If it’s not lice in the head, then what? - briefly
The symptoms most often indicate scalp dermatitis or a fungal infection such as «tinea capitis». Management includes antifungal agents or prescribed topical corticosteroids.
If it’s not lice in the head, then what? - in detail
When an individual experiences scalp irritation and the presence of lice has been excluded, the clinician must consider a range of alternative etiologies. Common causes include:
- Seborrheic dermatitis, characterized by oily, flaky scales.
- Psoriasis, presenting as thick, silvery plaques.
- Tinea capitis, a fungal infection producing patchy hair loss and scaling.
- Contact dermatitis, triggered by allergens or irritants in hair products.
- Scabies infestation, which can affect the scalp in children.
- Impetigo, a bacterial infection leading to crusted lesions.
- Atopic eczema, resulting in chronic itching and erythema.
- Xerosis, or dry scalp, often linked to low humidity.
Accurate identification relies on systematic examination. Steps typically involve:
- Visual inspection for lesions, scaling, and hair loss patterns.
- Microscopic evaluation of hair shafts and skin scrapings.
- Wood’s lamp examination to detect fluorescence associated with certain fungi.
- Culture of scalp swabs when bacterial infection is suspected.
- Dermoscopic assessment to reveal characteristic structures such as “comma hairs” in fungal disease.
Therapeutic measures correspond to the diagnosed condition:
- Antifungal agents (e.g., terbinafine) for fungal infections.
- Topical corticosteroids for inflammatory dermatoses.
- Keratolytic shampoos containing coal tar or salicylic acid for seborrheic dermatitis.
- Antibacterial ointments (e.g., mupirocin) for impetigo.
- Allergen avoidance and gentle cleansing agents for contact dermatitis.
- Moisturizing regimens for xerosis, employing emollient lotions.
Preventive strategies focus on maintaining scalp hygiene, limiting exposure to known irritants, and ensuring regular inspection in environments where contagion is possible. Early differentiation between these conditions reduces unnecessary treatments and promotes rapid symptom resolution.