If you've noticed itching and hair fall on just one side of your scalp -- especially if it improves right after a head bath -- the cause may not be hereditary at all. Dr. John Watts, a Hyderabad-based dermatologist and trichologist, answers a viewer's question about exactly this kind of localized itching, hair fall, and breaking beard hair.
A Likely Culprit: Fungal Infection
Dr. Watts explains that when hair fall and itching are limited to one area, and beard hair is breaking too, it often points away from a hereditary pattern. "Since your beard hair is also breaking it all points to a fungal infection called Tinea Capitis or Ringworm of the scalp. They leave itchy, scaly, bald patches on the scalp," he said. Seborrheic dermatitis can cause a similar picture, which is why an accurate diagnosis matters.
First-Line Treatment: Ketoconazole Shampoo
For a suspected fungal infection, Dr. Watts recommends starting with ketoconazole shampoo used for three consecutive days. "Later, you may use it again at an interval of 3 days or 7 days. If the problem persists, it is better to consult a dermatologist and undergo a KOH exam of the scalp, where a slide is rubbed on your scalp and examined under a microscope to identify the fungal infection," he explained.
If the KOH exam confirms a fungal infection, a dermatologist can prescribe oral anti-fungal tablets, with the dosage based on the patient's body weight. "The medicine works if you are in the early stage of infection, but if the problem is identified at an advanced stage, hair thinning is a possibility even after taking medication," Dr. Watts cautioned. This is why catching the infection early, rather than letting it spread across the scalp, makes such a difference to the outcome.
How Fungal Scalp Infections Spread
Fungal infections of the scalp spread easily from person to person through shared beds, towels, combs, or gym equipment. Scalp hygiene plays a big role too -- not drying your hair properly after a wash, or sleeping with wet hair, creates ideal conditions for the infection to take hold and spread.
"There is also the possibility of fungal infection if one does not take a head bath after heavy perspiration or sweat-generating exhausting work like heavy gym workouts. Sweat easily attracts fungal infection," Dr. Watts said.
Simple habits go a long way in prevention: avoid sharing towels, combs, pillows, or gym equipment, dry your hair thoroughly after washing or sweating, and don't go to bed with wet hair. These small changes reduce the chances of a fungal infection taking hold or spreading to others in the household.
Don't Mask Dandruff With Hair Oil
Dr. Watts also flags a common mistake: using hair oil to control dandruff flakes. "Applying hair oil gives an impression that dandruff flakes are in control, but the problem may get aggravated if they clog the pores, which may lead to secondary infection and formation of pustules on the scalp," he warned.
This article is for educational purposes only and is not a substitute for professional medical advice. Consult a qualified dermatologist for diagnosis and treatment.
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Frequently asked questions
What causes itching and hair fall on just one side of the scalp?
According to Dr. Watts, this pattern -- especially combined with breaking beard hair -- often points to a fungal infection like Tinea Capitis (ringworm) rather than hereditary hair loss.
How is a fungal scalp infection treated?
Dr. Watts recommends ketoconazole shampoo for three consecutive days, then at 3- or 7-day intervals. If it persists, a dermatologist can perform a KOH exam and prescribe oral anti-fungal tablets dosed by body weight.
How do fungal scalp infections spread?
They spread through sharing beds, towels, combs, or gym equipment, and are more likely if hair is left wet or you skip a head bath after heavy sweating.
Is it safe to use hair oil to control dandruff?
No -- Dr. Watts warns that hair oil can clog pores and worsen the problem, potentially leading to secondary infection and pustules on the scalp.
