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Itchy scalp: what are the possible causes? Answers from a dermatologist

An itchy scalp is a common problem with many possible causes. A dermatologist would usually consider the pattern of symptoms, skin appearance, and your medical history to identify the cause.

Here are some of the most common causes:

  1. Dandruff (seborrheic dermatitis)
    • One of the most common reasons for an itchy scalp.
    • Often causes white or yellowish flakes and redness.
  2. Dry scalp
    • Dry skin from cold weather, frequent washing, or harsh hair products can lead to itching and flaking.
  3. Contact dermatitis
    • An allergic or irritant reaction to hair dye, shampoo, conditioner, styling products, or fragrances can cause itching, redness, and sometimes a rash.
  4. Psoriasis
    • Can produce thick, silvery scales and well-defined red patches on the scalp.
  5. Eczema (atopic dermatitis)
    • May cause itchy, inflamed, dry skin and can affect the scalp in some people.
  6. Head lice
    • Intense itching, especially behind the ears and at the back of the neck, may be due to lice or their eggs (nits).
  7. Fungal infection (ringworm of the scalp)
    • More common in children but can affect adults.
    • May cause itching, scaling, and patchy hair loss.
  8. Stress or nerve-related itch
    • Stress can worsen existing scalp conditions or contribute to itching without an obvious rash.

What may help

  • Use a gentle shampoo if you have a dry or sensitive scalp.
  • If dandruff is present, try an anti-dandruff shampoo containing ingredients such as ketoconazole, selenium sulfide, zinc pyrithione, or coal tar (as appropriate).
  • Avoid scratching, as it can damage the skin and increase the risk of infection.
  • If you suspect a reaction to a new hair product, stop using it.

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