An itchy scalp (scalp pruritus) is a common problem that can cause frustrating symptoms, such as frequent scratching and discomfort. Sometimes itchy scalp is accompanied by visible signs, such as scabbed or flaking skin. Other times, your scalp can itch without any skin changes.
Itchy scalp doesn’t typically indicate a severe medical concern. However, in some instances, it can be a symptom of an underlying medical condition.
The most common cause of itchy scalp is seborrheic dermatitis, better known as dandruff. In infants, the condition is called cradle cap. This type of dermatitis is most likely to occur in the areas of sebaceous or oil-secreting glands, including the scalp and face. If the glands become inflamed, you can experience itching, flaking, red skin, and yellow or white scales on your skin.
While doctors don’t know the exact cause of seborrheic dermatitis, some potential causes include yeast on the skin, seasonal changes, and hormonal fluctuations.
An itchy scalp might simply be the result of having a sensitive scalp. However, it can also be a symptom of an underlying medical condition. Examples include diabetes mellitus and herpes zoster.
Additional causes include:
- allergic reaction to a medication
- anxiety disorder
- contact dermatitis or irritation due to something your scalp came in contact with, such as a new shampoo
- discoid lupus
- head lice
- hot comb alopecia, due to frequent heat styling
- migraine headache
- obsessive-compulsive disorder
- scalp psoriasis
- scarring alopecia
- ringworm (tinea capitis)
An itchy scalp can feel tingly or painful. Scratching or itching your scalp may help you feel better or it could cause pain. Symptoms that can accompany scalp itching include:
- bald patches
- dry skin
- irritated skin
- low-grade fever
- pus-filled sores
- scales or patches on the scalp
- scalp swelling
- sores on the scalp
If your scalp itch doesn’t go away in a few days and is accompanied by hair loss, pain, or intense itching, see your doctor. Itchy scalp due to a fungal infection or lice will not go away without medical treatments.
In addition to a physical examination of your scalp, your doctor may take a scraping of your scalp. In a lab, skin cells can be tested for the presence of fungus, bacteria, or lice. However, most doctors can diagnose your itchy scalp through a careful examination and medical history.
Treatment for itchy scalp depends upon its causes. For example, dandruff is treated through frequent hair washing with special topical agents. Each scalp medication works in a unique way, such as reducing oil on the scalp or killing off fungus.
Examples of scalp medications include:
- azole agents
- coal tar
- keratolytics, such as salicylic acid or coal tar
- pyrithione zinc
- sodium sulfacetamide
- topical terbinafine
Head lice require medical treatments, such as washing the hair with a pediculicide or using a medicine that kills lice. A fine-tooth comb can remove active lice while the medication kills lice eggs. In addition to these treatments, people living in close contact may need preventive treatment. All clothes, bedding, and towels that came in contact with the infected person must be washed or dry cleaned in temperatures greater than 128.3 degrees Fahrenheit.
If the itchy scalp is due to an allergic reaction, you should refrain from using the product that caused the reaction.
Reduce your risk for itchy scalp by washing your hair regularly to remove built-up oils. Wash your hair in warm, but not excessively hot, water to avoid irritating and drying out the scalp. To reduce allergic reactions, try to avoid using products that contain dyes, fragrances, and chemicals.
Avoid physical contact with people with head lice or fungal infections to prevent spreading the conditions. This includes refraining from sharing combs, brushes, hats, towels, helmets, or pillowcases.