What's Causing Your Itchy Scalp? Find Relief Now

An itchy scalp can drive anyone crazy, but did you know it could also be a sign of an underlying issue?

Medically known as scalp pruritis, itchy scalp is a more common problem than you may think. Although literature regarding its prevalence is limited, evidence suggests it affects anywhere from 13-45% of people. Stopping the itch requires identifying what's causing it in the first place. This article will explore common causes of an itchy scalp and what you can do about it.

[signup]

What is an Itchy Scalp?

Pruritis is the medical term for itching. An itchy scalp, or scalp pruritis, is characterized by an uncomfortable sensation on the scalp that provokes the urge to scratch. Sometimes, this sensation is described as tickling; other times, it can feel more painful. The scalp contains numerous nerve endings, making it sensitive to various irritants and conditions that can trigger itchiness.

How Scalp Itching Affects Daily Life

Studies have shown that patients with chronic itching due to dermatologic conditions may experience increased anxiety, depression, agitation, difficulty concentrating, and a reduction in sexual desire and function. Longer-lasting and frequent itching is more likely to negatively impact quality of life. 

Chronic scratching can damage hair follicles on the scalp, causing hair loss. Since hair appearance is closely tied to self-perception and body image, hair loss can contribute to psychological distress, negative emotions, and behavioral changes like depression, embarrassment, reduced confidence, reduced work performance, and social withdrawal. 

Common Causes of an Itchy Scalp

According to the American Academy of Dermatology, these are some of the most common reasons your head might itch.

Dandruff

Dandruff is the most common cause of an itchy scalp. This condition is considered to be a mild form of seborrheic dermatitis and manifests as white or yellowish flakes of dead skin that appear on the scalp and in the hair. It is typically caused by excess oil production and an inflammatory reaction to an overgrowth of Malassezia yeast on the skin. 

Hives

Hives, also known as urticaria, are raised, itchy welts that can appear on the skin, including the scalp. They result from an allergic reaction or other triggers, such as stress and extreme temperatures, that cause the body to release histamine.

Contact Dermatitis

Contact dermatitis occurs when the scalp reacts to certain substances applied to the skin, leading to irritation and itching. Common allergens documented to cause contact dermatitis of the scalp include:

• Paraphenylenediamine (PPD), an ingredient in hair dye
• Nickel, used in hairpins and brushes
• Fragrances and other ingredients in personal care products like shampoo and conditioner

Psoriasis

Psoriasis is a chronic autoimmune condition that speeds up the growth of skin cells, causing thick, scaly patches to develop on the affected areas of the skin. About 50% of people with psoriasis will experience a flareup (an episode of worsening symptoms) on the scalp at some point during their lives.

In addition to intense itching, psoriasis symptoms include: 

• Red patches covered with silvery scales
• Dandruff-like flaking
• Dry scalp
• Temporary hair loss

Atopic Dermatitis

Atopic dermatitis is the most common type of eczema, a chronic skin condition that causes dry, itchy skin and rashes. It can affect any part of the body, including the scalp. The itching associated with eczema can be so severe that it interferes with sleep in most affected children and adults. 

Tinea Capitis

Tinea capitis is a form of ringworm that affects the scalp. Unlike the name suggests, ringworm is an infection caused by fungus, not worms. 

Scalp ringworm causes a skin rash with the following symptoms:

• Swollen red patches
• Dry, scaly skin
• Itching
• Patches of hair breakage and hair loss

Head Lice

Head lice are tiny parasites that live on the scalp and feed on blood by biting the skin. Infestation is transmitted from person to person by direct contact or by sharing items (e.g., combs and hats) used by an infected person. 

The most common symptom of a head lice infestation is itching, especially on the back of the head, neck, and behind the ears.

Remedies for Relieving an Itchy Scalp

The most effective remedy for relieving an itchy scalp depends on what's causing it, which is why it's so important to get an accurate diagnosis. Treatment options may include: 

Home Remedies

Natural solutions may help soothe an itchy scalp without the need for medications. Some popular home remedies include:

• Tea Tree Oil: Research suggests that tea tree oil shampoos can reduce patient-reported dandruff, itching, and greasiness by stopping fungal growth associated with seborrheic dermatitis.  
• Aloe Vera Gel: Topical aloe vera may help alleviate skin dryness and itching by locking moisture into the skin and reducing inflammatory immune responses. You can apply pure aloe vera gel directly to the scalp and leave it on for 20 minutes before rinsing.
• Apple Cider Vinegar (ACV): It is postulated that ACV's acidic nature could help balance the skin's pH and microbial environment. While evidence is limited, the National Eczema Association suggests that soaking in a lukewarm bath with two cups of ACV for 15-20 minutes before rinsing the body with cool water could help restore the skin's natural pH and support healthy skin barrier function.
• Coconut Oil: Coconut oil is a highly concentrated source of medium-chain fatty acids (MCFAs). Research suggests that MCFAs are antimicrobial, which could benefit people with skin conditions characterized by an overgrowth of bacteria or yeast. For example, according to one study, people with mild-to-moderate atopic dermatitis who applied coconut oil to their skin experienced a reduced abundance of Staph aureus bacterial growth and less severe itching.

Topical Medications

There are numerous over-the-counter medicated products designed to treat common health conditions that cause itching. The appropriate product depends on the underlying condition. Examples include:

• Shampoos containing selenium sulfide or zinc pyrithione for dandruff and seborrheic dermatitis
• Coal tar shampoos for scalp psoriasis 
• Antiparasitic medicated shampoos that contain permethrin to treat head lice

If an over-the-counter product cannot control the itch, your doctor may prescribe something stronger. For example, research demonstrates that ketoconazole 2% shampoo is highly effective at treating seborrheic dermatitis and dandruff and preventing recurrence when applied to the scalp once weekly.

Always follow the instructions on product labels and consult with a healthcare professional before starting new treatments to ensure they are appropriate for your specific condition.

Lifestyle Changes

Making certain lifestyle adjustments might help to improve overall skin health and reduce itching. 

Eat a diet rich in antioxidants, molecules that neutralize inflammatory reactive oxygen species. Inflammation causes itching by releasing chemicals that activate the nerve endings in your skin. Antioxidant nutrients include: 

• Vitamin C: citrus fruits, strawberries, kiwi, bell peppers, and broccoli
• Vitamin E: almonds, sunflower seeds, peanuts, and spinach
• Selenium: Brazil nuts, seafood, meat, and poultry
• Resveratrol: red grapes, blueberries, cranberries, and peanuts
• Coenzyme Q10: fatty fish, eggs, and whole grains

Dry skin results from inadequate moisture and causes symptoms like roughness, scaliness, and itching. Insufficient water intake is a common contributing factor. Staying well hydrated can improve skin hydration and physiology. For instance, one study demonstrated that adding two liters (about eight glasses) of water per day to the regular diet over a month significantly increased both superficial and deep skin hydration in healthy females.

Stress can exacerbate certain skin conditions, such as eczema and psoriasis. Practices like yoga, meditation, and regular exercise can help manage stress.

Consult a healthcare professional before significantly changing your diet or lifestyle, especially if you have underlying health conditions.

When to See a Doctor

While many cases of itchy scalp can be managed at home, certain symptoms warrant professional medical attention.

Warning Signs of Serious Conditions

Schedule an appointment to see a doctor if:

• At-home treatments and self-care practices are ineffective at solving scalp itching
• You begin to experience new and worsening symptoms, such as sores, hair loss, and pain
• You cause the skin to bleed from scratching
• The itching is so severe that it disrupts daily activities or sleep

Diagnostic Approaches

Healthcare professionals may use several diagnostic tools to determine the cause of scalp itching:

• Collect a thorough patient history that focuses on the patient's medical history and exposures to common culprits of pruritis.
• Perform a comprehensive physical examination to assess the skin and inspect present skin lesions
• Blood tests to rule out systemic diseases that can cause itching
• Patch testing to identify potential allergens causing contact dermatitis
• Skin scrapings and biopsies to rule out infection and help diagnose conditions like psoriasis or eczema

[signup]

Key Takeaways

• A persistently itchy scalp is a sign of an underlying health issue that must be treated.
• Seven of the most common causes of an itchy scalp include dandruff, hives, contact dermatitis, psoriasis, atopic dermatitis, ringworm, and lice.
• Effective relief from itching depends on identifying the underlying cause. Depending on the reason, home remedies like tea tree oil and aloe vera, over-the-counter products containing ketoconazole or zinc pyrithione, and lifestyle changes can often alleviate symptoms. Persistent or severe itching may require professional medical intervention to address more serious conditions.
• Prioritizing scalp health improves comfort and confidence and ensures that any underlying issues are properly managed.