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| Infectious Agents |
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Ringworm Infection |
Ringworm has nothing to do with worms; it is a fungal infection. It is an infectious skin condition and can occur anywhere on the body, When it occurs on the scalp the professional term for scalp ringworm is “Tinea Capitis”. It can cause patches of hair loss.
The disease is caused when the fungus gets into the hair fiber, making them brittle to break off easily leaving a bald patch of skin. The affected areas are in form of scaly patches that are often itchy, red and inflamed, that may blister and ooze. The patches are usually redder around the outside with a more normal skin tone in the center. This may create the appearance of a ring, hence the name, ringworm. Some infections may expand very rapidly to affect the entire scalp whereas others may progress very slowly and the individual may experience scaly skin and mild hair loss for several months or even years before the diagnosis is made.
Typically, a tinea capitis infection spreads to cover a patch of scalp of up to four centimeters in diameter, but for some people ringworm of the scalp can be more extensive. In a superficial tinea capitis infection, the patchy hair loss may typically resolve in about 7 months, but again some people can have ringworm of the scalp for much longer.
This fungus is common in soil and may be transferred to humans by contact with infected animals. You can also get ringworm from pets that carry the fungus, and cats in particular are common carriers. Ringworm is contagious. It can be passed from one person to the next by direct skin-to-skin contact. You can also catch ringworm through contact with contaminated items such as combs, unwashed clothing, and shower or pool surfaces.
Treatment for ringworm of the scalp varies depending on the various types of fungus involved. Some types of ringworm infection will resolve spontaneously and so no treatments are required. Treatment with topical applications is the most common treatment approach for ringworm. The application blocks the fungus from infecting the keratin.
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| Folliculitis |
Folliculitis is a term for focal inflammation of hair follicles. It looks like acne with little rings of inflammation surrounding the opening of a hair follicle. The result of folliculitis is a tender red spot, sometimes with a surface pustule.
In the early stages of a folliculitis the hair fiber may still be present in the middle of the folliculitis, but as the folliculitis progresses the hair often falls out. It is also possible to have viral, fungal, or yeast induced folliculitis.
When folliculitis is severe, the inflammation is so intense that it can actually permanently destroy the hair follicles, leaving little bald patches.
Folliculitis causes can be divided broadly into two categories: infectious and non-infectious.
Infectious folliculitus is more common than non-infectious folliculitis. Infectious folliculitis evolves due to the damage of the hair follicles by friction from clothing, shaving, physical injury etc. The damaged hair follicles are invaded by various micro-organisms like bacteria and sometimes viruses which lead to severe infection called folliculitis.
The non-infectious folliculitis is caused by oils and greases applied to the skin that clog up the hair follicles, but folliculitis is usually due to a bacterial infection.
Types of folliculitis:
Folliculitis causes can be divided into two major categories on the basis of the histological location of the inflammation:
• Superficial
• Deep
The depth of involvement of the folliculitis in the hair follicle determines whether the folliculitis is superficial or deep. Infectious superficial folliculitis is seen as a tender pustule (a small swelling similar to a blister or pimple) that heals without scarring.
The deep folliculitis is more pronounced than superficial folliculitis. In deep folliculitis, infection extends deep into the follicle, affecting either the entire follicle or the deeper portion of the follicle. It leads to inflammation and reddening which may be with or without a pustule. The lesions are painful and they may lead to scarring.
To identify the intensity of folliculitis the best procedure is to obtain a professional diagnosis. Both superficial and deep infectious folliculitis can be caused by various micro-organisms including:
• Bacteria
• Fungi
• Viruses
• Parasites
Topical applications are used as hair loss restoration treatment options for minor folliculitis. For more serious infections, oral antibiotics would be prescribed.
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| Piedra |
Piedra in Spanish means stone. Piedra (Trichomycosis Nodularis) is a condition where the hair fibers are infected by a fungus. The visible indicator of a piedra infection is development of hard nodules on hair fibers.
There are two basic types of piedra, black piedra and white piedra, referring to the color of the nodules formed on the hair fiber. Black Piedra is due to the fungus Piedra iahortae and is mostly found in tropical countries while white piedra is due to Trichosporon beigelii and is found mostly in Europe and Southern parts of the USA.
The infection may affect hair of the scalp, body and genital areas. When the infection is severe the fungus weakens the hair fiber making it easy to break off. This can result in a patchy - diffuse hair loss.
Hair loss treatment generally involves shaving off affected areas or a topical application of medicines.
Oral therapy is also a major hair care product for this fungal infection.
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| Demodex folliclorum parasite |
Demodex is a little worm-like creature that likes to live on skin and in hair follicles. Demodex feeds on dead skin and oils, so it particularly likes to live in hair follicles where there are lots of both. Demodex parasitic infection of hair follicles is one of the common infectious diseases that affect the scalp. It can infect any hair follicle but it particularly prefers face and scalp hair follicles. Individuals affected by acne or seborrhea oleosa are more prone to be attacked by this particular parasite.
The demodex parasite feeds on dead skin and oils, so it particularly likes to live in hair follicles where there are lots of both and that usually mean the follicles of the face and scalp. Oil is produced in a large amount in pattern baldness under the influence of dihydrotestosterone (DHT).
The oils combine with dead cells of the affected hair follicle to make sebum. The sebum provides a rich source of nutrients for the Demodex folliculorum parasite. In general, the oil food supply to the parasite increases the severity of pattern baldness.
The affected hair follicles in pattern baldness can accommodate a large number of Demodex Folliculorum parasites. While they are sometimes found on the surface of the skin, they are more commonly encountered in the sebum substance of hair follicles called comedo plugs or blackheads. A comedo plug is situated under the skin surface in the canal of the hair follicle where the hair fiber grows. It is composed of keratin and sebum and is blackened at the surface. About five to twenty demodex parasites can be situated in the comedo plug of a single hair follicle.
Effects
Demodex folliculorum infection is one of the common infectious diseases found in men and women. The major problem with Demodex parasite is they may cause irritation, particularly if the infection is in the eyelashes.
It is believed that the frequency of Demodex folliculorum infection is less in children. It is rarely found in children who are below 5 years old. While between the age group of 5 to 10 years, it is found in around 50% and in between the age group of 10-20 the percentage is same as in adults (around 75%). It is impossible to consciously avoid the parasitic infection without the help of medications.
Treatments
The most widely available treatment for this parasitic infection topical application. However, application of this remedy does not promote any hair growth in pattern baldness.
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| Seborrheic Dermatitis |
Seborrheic dermatitis is not an infectious disease, but it can involve infection. Seborrheic dermatitis is a skin disease, but it can also involve temporary hair loss if the dermatitis is located on the scalp or other terminal-haired skin areas.
The dermatitis presents as scaly, sometimes oily, inflamed skin that can be itchy or even painful to touch. The condition worsens when the excess, rich sebum production in seborrheic dermatitis triggers the proliferation of skin flora. This excessive yeast proliferation causes more irritation and inflammation and can affect hair follicles in the vicinity and cause diffuse hair loss. The extent of flaking and inflammation may vary from person to person.
Causes:
Seborrheic dermatitis can also be observed in some new born babies when maternal androgen hormones are passed from the mother to the baby across the placenta. Conditions like Parkinson's disease, head injury, and stroke can also be associated with seborrheic dermatitis, and things like stress and chronic fatigue can make it worse.
Also the dermatitis and any associated infection is commonly aggravated by changes in humidity or seasonal changes.
Hair follicles find inflamed skin an unhealthy environment to grow. Thus seborrheic dermatitis may non-specifically cause diffuse hair loss. This hair loss should be reversible with reduction of the inflammation intensity. Times of hormone fluctuation, such as during puberty, can activate the onset of seborrheic dermatitis.
Association with dandruff:
The association between seborrheic dermatitis and dandruff is controversial. Some dermatologists use the term 'seborrheic dermatitis of the scalp’ as a way of describing severe dandruff. Others believe that the term ‘‘dandruff’’ should be used for any flaking of the scalp, regardless of the causes or origins.
The controversy regarding the relation between these two and any associated fungal infection has become all the more intense as a recent study has observed the role of Malassezia yeasts in the development of seborrheic dermatitis. Malassezia yeasts have been a suspected cause of dandruff for more than a century.
Treatment:
There are several treatments for seborrheic dermatitis. The simplest treatment involves the use topical application to control the skin proliferation and scaling. The inflammation may be directly treated using a corticosteroid cream or lotion to control the immune response. Seborrheic dermatitis can be very persistent, once it starts so persistence with treatment is required and preventative treatment is useful even when the symptoms are gone.
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| Scalp Infections |
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