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Bothered by an itchy scalp? Understand the cause to know how to relieve it

Itch can be a persistent, annoying problem for many patients. Itchy scalp can be particularly troublesome and is sometimes accompanied with dandruff, a rash or even open sores. By understanding the most common causes of itchy scalp and possible treatments, you will be able to determine if you might start relieving your itch with over-the-counter products or if you should see your doctor for a consultation.

What makes my scalp itchy?

If you think about it, scalp skin is very different from skin on other parts of the body. It holds many thick hair follicles and where hair follicles grow, there are also oil glands. Sometimes the presence of these glands can predispose the scalp to particular problems, including itching.  There are many causes of itchy scalp.  Here are four of the most common ones.

• Seborrheic dermatitis: This rash is very common. Sometimes it is barely visible and other times, it can be red-orange in color. Seborrheic dermatitis also causes dandruff and occurs in oily skin where there is increased growth of Malassezia yeast (though this type of rash is NOT a yeast infection). It can be seen on parts of the face and chest as well.
• Psoriasis: This condition can be seen on any part of the body, but some patients will only develop it on the scalp. Along with flaky, itchy skin, a bright pink rash occurs with psoriasis. It is important for psoriasis to be diagnosed and evaluated by a physician because, on occasion, it can be related to psoriatic arthritis.
• Allergic reactions: These can also present as red flaky rashes and are usually quite itchy. Often, there is a trigger for an allergic rash such as a new hair dye, a new shampoo or a new hair product. Common culprits would be preservatives and fragrances in over-the-counter scalp products. At times, allergy patch testing can be used to determine exactly the ingredients to which you may be allergic so that they can be avoided.
• Folliculitis: This condition occurs when the hair follicles become inflamed. Sometimes this happens when bacteria becomes trapped in the follicle. It can be itchy and look like pimples, bumps or sores on the skin. If you think you may suffer from this cause of itchy scalp, be sure to contact your physician.

What if my itch is associated with hair loss?

Occasionally, conditions that lead to hair loss can also cause itchy skin. These are not common and the hair loss is usually an obvious symptom whether it is noticed as hair shedding or decreased hair on the scalp.  If you think this may be happening to you, it is important to visit with your physician promptly as certain tests like bloodwork or skin biopsies may be needed for diagnosis and appropriate treatment.

What are treatments for itchy scalp?

Itchy scalp caused by seborrheic dermatitis and psoriasis will improve with over-the-counter shampoos that include ingredients like selenium, sulfur, tar, zinc or salicylic acid.  Importantly, these shampoos must be lathered into the scalp and left to sit for several minutes prior to washing off. They work best when used at least three times weekly.

At times, prescription medications may be required. Anti-yeast shampoos can help to improve seborrheic dermatitis and topical corticosteroid medications are often necessary to treat conditions such as psoriasis and allergic reaction. Folliculitis occasionally improves with over the counter shampoos and at other times may require topical or oral antibiotics depending on its severity.

The take-home message is that if your scalp itch is not resolving with simple over-the-counter measures, seems to be getting worse or is associated with hair loss, contact your primary physician or dermatologist. Here at SkinCare Physicians, all our medical dermatologists are trained in scalp conditions and can help to relieve even your toughest itch.

4 Responses to Bothered by an itchy scalp? Understand the cause to know how to relieve it

• Abolfazl says:

  December 24, 2020 at 7:19 am

  I usually wash my hair every other day, I have an almost dry hair, recently used aloe Vera gel to moisturize it , have changed my shampoo four times, but I still have the itchy scalp. My hair also has become very thin, what should I do?

  Reply
  • Dr. Laurel Morton says:

    January 5, 2021 at 11:50 am

    Thank you for posting your concern. We would recommend consulting with your primary care physician or dermatologist regarding this issue.

    Reply
• Ellie M Duncan says:

  September 8, 2020 at 9:45 am

  I have tried everything for my itching scalp. I have never had any flaking. It itches at night sometimes so much I can’t sleep. I need so much for my scalp to stop itching.

  Reply
  • Dr. Laurel Morton says:

    September 8, 2020 at 5:44 pm

    If your scalp itch is not resolving and getting worse, we recommend that you contact your primary physician or dermatologist.

    Reply