Itchy scalp is a common problem in general population. It can be caused by many skin diseases affecting the scalp and hair.
Itchy scalp can be caused by a number of diseases. A proper diagnosis is important to effectively treat the scalp itching.
Causes of Itchy Scalp
The commonest causes of itchy scalp are dry scalp, dandruff, seborrheic dermatitis, scalp psoriasis, contact dermatitis, head lice infestation, ring worm of the Scalp, pityriasis amiantacea, lichen planus, hair follicle inflammation, neurogenic excoriation and pyogenic infection of scalp. Needless to say, a definite diagnosis is necessary to effectively get rid of the itchy scalp.
Dry scalp is one of the overlooked causes of itching of the scalp. Dryness of the scalp may be caused by harsh shampoos, hair lotions or tinctures (with alcohol as base) or following frequent washing.
While mild dandruff may not cause much itching on the scalp, superadded yeast infection will cause itching of mild to moderate severity. The scaling of dandruff is generalized over the scalp.
Seborrheic dermatitis shows greasy scales throughout the scalp. The underlying skin may be reddish. In severe cases, red scaly rashes may be present on the sides of the nose, chest and back. The scalp itching in seborrheic dermatitis can be moderate to severe.
Scalp psoriasis, in contrast to seborrheic dermatitis, has thick scales with scattered plaques at different places of the scalp. Scrapping off the scales reveals bleeding points, what is known as the Auspitz’ sign. Itching is variable in scalp psoriasis.
Allergy to some scalp and hair applications (creams, lotions, gels, shampoos, hair dye etc) can present as severely itchy scalp with oozing and crusting and scaling. A history of topical applications prior to the clinical manifestations of scalp itching and dermatitis clinches the diagnosis in most cases.
Head Lice Infestation (Pediculosis capitis)
Pediculosis capitis or head lice infestation is a common cause of itchy scalp in girls and young woman who tie their hair before it is dry and create a perfect environment for the lice to flourish. Severe lice infestation can cause secondary bacterial infection, oozing, crusting and dermatitis changes on the scalp neck and forehead. At times a generalized itchy dermatitis, an ide eruption may appear all over the body if the lice infestation is very severe. Finding the louse and/or its nits confirms the diagnosis.
Ring Worm of the Scalp (Tinea capitis)
Ring worm of the scalp is usually seen in children, and rarely in adults. There is circumscribed and patchy scaling and itching with broken hairs or hair fall in the area.
Pityriasis amiantacea (Tinea amiantacea)
Pityriasis amiantacea is thought to be hypersensitivity response to a number of scalp diseases, like scalp psoriasis, seborrheic dermatitis or lichen simplex. Tinea amiantacea is a misnomer as fungal infection is rarely a cause for P.amiantacea. There is a thick yellow crusty flaking of the scalp along with matting of the hairs in the affected areas. Scaling is more prominent than itching in P.amiantacea.
Lichen planus can affect the scalp at times, and is known as lichen plano pilaris. Redness, itching, hair loss and scarring are the features of lichen planus.
Hair Follicle Inflammation
Hair follicles inflammation or infection, known as folliculitis can occur on the scalp due to yeast or bacteria. Itchy scalp and painful, scattered and infected bumps are the features.
Neurogenic excoriation or lichen simplex is another cause for itchy scalp and is related to stress and anxiety. Habitual scratching leads to thickening and hair loss to a localised area of the scalp, usually on the sides.
Pyogenic Infection of Scalp
Bacterial infection of the scalp is common in malnourished children. Itchy, flaky crusts with yellowish discharge mat the hairs together.
The information given in this article is for educational purpose only so that patients are aware of the options available for diagnosis and treatment of common skin, hair and nail diseases. No diagnosis should be made or treatment undertaken without first consulting your dermatologist. If you do so, the author will not be responsible for any consequences. The images provided are for illustration purpose only and should not be reproduced without the consent of the author.
About the Author of Skin Care Tips from Dermatologist: Dr Hanish Babu, MD
Dr Hanish Babu, MD is a dermatologist with more than 3 decades of experience in treating skin and sexually transmitted diseases in UAE and India. He has been practicing in UAE since last 22 years. He is a respected speaker during the Continuing Medical education Programmes for doctors, medical students and paramedical staff and is also a Stress Management Trainer. He organises group therapy sessions for patients with psoriasis, eczema and vitiligo.
He is available for consultation at Cosmolaser Medical Centre in Samnan, Sharjah (06 5678 200) from 9 am – 1 pm and at City Medical Centre, Al Bustan, Ajman (06-7 441 882) from 4.30 pm – 9.30 pm.
Visit his personal website dr-hanishbabu.com for more details and for educational articles on Skin, hair, nail and sexually transmitted diseases. Click here to Book an Appointment with dermatologist Dr Hanish Babu, MD