2018 has been among the hottest summers on record since records began in 1910.
Is your scalp suffering as a result? There are still conditions that can flare up on your scalp because of heat, sweat and UV radiation. I am a trichologist, which means I work in a specialist area within dermatology, where my job description entails diagnosing and treating hair loss and scalp conditions. The following are a few common conditions you should look out for towards the end of a long hot summer. These conditions are scalp folliculitis, seborrheic dermatitis and melanoma.
above: scalp folliculitis
Scalp folliculitis may be aggravated during a hot summer because heat and sweat may allow a warm and moist environment for bacteria to thrive in your hair follicles. It basically looks like acne around your hair follicles. Here’s an interesting insight into medical terminology, if you see ‘itis’ at the end of a word, it’s referring to the ‘inflammation’ of the thing before it. So folliculitis literally means inflammation of the follicle, which refers to the cavities in your skin from which hair is produced. Inflammation refers to a process that the body initiates to protect you from infection. Folliculitis is caused by certain bacteria (mostly likely staphylococcus aureus) thriving inside your follicles, which can become very hospitable to bacteria when you’re warmer and more moist than usual. In general men are more affected by this condition than women, especially those that have acne-prone skin. Pseudofolliculitis barbae and Sycosis barbae are two kinds of folliculitis that many men with beards will be familiar with. They target facial hair and are caused by general irritation of the hair follicles caused by shaving and ingrown hairs. These spots can be very itchy, sore, red and crusty and may leave depressed scars in extreme cases. Treatment is possible using antibacterial shampoos and light therapy. Some folliculitis cases can be very serious in that they are characterised by recurring or spreading infection, boils under the skin and scarring alopecia due to follicle damage, which causes permanent hair loss. For this, a doctor might prescribe a form of antibiotic. Note that antibacterial agents will not work if you have pityrosporum folliculitis, which is a fungal infection and therefore requires an antifungal medication.
Seborrheic dermatitis, which causes extreme dandruff, can also be aggravated by hot weather for a similar reason. The likeliest cause of this condition will be a fungus called Malassezia globosa, which thrives on your sebum (natural oils) especially when you’ve been warm and sweaty. Dermatitis describes inflammation of the skin and seborrheic dermatitis describes inflammation that results from excessive secretion of sebum from your skin. This is why seborrheic dermatitis targets the oiliest areas of the skin such as the scalp and the sides of the nose. On the scalp it may look like excessive dandruff (patches of whitish, greyish flakes) and will be itchy and red. This can disappear on its own but may be treated by topical antifungal medications prescribed by a doctor and commercially available shampoos like Nizoral if the problem is relatively mild.
above: seborrheic dermatitis
Now you might believe that your hair will protect your head from UV but this isn’t always 100% effective, because you still maintain a considerable surface area of gaps on your head, such as your parting, and melanoma only takes one rogue cell. Now have you ever realised that these areas are the most exposed to UV and don’t get any sunscreen? If you are in the process of losing your hair, such as if you have male pattern baldness, I sincerely hope you don’t forget your head when you’re applying sunscreen or you wear a hat. Melanoma is a type of skin cancer that arises from melanocytes, which are the cells in the skin that produce pigment (melanin). It is most often caused by excess UV light from the sun or tanning beds. Melanoma almost always begins with a mole or freckle, which can appear on the scalp too. The Journal of the American Medical Association (JAMA Dermatology) found that scalp or neck cancers had a death rate that was almost 2 times higher than melanomas arising from other places on the body. Researchers suggest that this increased risk is down to delayed diagnosis. I strongly suggest that after a summer like this you should monitor your moles or freckles for the next few months by checking them using the ABCDE’s of melanoma, including your head too. ‘ABCDE’ will show you how to differentiate a mole or freckle from a cancer. ‘A’ means it will be ‘asymmetrical’ in shape. ‘B’ means it will have an irregular as opposed to smooth ‘border’. ‘C’ means it will have more than one ‘colour’, or an uneven distribution of colour. ‘D’ means the ‘diameter’ will be more than 6mm most of the time. Lastly ‘E’ means ‘evolution’, this is to say when a mole or freckle has changed in size or colour, bring it to the attention of your GP immediately.