December 10, 2023

Itchy Scalp? 8 Common Causes and How To Find Relief

Options range from allergic reactions and head lice to chronic conditions and fungal infections

Back of person's head with long hair with hands scratching their scalp

Cartoons tell us that scratching your head means you’re thinking really hard or having a great idea. But in real life, having a consistently itchy scalp can indicate that you’re dealing with a health condition.

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Before you can stop the itch, you need to find out what’s causing it. But how? Dermatologist Melissa Piliang, MD, explains common causes and treatments for itchy scalp.

8 common causes of an itchy scalp

Unfortunately, there’s no single, straightforward answer to why your scalp is so freaking itchy. There are multiple reasons you could be experiencing this sometimes-excruciating feeling.

Dr. Piliang outlines some of the possible causes so you can start to figure out what might be behind your itch.

Reactions to a hair product

You could have an itchy scalp because you’re having a bad reaction to something you’re putting in your hair, like dye. Contact dermatitis is a rash that happens when your skin comes into contact with something that irritates it or that you’re allergic to.

A common offender is para-phenylenediamine, a chemical found in dark hair dyes and henna. But other products could be the source of your contact dermatitis, too.

What to do: “Allergic reactions will generally go away on their own if you can identify and avoid the chemical to which you are allergic,” Dr. Piliang says. “This can be challenging to do on your own, so you may need to do specialized tests in a dermatologist’s office to sort out the cause of your allergy.” 

Seborrheic dermatitis

The most common cause of an itchy scalp is seborrheic dermatitis, a skin condition that causes dandruff. It’s your body’s inflammatory response to an overgrowth of yeast.

“This causes itching and flaking,” Dr. Piliang explains. “Yeast normally lives on the scalp and other hairy areas of the body, but the problem arises when there’s too much yeast present.”

What to do: For mild cases, try an over-the-counter shampoo that contains selenium or zinc pyrithione. These ingredients help control yeast. But for serious cases, you may need to see a healthcare provider for a prescription-strength antifungal shampoo, topical cortisone or medicated foam, solution, cream or ointment. 

Hives

If you’ve ever broken out in hives — say, on your face, chest or arms — you know how itchy and unpleasant they can be. They can occur on your scalp, too.

What to do: Hives often go away on their own pretty quickly. But if they don’t go away or you get them often, it’s time to see a dermatologist. 

Psoriasis

Scalp psoriasis is a chronic autoimmune disease that causes raised, reddish, scaly patches on your scalp. These are called plaques.

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Experts don’t have a clear understanding of what exactly causes this skin disorder, but you’re more likely to develop it if someone in your family has it. But you can’t “catch” psoriasis from other people

What to do: “Medicated shampoos that have coal tar or salicylic acid can help keep scalp psoriasis under control,” Dr. Piliang says. If those don’t work, make an appointment with a dermatologist, who can prescribe stronger shampoos and topical cortisone.

Ringworm

Also known as tinea capitis, scalp ringworm is a fungal infection that can infect the scalp. It extends deep into the hair follicle, causing round patches of hair loss that get bigger over time. The rash may appear raised and with black dots or have a stubbly appearance. 

What to do: When you have a ringworm infection of the skin, you can use an over-the-counter (OTC) antifungal formulation to get rid of it. But that’s not the case when you have ringworm of the scalp.

“Because the organism exists deep in the hair follicle, you’ll need to take oral anti-fungal medications to resolve the problem,” explains Dr. Piliang, “but your doctor will want to verify that this is actually what’s causing the problem before they prescribe this type of powerful medication.”

Head lice

These tiny insects can invade anyone’s scalp, not just children’s — and they actually prefer to live in clean hair, contrary to the popular assumption that having head lice is the result of poor hygiene.

If you look closely, you can see tiny nits (eggs) attached to individual hair strands. They look a bit like dandruff, but they aren’t easily shaken off because they’re “glued” to the hair shaft. Adult lice move around the head, but they’re harder to spot than nits.

What to do: Start by looking for over-the-counter shampoos that contain pyrethrin or permethrin. These work well — but only if you use them as directed.

“Each head lice shampoo formula has its own treatment protocol,” Dr. Piliang states. “You must follow the instructions on the box exactly to get rid of the lice.”

If the shampoo doesn’t work, it’s time to ask a dermatologist for help. Don’t use any type of chemicals to try to loosen the nits, and skip home remedies like mayonnaise, olive oil and petroleum jelly. They don’t work and can cause further damage.

Acne

Yep, you can get acne and pimples on your scalp. Ouch! They can be painful, but they can also cause itchiness.

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Pimples on your scalp can have some of the same causes as pimples on the rest of your body, including sweat and beauty products.

What to do: You may be able to prevent this issue moving forward by: 

  • Using different hair products.
  • Washing your hair more often, especially after you’ve gotten sweaty.
  • Avoiding tight-fitting hats or headbands.

“If none of these tips help, talk to a dermatologist about other options, including prescription topical or oral medication,” Dr. Piliang advises.

Atopic dermatitis

Atopic dermatitis is the most common type of eczema. It’s a chronic condition that causes itchy, dry, scaly skin and can affect any part of your body, including your scalp. Periods of itchiness and rash may come and go throughout your life.

“The itchiness associated with atopic dermatitis can be so severe that it interferes with school, work and sleep,” Dr. Piliang says. Because it’s a lifelong condition that often appears in childhood, it’s unlikely to appear for the first time in the form of an itchy scalp — but late-onset eczema is possible.

What to do: Atopic dermatitis can’t be prevented, but you can manage it so your flare-ups are less severe (aka, less itchy!). If your scalp itchiness won’t subside, see your dermatologist about the possibility of medication that can help. 

How to stop an itchy scalp

The solution for your itchy scalp depends on the reason for your itchy scalp, but treatments may include:

  • Over-the-counter medicated shampoos: There are lots of OTC shampoos on the market, each designed to treat different causes of itchy scalp. But what kind you need depends on what condition you’re dealing with. Be sure you’re looking at the ingredient list to match it up to the issue you’re having. 
  • Prescription-strength shampoos: If over-the-counter shampoos don’t work, a dermatologist may prescribe you something stronger.
  • Topical medication: Shampoos aren’t the only answer. Dermatologists also sometimes prescribe medicated foams, ointments and other forms of medication that are applied directly to your skin. 
  • Oral medication: Depending on the cause of your itchy scalp, you may need to take oral medication (pills) to tackle the issue once and for all.

Just beware of trying any so-called home remedies without a doctor’s go-ahead. They can be unhelpful at best and harmful at worst, so to protect your skin and hair — and tackle the problem quickly and efficiently — it’s always best to make an appointment with a healthcare provider.

When to worry about scalp itchiness

Most of the time, an itchy scalp isn’t cause for concern. But there are times when it can indicate something more serious. See a doctor if:

  • Over-the-counter shampoos don’t make any difference.
  • The itching keeps you up at night and affects your work or study.
  • You see lice or nits in your hair.
  • The itchy spots are very sore to the touch.

Dr. Piliang says it’s always a good idea to see a dermatologist when you have a persistent itchy scalp — even if you think it’s just common dandruff.

“They can check it out and tell you which remedies will bring you some relief,” she assures.

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