several medical conditions that can result in this, the commonest being the following: scalp psoriasis, seborrheic dermatitis and scalp eczema. 

Dandruff and Seborrheic dermatitis 

We have spoken about seborrheic dermatitis earlier, and how it can lead to itchy scalp and scalp inflammation. Additionally, seborrheic dermatitis could also be the cause of your recent dandruff outbreak. It mainly affects the sebaceous, gland-rich regions of the scalp, face, and trunk. Seborrhea or seborrheic dermatitis is a common, chronic or relapsing form of eczema/dermatitis. 

Dandruff, also known as pityriasis capitis, is considered to be an uninflamed form of seborrhoeic dermatitis. Scattering within hair-bearing areas of the scalp, dandruff of such presents as itself as bran-like scaly patches. 

The cause of seborrheic dermatitis is associated with the proliferative species of the fungus Malassezia. Its metabolites (such as fatty acids oleic acid, malassezia, and indole-3-carbaldehyde) may cause an inflammatory reaction. Therefore, there is a link between dandruff and the bacteria and fungi that grow on the scalp. 

The Copper Peptide Deep Cleanse Shampoo contains amino acid surfactant for gentle cleansing of sensitive scalps,  zinc pyrithione that has anti-dandruff properties, and copper peptide that helps to promote healthy hair growth. 

Scalp folliculitis

Scalp folliculitis is an inflammatory disorder of the hair follicles in the scalp, also known as “acne necrotica miliaris” or “Proprionibacterium folliculitis”.

It is characterised by small, very itchy pustules on the scalp, often most troublesome on the frontal hairline. Depending on the severity, there may be only a small number or may appear as very numerous lesions. Due to the itch, they are hard to leave alone and overtime often become sore and crusted. 

Causes of scalp folliculitis

The cause of scalp folliculitis is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include:

●  Bacteria (especially Cutibacterium acnes, but in severe cases, also Staphylococcus aureus)

●  Mites (Demodex folliculorum)

●  Yeasts (Malassezia species)

An imbalance in these microorganisms can lead to an inflammatory reaction on the scalp, causing scalp folliculitis. 

To explain, Malassezia is the causative yeast organism belonging to the family of fungi that colonizes the scalp of individuals who suffer from seborrheic dermatitis. Chronic inflammation of the scalp’s follicles can lead to pimple-like lesions that can be painful, lead to deeper cysts, and even abscesses in a more serious type of scalp folliculitis known as dissecting folliculitis. These are typically associated with imbalances in the bacterial flora of the scalp. Research shows a link between scalp folliculitis and scalp sensitivity, as well as the sebum and bacterial imbalances. The microorganisms interact with environmental factors such as increased temperature, humidity, the presence of sweat in a genetically predisposed individual to create chronic inflammation. 

Keeping the scalp microbiome healthy

Shampoo

Research has shown that zinc pyrithione medicated shampoo is a safe and effective way to treat dandruff. Fighting off Malassezia can help to restore the health of your scalp microbiome. 

Hair serum

Use of antioxidants serums on the scalp can encourage healthy cell talk between the immune cells, and improve the ability of the scalp to fight off disease-causing bacteria and fungus. This also helps to maintain regular sebum production. Copper tripeptide is a potent antioxidant with minimal to zero risk of scalp irritation. It helps to maintain healthy, immunological function of the scalp, promoting beneficial scalp microbiome.

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