Research Team

Scalp Calcification: What Is It, and What Role Does It Play in Hair Loss?

Since the 40s, researchers have been puzzled by the way some patients start to accumulate plaques of calcium in their scalp.

The mechanism is not entirely understood yet, and it is likely to be controlled by a variety of factors, both external and internal. In this article, we’ll explore these factors in-depth. We’ll also provide steps you can take to counteract their effects.

From a biological point of view, hair serves the simple purpose of protecting the scalp against ultraviolet rays. However, in the Western world at least, hair is so much more important than that.

In our society, we all know how the perception of beauty and physical attractiveness is intimately linked to how your hair looks. After all, nobody wants a “bad hair day!”

It is hardly surprising then that people seek medical help when they start losing their hair. From dandruff to psoriasis, there are many conditions known to affect the scalp and cause baldness. Scalp calcification is one such example.

If you’ve just started looking for information about this condition, it can be daunting to find accurate data. There are hundreds of articles about dandruff and itchy scalp, but it’s virtually impossible to find something reliable about the accumulation of calcium in your scalp.

The truth of the matter is that this condition has not received much attention from the scientific community and as such, there isn’t much reliable information out there to find. This review attempts to gather studies available in this field and put together a possible list of factors involved in scalp calcification. The list is short, but one of these factors may be the trick to solve your case of scalp calcification.

Despite the lack of strong evidence, it’s generally accepted that the combination of hard water and wrong shampoo can cause calcium accumulation in the scalp. Many researchers also believe there are further internal factors which have the same result, but the explanation is a little fuzzier.

Scalp Calcification: What Is It?

In simple terms, scalp calcification refers to the accumulation of calcium in the scalp. Not surprisingly, this leads to a poor and unhealthy scalp, which in turns leads to loss of hair (more on that later).

It is known that calcium accumulation occurs in response to inflammation and, in turn, inflammation is a common symptom in a variety of situations, such as oxidative stress and scalp injuries. The big question now is what inflammatory conditions may actually cause scalp calcification.

The earliest note of scalp calcification came in the 1940s with observations connecting bald patches and areas where calcification of the skull was obvious (1). It was noted how bones in the skull had calcified together and blocked blood flow to the skin, putting this down as the most likely cause for baldness.

Researchers have moved on from these simple observations, developing studies to look at the mechanisms behind scalp calcification.

There is now a wealth of information looking at many different conditions of the scalp – including scalp calcification, among others – providing evidence for the role of the scalp in supporting the production of healthy hair.

The most common symptoms of scalp calcification include:

  • Hair loss and bald patches
  • Dry flakes
  • Itchy scalp
  • Increased scalp tension
  • Shiny scalp
  • Possible headaches in severe cases
  • Hair feeling “heavy”
  • Greasy hair

The most likely symptom associated with scalp calcification is dry flakes, which may be mistaken for dandruff at first. If not treated, it is likely the situation will deteriorate, with more symptoms developing, such as hair loss or itchy scalp.

If you start getting heavy headaches then it may be time to visit your doctor.

What Factors Cause Scalp Calcification?

It was originally believed that scalp calcification was an inevitable consequence of ageing, but researchers have a better understanding of this process now. It turns out that there is no link between ageing and calcification, but there are two specific factors which may contribute to this process:

  1. Effects of shampoo and water
  2. Calcium deposits on the scalp

If you find yourself experiencing calcification in your scalp, it is important to determine what may be causing this condition. Knowing what factors are causing is halfway to find a solution to solve it.

External Effects: Shampoo and Water

The most common reasons to explain your case of scalp calcification are external factors, of which wrong shampoo, hard water, or a combination of both are top of the list. Let’s have a look at how these issues can affect your scalp.

When You Pick the Wrong Shampoo

One of the reasons you may be experiencing scalp calcification is due to a poor choice of shampoo.

In theory, hair products are designed to be easily washed away with water But this may not always be the case.

Studies have shown that some surfactants – a common ingredient in shampoo – are not completely removed by washing (2).

Similarly, typical ingredients in 2-in-1 shampoos can stay in the scalp for up to three subsequent washes, potentially leading to serious build‐up issues (3). Not surprisingly, this is not a good scenario for you and may lead to scalp calcification.

If you start noticing a build-up in your hair, it may be time to find yourself a new shampoo.

If the Problem is Hard Water

Irrespective of what shampoo you’re using, there may be another factor contributing to scalp calcification. The problem is that this one is more difficult to control: hard water.

The main problem with hard water – water with a high minerals content, including calcium – is that it forms a metallic soap when mixed with shampoo. This is often referred to as soap scum.

This metallic soap is defined as an insoluble complex formed between the minerals in the water and the fatty acids in the soap.

There are no specific studies on the effect of soap scum on scalp calcification, but many studies have linked exposure to hard water with an increased risk of dermatitis caused by the metallic soap (4).

In view of these results, ideally, you should try to wash your hair with soft water. Several studies suggest this option to prevent the harsh effects of metallic soap on the scalp (4, 5).

For example, researchers from Tokyo University observed significant improvements with dogs suffering from skin conditions when the animals were washed with soft water. Shampoo treatments with soft water significantly improved dermatitis in the dogs, whereas the same shampoo with tap water didn’t. The authors suggested that that use of soft water improved the skin and stopped itchiness (5).

This time in mice, the same group of researchers found similar results when animals with dermatitis were treated with soft water (4). Like in the dog study, application of soap with soft water reduced the clinical severity of dermatitis and improved the skin.

Several studies with human participants have also shown the beneficial effects of bathing with soft water.

Patients with dermatitis and/or itchy skin claimed significant improvements with soft water probably as a result of a lower amount of residual metallic soap in the skin.

If metallic soap is allowed to remain on the skin (which would happen with hard water), it will act as an irritant and induce an inflammatory reaction, which may lead to scalp calcification (6, 7).

The higher the concentration of calcium, the more soap is needed to lather the water, and the higher the risk of calcium accumulation in the scalp.

The use of soft water, on the other hand, reduces the amount of water needed and the risk associated with soap washing.

Unfortunately, there are no studies done in humans in relation to hair loss and scalp issues. However, it’s not unreasonable to assume that shampoo treatment with soft water is likely to promote skin recovery. It could be considered as a possible therapeutic option in the management of scalp calcification.

Internal Effects: Calcium Deposits

Calcium deposits in the body are not only affected by external factors but also occur in response to internal inflammation.

Inflammation is a natural response of the body as a result of an injury. In most cases, it follows its natural course and when the source of the inflammation disappears, the body returns to normal. However, chronic levels of prolonged inflammation can lead to calcium deposits in the inflamed tissues (8).

Atherosclerosis is an example, where blood vessels start calcifying, trapping other substances over time and form a plaque. These plaques can be extremely dangerous, as they narrow the arteries and may trigger the release of blood clots.

Calcium deposits in breast tissue are another example of small-scale calcification in the body.

When calcification occurs in the scalp over a long period as a consequence of low-grade inflammation, it should be called microinflammation. This is because it’s often a slow and subtle process, in contrast to the fast and destructive mechanisms in the classical inflammatory scarring alopecia (9).

The main question at this stage is what can cause the initial inflammatory reaction which triggers calcium accumulation, and ultimately affects hair follicles? At this stage, there is no definite answer, but there are several options currently being studied:

Option 1: Mild Injuries and High Levels of Calcium in the Blood

If you suffer from hypercalcemia – high levels of calcium in the blood – even the smallest injury to the scalp may lead to calcium accumulation. This has not been confirmed in humans, but rats with high levels of calcium in their diets reacted with calcium accumulation after mild skin injuries (10).

When these animals were cut in the skin, it only took about three hours for researchers to notice an increase in calcium circulating inside the hair follicles, and by six to twelve hours there were visible mineral deposits (11).

Option 2: Possible Genetic Predisposition to Inflammation

Even if you don’t have high levels of calcium in your bloodstream, you may be unlucky in your genetic makeup and still develop calcified spots in your scalp.

Researchers from Procter and Gamble Company (USA) analysed more than 7000 samples from healthy and flaky scalps and noticed important differences in gene expression. Inflammatory genes were mainly expressed in patients suffering from a flaky scalp, even in the areas that appeared healthy.

For the authors, this suggests not only that the condition is most likely going to spread without treatment, but also it seems to point to predisposing factors associated with inflammation (12).

Option 3: Microbiota in the Scalp Leads to Hair Loss

Another aspect that is receiving much attention from the scientific community recently, and which could be involved in explaining scalp calcification, is the skin microbiome (13). Or in other words, the bacteria that live on your skin, including the scalp.

On the positive side, this seems particularly important for the development of a healthy hair follicle. On the negative side, the presence of harmful bacteria can also contribute to a pro-inflammatory environment in chronic inflammatory scalp conditions, including scalp calcification.

There are no studies in humans, but it has been demonstrated in mice that the wrong bacteria present in the skin can trigger an immune response and lead to inflammatory skin conditions such as psoriasis (14).

Option 4: Oxidative Stress and Fatty Acids

Lastly, it may not be high levels of calcium, genetic predisposition, or the wrong bacteria that explain your case of scalp calcification. It may all be down to oxidative stress in unhealthy scalps, which in turn triggers an inflammatory response, resulting in itchy/redness, flakes, dryness and calcium accumulation (15, 16).

The bad news is that a high oxidative stress environment in the scalp can not only develop into calcification, but it also makes your hair more susceptible to damage. The good news is that an appropriate shampoo designed to combat oxidative stress has the potential to improve both scalp and follicle health, and indirectly, limit the effects of scalp calcification (17).

How Scalp Calcification Can Affect Hair Loss

The current theory explains hair loss as a consequence of scalp calcification in a series of steps (18).

It all starts with increased scalp tension as the skull bones grow and fuse together. This may lead to localized inflammation patches, which in some people may become a trigger for calcification.

One or more of the factors described above may be involved. Over time, this calcium accumulation results in hardening of the inflamed tissues and leads to further inflammation, creating a vicious circle of inflammation and calcification.

Inevitably, this calcification process suffocates hair growth. Hair is in intimate contact with the surrounding scalp tissue and relies on it to receive oxygen and nutrient supplies (19, 20). As the calcium accumulates and spreads, hair follicles struggle to get what they need to grow.

In the early stages, this leads to unhealthy hair coming out of the follicles. Unfortunately, after the hair has emerged from its follicle, there’s nothing that can be done to repair it and only invasive cosmetic solutions can minimize the look and feel of the hair.

Sadly, it only gets worse from here, as eventually prolonged inflammation and calcification surrounding the hair follicles completely obliterates hair stem cells, resulting in permanent hair loss (18).

What To Do Next?

If you’re experiencing symptoms related to scalp calcification, the first step to solve this issue is to find out what could be causing this condition.

On one hand, if you think hard water or the wrong shampoo are to blame, then the problem has an easy solution: change shampoo and/or try to wash your head with soft water only. Find out what the water hardness is in your area and this should give you an idea whether you’re on the right track.

If you find out that neither the water nor the shampoo are the source of the problem, then it may be time to start looking at internal factors.

Unfortunately, if that’s the case, the solution may be harder to reach. Most likely there’s something causing an inflammatory response, possibly creating the ideal environment for the wrong bacteria to thrive or developing high levels of oxidative stress. The answer may still be a new shampoo to try, but this time it may require a trip to your doctor.

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