Itchy Scalp: 6 Common Causes & What to Do

September 2022

An itchy scalp can occur for many reasons, like anxiety or stress, a fungal infection, seborrheic dermatitis, lice or allergies. It can occur with symptoms like redness, sensitivity, flaking or skin irritation. 

Treatment for an itchy scalp can range from simple interventions, like avoiding washing your hair in hot water, to more specific treatment, like using a mild, less-irritating shampoo. Depending on the underlying cause, the doctor may even prescribe a medicated shampoo to help relieve itchiness. 

If you notice you have a persistently itchy scalp, you should see your doctor for assessment and treatment as necessary. 

The main causes of an itchy scalp are: 

1. Anxiety or stress 

Anxiety or stress can cause mild to intense scalp itchiness that is occasional or constant. Many times, it occurs with other symptoms like a burning sensations to the scalp well as other parts of the body, like the arms, legs and face. 

This occurs because the areas in the brain that are responsible for our touch sensitivity, movements and emotions are in constant communications with nerve cells endings in the skin. These nerve endings are activated in times of stress of anxiety, which results in and itchy scalp and skin. 

What to do: You should engage in activities that help you to cope with stress or anxiety, like relaxing in a calm environment or drinking a soothing tea like chamomile, passion fruit or valerian. Other examples to help relieve stress include walking or maintaining a hobby. If you feel overwhelmed or unable to cope, you should seek medical attention for further therapy. 

2. Dry skin

Dry skin occurs when there is insufficient oil production in the skin. Oils are important to maintain the skin’s hydration, and decreased production may be related to different health conditions, like eczema or psoriasis. Dry skin may also be related to changes in temperature, and is more common in the winter, when the air is colder and dryer. These factors can all lead to irritation or flaking in the scalp or throughout the body and cause itchiness. 

What to do: During the winter, it is important to wash your hair in warm water with a mild shampoo. Avoid showers that are longer than 5 to 10 minutes, as these can strip your hair of natural oils and lead to a dry scalp. People with eczema or psoriasis should be followed by a dermatologist, who may prescribe medicated shampoos that contain clobetasol propionate, vitamin D, or acetylsalicylic acid. 

3. Seborrheic dermatitis

Seborrheic dermatitis is a skin condition that causes itching, flaking and red rashes. It is commonly noted on the scalp. 

The pathology of this condition is not fully known, however some studies have shown a relationship between increased sebum production in the scalp and a fungal infection. These factors can be influenced by a weakened immune system or stress. This condition does not always have a cure, and can emerge several times along the lifestyle. Symptoms can be managed, however, with use of the right prescription medications and shampoos. 

What to do: Treatment can be initiated with anti-dandruff shampoos, which often contain antifungals and other moisturizing ingredients that can accelerate cellular repair. If the itchiness does not resolve with shampoos, that doctor may prescribe additional ointments, like corticosteroids or diprosalic solutions. 

In order to ensure best treatment outcomes, it is important to keep your scalp and hair clean and dry. Be sure to remove all shampoo and conditioner after showering and avoid using very hot water. You should also avoid stressful situations, drinking alcohol and eating fatty foods.

4. Fungal infection

Fungal infections that affect the scalp, also known as Tinea capitis infections, often cause symptoms like intense itching, dandruff and yellow crust throughout the scalp. Some people may also present with swollen lymph nodes in the neck, due to the body’s immune response to fighting the infection. 

Fungal infections are very contagious, therefore you should avoid sharing intimate items like hair brushes, towels or hats with people who are infected. 

What to do: Fungal infections can be treated with antifungal medications, like terbinafine or griseofulvin. There are also antifungal shampoos available to help relieve symptoms and eliminate fungal cells. 

5. Lice

Lice are small insects found at the base of hair follicles that can cause intense itching. They are commonly found in school-aged children, and can easily transmit from person to person following direct contact with an infected scalp, or after using contaminated objects, like hats or pillows. 

What to do: Lice requires specific treatment with medicated shampoos, sprays or lotions, like permethrin 5%. You should then pass a fine tooth comb through all hair strands to individually remove any remaining lice.

When treating lice, you should wash all pillows, bedsheets and clothes at a temperature above 60ºC (or 140ºF). If this is not possible, be sure to seal contaminated objects in closed plastic containers for about 15 days.

6. Scalp allergy 

A scalp allergy can be triggered by cosmetic products, chemicals, sun exposure or hair dye. This type of irritation is associated with intense itching, redness, flaking, and increased sensitivity with palpation. . 

What to do: To treat this problem, you should see a dermatologist to determine what triggered the allergy, as this will ultimately help to guide treatment. 

Treatment generally consists of using topical corticosteroids, like hydrocortisone or betamethosone. Anti-histamines, like cetirizine, loratadine or ebastine, may also help to relieve symptoms on a system level. Calamine or aloe vera lotions can additionally help to reduce itching and redness. 

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Edited by Tua Saude editing team in September 2022. Medical review completed by Dr. Clarisse Bezerra - Family Doctor in August 2022.

References

  • LEUNG, A. K. C.; et al. Tinea Capitis: An Updated Review. Recent Pat Inflamm Allergy Drug Discov. 14. 1; 58-68, 2020
  • MADKE, B.; KHOPKAR, U. Pediculosis capitis: an update. Indian J Dermatol Venereol Leprol. 78. 4; 429-38, 2012
Show more references
  • BERK, Thomas; SCHEINFELD, Noah. Seborrheic Dermatitis. Pharmacy and Therapeutics. 35. 6; 348–352, 2010
  • WANG, T. S.; TSAI, T. F. Managing Scalp Psoriasis: An Evidence-Based Review. Am J Clin Dermatol. 18. 1; 17-43, 2017
  • WILSMANN-THEIS, D.; BIEBER, T. Psoriasis und Ekzeme am Capillitium [Psoriasis and eczema on the scalp]. Hautarzt. 65. 12; 1043-9, 2014
  • GUERRA-TAPIA, A.; GONZALEZ-GUERRA, E. Hair cosmetics: dyes. Actas Dermosifiliogr. 105. 9; 833-9, 2014
  • MISERY, Laurent; et al. Psychogenic itch. Transl Psychiatry. 2018; 8: 52. 8. 52; 1-8, 2018
  • WEISSHAAR, E. Epidemiology of Itch. Curr Probl Dermatol. 50. 5-10, 2016
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.