Why does your scalp itch?

Image produced by Frank Gaillard

An itchy scalp is a relatively common complaint in the dermatologist’s office. Sometimes, a rash of the scalp is visibly present, but other times, the scalp can look completely normal making it quite difficult to tell what the cause of the itchy scalp is!

So here are some causes of an itchy scalp with a rash:

– Seborrheic dermatitis – Dandruff is a variant of this as is cradle cap in infants. The scalp is often red with greasy yellow scale.
– Psoriasis – Patients often has psoriasis elsewhere on the body too. Red areas are present with drier whitish or silvery scale.

Here are some causes of itchy scalp with visible change of the scalp and hair loss:

– Frontal fibrosing alopecia
– Central centrifugal cicatricial alopecia
– Lichen planopilaris

(These are rare so don’t go diagnosing yourself!)

Infections of the hair follicles can lead to itchy scalp too. e.g. infection by bacteria, fungus, or mites.

There is definitely a strong neuro-derm component to itchy scalp as well. Researchers have found a close association of nerve endings with hair follicles — so there’s an anatomical reason as to why you might have itching of the scalp but not of other areas of the body.

Regardless, if itchy scalp is something that you are struggling with, see your dermatologist. Dermatologists are doctors of the skin but also of the hair and nails!