Scaly scalps have a number of causes, virtually none reflective of your child's grooming habits. Most of them can be eliminated with medicated shampoos or a prescription from your pediatrician. Afterward, set a schedule to monitor the condition of your child's scalp on a weekly or monthly basis to check for recurrences.
Symptoms
No matter which condition caused it, an itchy, scaly scalp has certain characteristics that indicate trouble. Examine your child's scalp and look for things like scaly patches in white, silver or yellow, pimple-like bumps, areas where hair seems to have thinned, or reddened marks that indicate your child has been scratching repeatedly. If you see one or more of these symptoms, verify that there isn't an alternate explanation---an insect bite causing your child to scratch, for example---and make an appointment with your pediatrician.
Possible Causes
Common conditions that cause scaly scalp include ringworm, or tinea capitis, and seborrheic dermatitis. Ringworm is caused by a fungus called T. tonsurans that spreads through contact with infected people or animals. According to Professor Susan Abdel-Rahman of Children's Mercy Hospitals and Clinics, incidences of ringworm are on the rise in urban areas---and some of these fungi have become resistant to treatment. Seborrheic dermatitis occurs in oily areas of the scalp or ears. A likely cause involves excess oil production combined with a yeast irritation.
Psoriasis
Unlike ringworm or seborrheic dermatitis, psoriasis is a chronic condition. Treatment can relieve an outbreak, but the problem will recur. According to the National Psoriasis Foundation, at least half of all sufferers experience scalp psoriasis. Whereas seborrheic dermatitis creates yellow, greasy flakes, psoriasis flakes will look silver and powdery. Medicated shampoos can treat light cases, while severe cases may need oral antimicrobial treatments in addition to medicated shampoo.
Treatments
Ringworm treatment involves six to eight weeks of antifungal medication. Your child may also need to use a medicated shampoo several times a week. Unless treated in a timely fashion, ringworm can lead to hair loss. If your child has seborrheic dermatitis, medicated over-the-counter shampoos usually help with the flaking; if your child's case is severe, the pediatrician may prescribe medication lotions or corticosteroids.
Preventive Measures
Once your child's medication clears up the problem, make sure she knows what to do to keep it from coming back. If she had ringworm, keep her from sharing things that touch the scalp, including hats, hair decorations, combs and pillows. T. tonsurans can pass easily through such contact, sometimes even after the infected child has been treated. To prevent seborrheic dermatitis, shampoo more frequently, discontinue use of lotions with alcohol and reduce your child's stress level. UV light can help clear up outbreaks of psoriasis. Your doctor may suggest you get a device called a UV comb to make sure light penetrates your child's hair.
