What Is a Scalp Yeast Infection?

Yeast on the scalp that causes infection is a condition that can occur at any age, although it is more common in children.

There are many factors that can contribute to a scalp yeast infection, but an overgrowth of yeast is the primary underlying cause. Several types of over-the-counter shampoo products, as well as prescription medications, can be used to treat a yeast infection on the scalp.

Learn more about the symptoms, causes, and treatment of yeast on the scalp.

Symptoms

Symptoms of a yeast infection on the scalp may include:

• Itchy, red patches of various shapes
• Red or purple patches
• Flaky, white scales
• Crusts on the scalp that may cause hair loss
• Soft, white, moist areas
• Red-based pustules (pimples filled with pus)
• Thick, white, or yellow greasy scales on the scalp (symptoms of seborrheic dermatitis in infants, commonly called cradle cap)
• Flaky, greasy, red patches on the scalp (symptoms of seborrheic dermatitis, or dandruff, in adults)

Complications

When a scalp yeast infection goes untreated, over time it could lead to:

• An accumulation of dead skin and flakes
• Damage to the hair follicles
• Hair loss (particularly in those with hypothyroidism, an underactive thryroid)

Causes

The skin (and scalp) has a natural balance of yeast and bacteria that is known as the skin's natural flora. Certain types of bacteria (lactobacillus) help to prevent an overabundance of yeast from growing on the skin. When the natural balance is disrupted, a yeast infection can form.

A yeast infection on the scalp is caused by an overgrowth of one of two genuses of yeasts, either Candida or Malassezia. Many factors can lead to a yeast infection on the scalp, including:

• Certain medical conditions: Such as those that compromise the immune system, like cancer
• An unhealthy diet: Eating a diet with too many sugary and starchy foods
• Using certain types of personal grooming products: Particularly those with harsh chemicals
• Living in a warm, humid climate where yeast thrives
• Having a condition called follicular occlusion syndrome: Hair follicles that become blocked by scale (keratin) and then rupture, resulting in inflammation
• Having hyperhidrosis: A condition causing excessive sweating
• Having uncontrolled diabetes mellitus
• Taking systemic (oral or injectable) corticosteroids
• Taking antibiotics

Diagnosis

A yeast infection on the scalp can usually be diagnosed during a physical examination. But if your healthcare provider is unsure of the cause of the infection—whether from Candida or Malassezia—some lab tests may be ordered.

Commonly, a sample of tissue is taken from the affected area, and a microscopic examination of the tissue is performed. The organism's size, shape, and structure are examined under a microscope to determine whether it is yeast and which kind.

It’s important to identify the genus of yeast that is the underlying cause of the scalp infection so the right type of antifungal medication can be ordered and be most effective against the specific type of organism. 

Treatment

Antifungal ointments, foams, and shampoos are usually the treatment of choice for scalp infections caused by yeast. Antifungal medications such as fluconazole (brand name Diflucan) have been shown in clinical research studies to provide an 80% or greater effectiveness rate in treating Candida.

Medications

Mild cases of seborrheic dermatitis caused by Malassezia yeast can be treated with over-the-counter products, such as dandruff shampoos, that have active ingredients such as:

• Selenium sulfide
• Zinc pyrithone
• Coal tar  

Antifungal shampoos with 2% ketoconazole (Nizoral) are often prescribed for daily use (or several times each week) for long-term control of dandruff. The use of ketoconazole one time per week may be prescribed to prevent dandruff from coming back once it’s resolved.

Sometimes topical (on the skin) corticosteroids are used for severe scalp inflammation. However, side effects can occur with long-term use, so this type of medication should be given for a short period until the inflammation subsides.

There are corticosteroid shampoos available such as fluocinolone 0.01% solution (Synalar) and betamethasone valerate 0.12% foam (Luxiq) that are often prescribed for use twice per week, alternating with ketoconazole 3% (Nizoral) twice weekly.

Home Remedies

Home remedies for the treatment of a scalp fungus include:

• Eating foods rich in probiotics
• Apple cider vinegar application, diluted
• Tea tree oil shampoo
• Emollients

Home remedies for any type of infection (including fungal infections) should not be used without consulting your healthcare provider.

Prognosis

Once treated, a scalp infection caused by yeast usually clears up in two to eight weeks, depending on the strength of the antifungal medication. Prescription medications are stronger therefore, they usually work faster.

Prevention

Measures for preventing scalp yeast recurrence include:

• Keeping the scalp clean and dry; practicing good hygiene
• Eating a healthy, well-balanced diet
• Avoiding the overuse of antibiotics
• Avoiding the use of hats, caps, hoods, and scarves as much as possible

Summary

Yeast on the scalp involves an imbalance of the skin’s flora from an overgrowth of yeast, such as Candida or Malassezia. Several types of over-the-counter shampoo products, as well as prescription medications, can be used to treat a yeast infection on the scalp. If you think you have yeast on the scalp, speak with a healthcare provider.