Our bodies are made up of different microbiomes that stick with us from birth.
We have the gut microbiome, which exists in the intestines and is known for having the largest count of microbes in the entire body; we have the skin microbiome, which is the most wide spanning microbiome; we have the oral microbiome, which is often considered the gateway to whole-body health; and then we have the scalp microbiome, which some experts say may be the most unique of them all.
Life on the Scalp
According to trichologist William Gaunitz, the scalp microbiome is a collection of bacteria, fungus and microorganisms that coexist on the skin of the scalp. While they are very similar to that of the skin, the microbes on the scalp are a little extra unique. “The scalp’s microbiome is distinctive because of the concentration of sebaceous glands within a humid environment,” says Chuck Hezekiah, educator and brand ambassador at René Furterer. “This type of crowded environment is not found anywhere else on the body, which results in an increase of fungi, bacteria, yeast and other organisms, and as a result, excess flaking, irritation, inflammation, dandruff, and seborrheic dermatitis are common.” Another major difference between the skin and scalp microbiome: “The inside of each hair follicle on the scalp has its own microbiome,” says Omaha, NE dermatologist Joel Schlessinger, MD.
Gaunitz explains that, typically, the scalp microbiome will remain healthy on its own as long as there have been few disruptions. “Just like the active microorganisms living in your gut, there needs to be a balance of healthy microorganisms on the scalp to ensure peaceful coexistence. If a high level of unhealthy microorganisms begins to take hold, then symptoms can occur.”
Look Out for Symptoms
When our microbiome becomes imbalanced—also known as scalp dysbiosis—Anabel Kingsley, brand president and consultant trichologist at Philip Kingsley, says scalp issues like dandruff and seborrhoeic dermatitis can flare. “Yeasts live naturally on the scalp and usually do not cause any problems. However, when a certain species of yeast known as malassezia yeast begin to overgrow, it can cause skin cells to divide too rapidly, leading to flakes and itching.” Gaunitz adds that an out-of-balance scalp microbiome has a slew of other symptoms as well: “Look out for itching, burning, flaking, excessive oil, dryness, redness, and general inflammation.”
“An unbalanced microbiome can also cause hair loss, but just as different scalps have different microbiomes, not all imbalances will directly result in this,” says Hezekiah, who adds that if you are losing hair for this reason, it is typically diagnosed as androgenetic alopecia. “This occurs due to DHT or dihydrotestosterone, which is a molecule created by testosterone. DHT triggers miniaturization, which impacts the microbiome and results in hair loss.” Androgenetic alopecia is one form of an impacted microbiome, but there are many other contributions that can result in hair loss.
While these imbalances are a bit more difficult to prevent, a rapidly deteriorating microbiome due to poor hygiene is avoidable. “Neglecting your scalp health and picking at your scalp irritations can lead to scalp folliculitis or breakouts of pimples on the scalp with slow-healing scabs, which is another common expression of microbiome disruption.” Davie, FL dermatologist Marianna Blyumin-Karasik, MD notes that changes in temperature or emotional stress can also be blamed for scalp imbalances.
01: Look for the right ingredients
“Just like there are different skin types, scalps also have different microbiomes,” says Hezekiah, who adds that you must tailor the ingredients you use on the scalp to specific microbiome concerns. “For someone with an excessive amount of sebaceous production or an oily scalp, ingredients like orange and lavender oils can help exfoliate and tone while breaking down excess sebum. On the other hand, sensitive scalps benefit from ingredients such as peppermint, eucalyptus and echinacea to help soothe and calm. Lastly, a dry, flaky scalp does well with wild ginger and celery extracts, which eliminate dandruff and reduce itchiness while simultaneously strengthening the scalp.”
02: Consult your doctor
Before trying treatments of your own or if the all-natural route isn’t working, Dr. Schlessinger recommends visiting your board-certified dermatologist to rid signs of irritation or discomfort on your scalp. “Many patients are misdiagnosing themselves: There are many people who are dealing with staph aureus and other infections that are being mistaken for dandruff and irritation.”
To treat this, Dr. Schlessinger often suggests an over-the-counter product called CLn shampoo. “It treats pores on the scalp and reduces bacterial colonization with sodium hypochlorite.” In Dr. Blyumin-Karasik’s office, she also prescribes medicated antifungal shampoos such as Nizoral, Plexion or anti-inflammatory Clobetasol.
03: Prioritize the wash cycle
While TikTok might have you going a week without washing your hair, New York trichologist Shab Reslan says the most common way to throw off the microbiome is by washing too infrequently or insufficiently. “Removing sebum, debris, water and product residue from our scalp is the number-one priority we should maintain for the betterment and health of our hair,” she explains. “Neglecting the cleanliness of our scalp can cause excess buildup that will suffocate the follicle opening of the hair, impede strong hair growth and even influence hair thinning.” To ensure that you’re keeping your scalp squeaky-clean, she recommends using an exfoliating scrub before shampooing once a week. “Shampooing would then be followed by a gentle and hydrating scalp conditioner that does not leave behind any harsh debris that microorganisms would feed on,” Gaunitz adds.
04: Get an inside view
The term “you are what you eat” also applies here. “Certain foods like full-fat dairy products and ultra-sugary snacks can worsen scalp issues,” says Kingsley. “Eat foods that contain anti-inflammatory omega-3s, like salmon, sardines and flax seeds, to keep your microbiome at ease and healthy.” For Gaunitz, it’s all about getting the right level of nutrients, “including proper levels of iron, vitamin D3 and zinc.” To get them all in at once, add a daily multivitamin to your diet.
If you don’t know where to start, Kingsley says keeping a food diary to track the relationship between what you’re eating and how your scalp is reacting, is a smart move.
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