Scalp pruritus, commonly known as itchy scalp, is a widespread issue that can lead to hair loss if excessive scratching damages the hair follicles or affects their structure. Various factors can cause this condition, and it may indicate an underlying medical problem. In addition, it can result in flaky, scaly patches, bumps, and hair loss. Proper treatment of the underlying scalp condition can often restore hair growth.
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What Are the Symptoms of An Itchy Scalp?
Experiencing an itchy scalp can result in a tingling or painful sensation. While scratching or itching the scalp may provide temporary relief, it can also lead to discomfort. Additional symptoms that may accompany scalp itching include dry or irritated skin, hair loss, pus-filled sores, redness, scalp swelling, and the appearance of scales or patches on the scalp.
If the itchiness persists for more than a few days and is accompanied by hair loss, pain, sores, or intense itching, seeking medical help is necessary. Some conditions that cause an itchy scalp, such as fungal infections or lice, require medical treatment for resolution. A physical examination and review of medical history are usually sufficient to diagnose the cause of the itchiness, but a doctor may also take a scraping of the scalp to test for the presence of fungi, bacteria, or lice.
Diagnosis of Itchy Scalp
An itchy scalp can be caused by a variety of factors, ranging from minor to more serious conditions. Some common causes of itchy scalp include:
- Dandruff: Dandruff is a common skin condition that affects the scalp. It causes flaky skin that may be white or yellowish in color. The flakes may be visible on the scalp or may fall onto clothing. Dandruff is often accompanied by itching and can be caused by a variety of factors, including an overgrowth of yeast on the scalp, dry skin, or sensitivity to hair care products.
- Psoriasis: An autoimmune condition that causes red, scaly patches on the skin, including the scalp.
- Eczema: A chronic condition that causes dry, itchy, and inflamed skin.
- Contact dermatitis: An allergic reaction to a substance that comes into contact with the scalp, such as hair dye or certain shampoos.
- Head lice: A parasitic infection that can cause intense itching and redness.
- Fungal infections: Infections caused by fungi, such as ringworm, can cause itching and flaking.
- Allergies: Allergic reactions to certain foods, medications, or environmental factors can cause an itchy scalp.
- Stress: Emotional or physical stress can cause a variety of physical symptoms, including itching and flaking of the scalp.
To determine the cause of an itchy scalp, it is best to consult with a healthcare professional or dermatologist. They can conduct a physical examination and may perform additional tests, such as a scalp biopsy or blood tests, to make an accurate diagnosis.
Common Causes of An Itchy Scalp And Treatment Options
An itchy scalp can be a major annoyance, but identifying the root cause of the itch is essential for effective treatment. Below, we’ve listed several common causes of an itchy scalp, including the effects they can have on your hair follicles and general hair growth, and what you can do to treat each condition.
Scalp Ringworm (Tinea Capitis)
Scalp ringworm, also known as tinea capitis or scalp fungus, is a type of fungal infection that develops on the scalp and inside hair follicles. This condition can cause small patches of inflamed, scaly skin on the scalp, broken hair strands, and severe itching. In severe cases, pus-filled nodules called kerions can develop on the scalp.
Hair loss is also common with this type of infection, and it can even cause scarring that may damage hair follicles and lead to permanent hair loss in certain areas of the scalp.
Causes: Fungi like Microsporum and Trichophyton, often found in wet areas like locker rooms, showers, or spread from person to person through combs, hats, and sports clothes. Some pets, such as cats, can also transmit fungal infections like tinea capitis to humans.
Treatment: Oral antifungal medication, shampoo, or topical medication to control fungal growth and reduce itching.
Folliculitis is a skin condition in which hair follicles become infected and inflamed, causing small bumps or pimple-like lesions to develop on the scalp. Bacteria is often the cause of this condition, which can make its way into the surface layers of hair follicles. Other causes of folliculitis include fungal species, viruses, and even mites that inhabit the skin.
You may be more likely to develop folliculitis if you shave your head, wear clothing that rubs or brushes against your hair, or touch your scalp often. Some medications, such as lithium and cyclosporine, can also increase the risk of developing folliculitis.
Treatment: Folliculitis often clears up on its own, but applying a hot compress to the affected area can help to drain affected follicles and prevent itching. Some antibiotics and antifungal medication may also help to clear this type of infection and improve recovery.
Seborrheic dermatitis is an inflammatory skin disease that can affect the scalp and other areas of the skin with large numbers of sebaceous (oil-producing) glands. This condition is most common in infants and middle-aged adults, causing itching, inflammation, swelling, dandruff, and greasy white scales to develop on the scalp and other areas of the body.
You may be more likely to develop seborrheic dermatitis if you’re male, have an immune system disorder, use immunosuppressant medication, live in a region with low humidity, or have a health condition such as Parkinson’s disease, depression, or dementia.
While there is no direct link between seborrheic dermatitis and hair loss, scratching your scalp often or overly aggressively may damage hair follicles and cause hair loss.
Treatment: Washing hair with a shampoo that contains coal tar, pyrithione zinc, ketoconazole, or selenium sulfide can help control itching and relieve symptoms. Medication can also be used to stop breakouts from returning in recurrent cases.
Lichen planopilaris (LPP) is an inflammatory condition that can affect the scalp and hair. It’s a form of lichen planus, a common disease that can cause swelling and inflammation in mucous membranes.