Scalp disorders can lead to various hair problems, including hair loss. Some scalp issues resolve quickly on their own with little to no care. However, other scalp disorders need a long term treatment to avoid damaging results.
Pityriasis Amiantacea is one such scalp disorder that can cause excessive scaling and hair loss, even during treatment. It can also lead to hair sticking together in clumps.
If you are worried about this scalp condition, or want to know more, read on to learn more. We will discuss Pityriasis Amiantacea in detail, including its signs, symptoms and treatment plan.
Pityriasis amiantacea is an inflammatory scalp condition. The word “pityriasis” means scaling, and “amiantacea,” derived from asbestos, describes the appearance of the thick, silver or yellow, adherent scales. These scales often encircle hair shafts, binding them together in tufts.
It’s a potentially confidence-damaging condition that can manifest in patches across the scalp.
What Causes Pityriasis Amiantacea?
Pityriasis amiantacea is more of a reaction pattern that can be caused by any skin condition rather than a clinical disease. Conditions that can present with this clinical picture of scaling include:
- Atopic dermatitis
- Seborrheic dermatitis
- Scalp psoriasis
- Tinea capitis
- Lichen simplex
- Lichen planus
- Head lice
Note: If there is no obvious underlying cause, it can be called idiopathic pityriasis amiantacea.
What Are The Clinical Features Of Pityriasis Amiantacea?
While some features are characteristic of the underlying disease, others are quite common to all. These include:
- Silver or yellow scales
- Dryness
- Hair loss
- Flaking scales which resemble dandruff
- Burning sensation
- Redness on scalp
On the other hand, some features can help you identify the cause of the pityriasis amiantacea.
| Skin Condition | Characteristic Features |
|---|---|
| Psoriasis | Well defined scaly plaques on elbows and knees, red shiny patches in flexures, nail changes such as pitting, thickening or yellowing |
| Seborrheic Dermatitis | Less defined or less red patches resembling psoriasis, yellow scales, affects eyebrows, nasal crease, behind ears and chest |
| Tinea Capitis | Localized bald patches with scales, hair breakage, fungal infection as shown by culture reports |
| Atopic Dermatitis | |
| Skin folds of arms and legs, dry itchy skin, red blistered patches | |
| Lichen Simplex | Localized dry and itchy skin patch, thick dark plaques |
| Head Lice | Lice and eggs on hair shafts, more common on back of neck and behind ears |
How Do You Diagnose Pityriasis Amiantacea?
Most of the time, diagnosis is clinical only. Some tests can help diagnose pityriasis amiantacea such as skin or hair samples for fungal and bacterial culture. On very rare occasions, a skin biopsy may be requested. However, it will not help in diagnosing a specific cause.
Some nonspecific features on scalp biopsy include:
- Diffuse hyperkeratosis
- Parakeratosis with follicular keratosis
- A sheath of horn around the hair shaft
Dermoscopy may also be used to rule out tinea capitis. It shows ‘comma’, ‘elbow shaped’ and ‘corkscrew’ hair. For pityriasis amiantacea, it will show diffuse white or yellow scales. The compact scales can be thick, silver and adherent to tufts of hair thus causing a clumped hair appearance.
See Also: Frontal Fibrosing Alopecia
What Is The Treatment For Pityriasis Amiantacea?
Treatment for pityriasis amiantacea depends on the underlying cause. Therefore, it is important to identify the cause before starting treatment.
Some common nonspecific treatment options include:
- Mineral or vegetable oil to loosen hard scalp scales.
- Medicated creams containing tar and salicylic acid.
- Topical steroids and steroid creams for hair loss caused by psoriasis or dermatitis.
- Antifungal shampoos such as ketoconazole for seborrheic dermatitis.
- Oral antifungal tablets for fungal infections such as tinea capitis.
- Oral antibiotics for bacterial infections.
Most treatments are used together for effective results based on the underlying skin condition.
Does Pityriasis Amiantacea Cause Hair Loss?
Yes, Pityriasis Amiantacea can cause temporary hair loss, especially during treatment. Hair breakage is common, when crusts are removed from hair follicles. However, hair loss is temporary and grows back normally after treatment.
If you are worried about temporary alopecia due to treatment, you can manage it with oral tablets like Finasteride or topical treatment like Minoxidil.
Population Susceptible To Pityriasis Amiantacea
Although this condition can occur at any age, it is often observed in children, adolescents and young adults. Among the two genders, it is more common in females than males. It is also more prevalent in people with existing skin conditions such as psoriasis, eczema, seborrheic dermatitis and lichen simplex etc.
See Also: Why Does Lupus Cause Hair Loss
Frequently Asked Questions
How long does it take to treat pityriasis amiantacea?
The treatment duration depends on the severity and extent of the disease. There are no fixed guidelines and doctors usually modify the duration based on treatment results. Mild cases may require at least 3 months, while severe cases may need 6-9 months.
What is the average age of pityriasis amiantacea?
Pityriasis amiantacea can occur at any age but it is more common in children and young adults. Research shows the median age of patients is around 23-24 years.
What bacteria causes pityriasis?
Pityriasis amiantacea is generally not caused by bacteria. However, some studies suggest that staphylococcus aureus was detected in the majority of patients diagnosed with this scalp condition.
What does pityriasis simplex look like?
It looks like diffuse scaly patches on the scalp, especially around hair follicles. These scales can be easily brushed off with normal to red skin underneath. It can be itchy or asymptomatic.
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