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Scalp conditions that cause hair loss

In shortHair loss with an itchy, sore, burning or scaly scalp is not pattern hair loss and shouldn't be treated at a hair clinic first. It may be psoriasis, dermatitis, a fungal infection or a scarring alopecia. See your GP: most are treatable, and the scarring types need early treatment to save hair.

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Which are you?

The common ones

ConditionWhat you seeDoes the hair come back?
Seborrhoeic dermatitisGreasy yellow flakes, itch, rednessYes. It causes little true hair loss
Scalp psoriasisThick silvery scale on raised patchesUsually. The HSE says hair loss from it is usually short-lived
Ringworm (tinea capitis)Scaly patches with broken hairs, mostly in childrenYes, with antifungal tablets from a doctor
FolliculitisSore pimples around hairsUsually, once treated
Scarring alopeciaSmooth, shiny skin, redness or scale around the remaining hairsNo. Treatment aims to stop it spreading
Fingers parting dark hair to show a dry, flaking scalp

Scarring alopecia

In lichen planopilaris, frontal fibrosing alopecia and a few rarer conditions, inflammation destroys the follicle and leaves scar. Lost hair doesn't return. Signs are a burning or tender scalp, redness around hairs, and a patch or hairline that keeps moving. A dermatologist confirms it, sometimes with a small skin sample, and treats it to stop the spread.

What your GP does

Looks at the scalp, may take a scraping or plucked hairs to test for fungus, and treats the common conditions with medicated shampoos, steroid lotions or tablets. If scarring is possible, they refer you to a dermatologist. Ask for the referral to be marked for the scalp so it's seen by the right clinic.

What to tell your GP

  • When the itch, soreness or scale started, and whether the hair loss came before or after
  • Any new hair dye, relaxer, shampoo or scalp product in the weeks before
  • Skin problems elsewhere: psoriasis, eczema, rashes in the mouth or on the wrists
  • Whether children or pets at home have scaly patches
  • What you have already put on it

Photos of the scalp taken over a few weeks help, because scalp conditions flare and settle and may look quiet on the day of the visit.

What not to do

Don't start minoxidil, PRP or oils on an inflamed scalp. They can sting and they delay the diagnosis. Don't pick or scrub scale off. Get it named first.

Questions people ask

Can dandruff cause hair loss?

Not by itself. Heavy scratching and inflammation can cause some shedding, which recovers when the scalp is treated.

Why is my scalp sore where I'm losing hair?

Soreness or burning isn't part of pattern hair loss. It needs a GP's look, in case it's an inflammatory or scarring condition.

Is scalp ringworm catching?

Yes. It spreads through contact, combs and hats, mostly among children, and needs tablets from a doctor.

Can psoriasis cause permanent hair loss?

Rarely. The HSE says scalp psoriasis can cause hair loss in extreme cases, but usually only for a short time.

More guides

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