Mild flaking or dandruff.
A pharmacist can advise on an anti-dandruff shampoo and how to use it. If symptoms have not improved after using it correctly for up to 4 weeks, arrange a GP assessment.
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Hair & scalp concerns · GP care
Understand the change. Start with the scalp.
Flaking, itching, tender areas, patchy hair loss and increased shedding can have very different causes. A focused assessment can help separate everyday scalp problems from infection, inflammatory skin conditions and hair loss that may need investigation.
Clear photographs can be useful, but some scalp and hair concerns are best assessed in person. Treatment, tests and any prescription depend on an individual clinical assessment.
Choose a suitable route
Match the care to what you can see and feel.
A mildly flaky scalp can often start with pharmacy care. Persistent inflammation, patches of hair loss, suspected scalp ringworm or sudden shedding deserve a clinical review.
Persistent, patchy or changing.
Arrange a review for severe itching, a red or swollen scalp, patchy hair loss, marked shedding, broken hairs, scaling that spreads beyond the scalp or symptoms affecting your wellbeing.
Explore GP appointmentsPainful, hot, swollen or unwell.
Seek prompt advice for rapidly worsening pain or swelling, spreading redness, pus, crusting with fever, or if you have a weakened immune system and are concerned about infection.
Contact NHS 111Scalp ringworm usually needs prescription antifungal tablets as well as shampoo, so it should be assessed by a GP. Avoid sharing combs, brushes, towels or bedding while a contagious fungal infection is possible.
Notice the pattern
The scalp often gives important clues.
Where a change begins, whether the skin is inflamed and how the hair is affected can help narrow the possibilities. Colour changes may be less obvious on brown or black skin, so texture, heat, swelling and discomfort also matter.
Flakes and itch
Dandruff is common, but persistent scaling can also be linked to seborrhoeic dermatitis, eczema, psoriasis or a reaction to hair products.
Patchy hair loss
Smooth patches, broken hairs or scaly areas can have different causes, including alopecia areata, fungal infection or repeated pulling and tension.
Diffuse shedding
Hair may shed more widely after illness, stress, weight loss or iron deficiency, while gradual thinning may follow a familial pattern.
Pain, bumps or crusts
Tender spots, pustules, weeping, thick crusting or a hot swollen area need closer assessment for inflammation, irritation or infection.
Avoid assuming that every flaky scalp is dandruff or that every patch of loss is permanent. The same-looking symptom can have several causes, and using the wrong treatment can delay recovery.
A focused GP assessment
Review the hair, scalp and wider health together.
A GP can examine the pattern, ask about relevant changes and decide whether self-care, pharmacy treatment, a prescription, selected tests or specialist review is appropriate.
Explore in-person GP care01
Map the change.
When it started, whether loss is patchy or widespread, whether hairs are shedding or breaking, and whether there is itch, scale, pain, discharge or swelling.
02
Review possible contributors.
Recent illness, stress, pregnancy or childbirth, weight or dietary change, medicines, family history, hair styling, tight hairstyles, dyes and new scalp products.
03
Choose proportionate tests.
Many concerns can be assessed clinically. Selected blood tests, skin or hair sampling, or dermatology referral may be considered when the history and examination suggest they would help.
A plan built around the cause
Treat the condition—not just the visible flakes.
Scalp treatments are not interchangeable. The safest plan depends on whether the problem is dandruff, dermatitis, psoriasis, fungal infection, another infection or a type of hair loss.
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Targeted scalp care
For straightforward dandruff, a pharmacist may suggest a shampoo containing ketoconazole, coal tar or salicylic acid. Follow the label and allow the advised treatment period before judging the result.
02
Condition-specific treatment
A clinician may recommend a prescription treatment when examination suggests dermatitis, psoriasis or infection. Scalp ringworm usually needs oral antifungal treatment rather than cream alone.
03
Hair-loss assessment
Temporary shedding may improve when its trigger resolves, while other patterns need a longer-term plan. No hair-loss treatment works for everyone, so establish the likely cause before choosing one.
Stop using a new dye, oil, spray or styling product if it clearly irritates your scalp, then seek advice if symptoms are marked or persistent. Do not use someone else’s prescription or apply steroid treatment to a possible fungal infection without clinical advice.
Prepare for a useful review
Show how the pattern has changed over time.
Take photographs in consistent lighting: the front hairline, both temples, the crown and any specific scalp patch. Add a close image of scale, broken hairs, bumps or redness, plus a wider image showing its position.
Note recent illness, stress, weight change, pregnancy or childbirth, new medicines and supplements, family hair-loss patterns, hair treatments and products already tried. If possible, attend an in-person examination without fibres, heavy oils or concealers on the scalp.
Explore face-to-face GP appointments ↗Good to know
Questions about hair and scalp changes.
Practical answers to help you choose a sensible first step without self-diagnosing from one symptom.
Is dandruff contagious or caused by poor hygiene?
No. Dandruff is not contagious and is not caused by poor hygiene, although flakes may be more noticeable if hair is not washed regularly.
How long should I try an anti-dandruff shampoo?
NHS guidance suggests using an anti-dandruff shampoo for up to 4 weeks to see whether symptoms improve. Follow the instructions and ask a pharmacist if you are unsure which product is suitable.
Does scalp ringworm need a GP?
Yes. Ringworm on the scalp can cause scaling and patchy hair loss and usually needs prescription antifungal tablets and shampoo. It can spread through close contact and shared combs, towels or bedding.
Can a video appointment assess my scalp?
Clear photographs and video can help review the history and visible pattern. An in-person appointment may still be advised when the diagnosis is uncertain, hair loss is patchy, infection is possible or the scalp needs close examination or sampling. Explore remote GP formats.
Will I need blood tests for hair shedding?
Not always. A GP may consider selected tests when the history suggests issues such as iron deficiency, thyroid disease or another medical contributor. Testing should be guided by your symptoms rather than ordered routinely.
Should I visit a commercial hair clinic first?
The NHS recommends seeing a GP to get an idea of the cause before considering a commercial hair clinic. This is particularly useful when loss is sudden, patchy, associated with scalp symptoms or affecting your wellbeing.
Clinical information: NHS hair lossNHS dandruffNHS ringwormNHS cellulitis. This information is general and does not replace individual medical advice.