An itchy scalp is a common and uncomfortable symptom that can be caused by a number of conditions, including dandruff, head lice, and ringworm. The level of itchiness can range from mild to intense, causing minor-to-moderate discomfort or intense itching.1

Fortunately, an itchy scalp can be effectively treated. Depending on the cause, itchy scalp can be treated with over-the-counter solutions or prescription medication. A healthcare professional, such as a dermatologist (a doctor who specializes in conditions that affect the hair, skin, and nails), can diagnose the cause and identify the best treatment.12

Itchy Scalp Causes 

The reasons why your scalp might be itching vary greatly. From skin conditions to parasites, here are some potential causes of itchy scalp.

Infrequent Hair Washing

As you go about your day, sebum accumulates on your scalp. Sebum is an oily substance that prevents your skin from drying out. When you wash your hair, sebum and other debris are washed away. Not washing your hair enough can cause sebum to accumulate, and it’s believed that sebum accumulation and itchy scalp are associated.3

Research has shown that scalp itchiness can get significantly more severe three days after shampooing for populations with oily hair. Higher frequency shampooing is associated with less itchiness.3

Reaction to a Hair Product

Your scalp might get itchy if you aren’t rinsing out your shampoo well enough. Leftover shampoo can irritate your scalp.1

If you develop a rash alongside your itchy scalp, you might be allergic to one of your hair products, such as your shampoo, conditioner, or hair dye. Such a reaction would be known as allergic contact dermatitis, which is an itchy rash brought on by exposure to a substance to which you are allergic.1

Dandruff

Dandruff is a common condition that causes small, flaky pieces of skin to fall off your scalp. These yellow or white flakes flakes can bring on itching.45 The flaking may be oily or dry, and people with dandruff may notice visible flakes on their hair or clothing.6

Sometimes dandruff can be caused by an underlying medical condition like eczema. It’s still unclear why people without any such health condition develop dandruff, but certain factors, like not washing your hair often enough, can exacerbate dandruff.4

Seborrheic Dermatitis

Seborrheic dermatitis is a common skin condition that causes a scaly rash. The condition can affect any oily part of your body, including your scalp.7

The white or yellow scales can be dry or oily and are itchy. The itching can get worse if the area becomes infected. Because seborrheic dermatitis is an inflammatory condition, you can develop a rash as well. The rash can cause swelling and discoloration. If you have darker skin, the rash may look pink, purple, or lighter than the surrounding skin. If you have lighter skin, the rash will look red and raised.7

Head Lice 

Head lice are tiny insects that can invade and live on your scalp.8 You may see adult lice on the scalp or hair. They are about the size of a sesame seed and are light brown in color. Since they move, they are harder to find than the parasites’ eggs (also called nits). Nits are yellow, brown, or tan and are stuck on the hair.9

Head lice spreads easily and is especially common among children 3-11 years old. The main symptom is intense itchiness of the scalp.8 The itching is actually an allergic reaction to the insect bites.10

Scalp Psoriasis 

Plaque psoriasis is an autoimmune inflammatory skin disorder that causes silvery-white scales and thick reddish patches, called plaques, on the skin.11 About 50% of people with plaque psoriasis experience it on their scalp at some point.1

The plaques may extend beyond the scalp to the back of the neck or behind the ears. The intensity of itching can range from mild to severe.1

Nerve Problem

After nerve-related damage or disease, your nerves can change in ways that make you experience abnormal sensations. When the nerves that affect your scalp are impacted, the abnormal sensation may come in the form of itch.12

A healthcare provider may refer to the nerve change as neuropathy. Deep scarring from hair loss has the potential to damage nerves and cause an itchy scalp.1 Diabetes, brow lifts, and burn-related scars can also cause neuropathy and, in turn, itching of the scalp.12

Some neurological conditions, like stroke and tumors, can also cause an itchy scalp.13

Diagnosing the Cause

An itchy scalp is often caused by a minor irritation or sensitivity. However, persistent itchiness can sometimes indicate an underlying skin condition or disease. To properly diagnose the cause of an itchy scalp, it’s important to consult a dermatologist.

The dermatologist will likely start with a physical exam of the scalp. They will look for signs of redness, inflammation, scaling, sores, or hair loss. The distribution of itchiness and scaling can help determine if it’s caused by dandruff, seborrheic dermatitis, psoriasis, or an allergic reaction.

The next step may involve taking a skin sample or scraping to examine under a microscope. This can detect ringworm, bacterial infections, and fungal infections like tinea capitis. Skin scrapings can also test for scabies mites.

Allergy testing may be recommended if the cause is suspected to be contact dermatitis or an allergy to hair products. Patch testing can help identify allergenic ingredients. Blood tests can measure IgE antibodies to detect allergies to foods, dust mites, pollen, and other triggers. Identifying and avoiding triggers is key to managing allergic itchy scalp.

Getting an accurate diagnosis from a dermatologist ensures proper treatment. It also rules out contagious conditions or more serious underlying disorders. Leaving itchy scalp untreated allows symptoms to worsen over time. Early diagnosis and treatment helps resolve irritation and itchiness.

Lifestyle Remedies for an Itchy Scalp

An itchy scalp can often be managed at home with some simple lifestyle changes and home remedies. Here are some tips:

• Use gentle, fragrance-free hair products. Fragrances, preservatives and chemicals in hair products can irritate the scalp and make itching worse. Switch to fragrance-free shampoos and conditioners formulated for sensitive skin.

• Wash hair less frequently. Over-washing strips the scalp of natural oils that protect and moisturize. Limit washing to 2-3 times per week if possible.

• Manage stress and get enough sleep. Stress and lack of sleep may worsen itching. Practice relaxation techniques and maintain a regular sleep schedule.

• Stay hydrated. Drink plenty of water throughout the day. Dehydration can cause an itchy scalp.

• Avoid excessive heat styling. Limit use of hot tools like blow dryers, straighteners and curling irons. Heat can dry out the scalp. Let hair air dry when possible.

Making simple changes to hair care routines and lifestyle habits can help control an itchy scalp without the need for medications. Be gentle with your hair and scalp. Reducing irritation is key to managing the itch.

Medicated Shampoos

Medicated shampoos containing anti-fungal, anti-bacterial, and anti-inflammatory ingredients can help treat an itchy scalp caused by conditions like seborrheic dermatitis, psoriasis, and fungal infections. Some of the most common medicated ingredients to look for include:

• Ketoconazole – This anti-fungal medication inhibits the growth of the yeast Malassezia that can trigger seborrheic dermatitis. Ketoconazole shampoos include Nizoral.

• Selenium sulfide – This ingredient has anti-fungal and anti-dandruff properties that help with conditions like seborrheic dermatitis. Popular selenium sulfide shampoos are Selsun Blue and Head & Shoulders.

• Coal tar – Derived from coal, coal tar has anti-dandruff, anti-itch, and anti-inflammatory effects. It helps treat scalp psoriasis, seborrheic dermatitis, and cradle cap. Common brands are Neutrogena T/Gel and Denorex.

• Salicylic acid – This beta hydroxy acid acts as a keratolytic agent to soften and loosen dry, scaly skin. Salicylic acid shampoos like Neutrogena T/Sal help treat scalp psoriasis.

• Corticosteroids – For severe itching and inflammation, shampoos containing corticosteroids like clobetasol or fluocinonide may be prescribed. They help resolve symptoms of conditions like scalp psoriasis.

Using these medicated shampoos as directed can significantly relieve itchiness and irritation caused by scalp conditions. Consult a dermatologist to determine which ingredient or prescription-strength formulation is right for your needs.

Natural Oils and Extracts

Natural oils and extracts can help soothe and treat an itchy scalp without harsh chemicals. Some of the most effective options include:

Tea Tree Oil

Tea tree oil has natural antifungal and antibacterial properties that can help treat fungal infections and skin conditions causing an itchy scalp. It may also help reduce inflammation. Dilute a few drops of tea tree oil with a carrier oil like coconut oil and massage into the scalp before showering.

Peppermint Oil

The menthol in peppermint oil creates a cooling sensation on the skin that can relieve itchiness. Mix a few drops into shampoo or dilute with a carrier oil to apply to the scalp. Peppermint also has antimicrobial effects.

Coconut Oil

Coconut oil is an excellent moisturizer for the scalp. It can help replenish moisture, reduce dryness and irritation, and protect the skin barrier. Warm a small amount in your hands and massage into the scalp before showering. Rinse thoroughly.

Apple Cider Vinegar

Apple cider vinegar helps balance the pH of the scalp while removing dead skin cells and product buildup. It also has antimicrobial effects. Dilute 1 part vinegar with 1-2 parts water and rinse through the hair and over the scalp. Rinse thoroughly.

Aloe Vera

Aloe vera gel is incredibly soothing and hydrating for the skin and scalp. It contains enzymes and polysaccharides that help reduce inflammation. Apply pure aloe vera gel to the scalp and let it sit for 30 minutes before rinsing out. It can be used daily.

Using natural oils and extracts can be an effective way to find relief from an itchy, irritated scalp without harsh chemicals. They help treat the underlying causes while providing symptom relief. Monitor for allergic reactions when trying new ingredients. Consult a dermatologist for severe or persistent symptoms.