Got an itch on your head that you just can’t scratch? If those prickles and tingles go way beyond what feels normal, you might be wondering what’s to blame. Is it an allergy? An infection? Something even more serious?
Luckily, an itchy scalp is super common and typically has a pretty harmless cause that you can easily take care of. Here, the most likely causes of scalp itch, according to dermatologists, and what to do about it so you can stop scratching for good.
1. Dandruff
What it looks and feels like: You’ve got flakes and itchiness all over your head.
What causes it: Dandruff has three main causes: an oily scalp (not a dry one), a buildup of dead skin or styling products, or a yeast-like fungus called malassezia.
How to get relief: Vigorously massaging shampoo into your scalp (not just into your hair) may lift product buildup, but if flaking persists, use shampoo containing zinc or salicylic acid, which treat fungus, buildup, and oil, like Head & Shoulders Classic Clean Shampoo ($6, amazon.com). Still itching after a few weeks? You may need to visit your derm to see if something else is going on.
2. Allergic reaction
What it looks and feels like: Your whole scalp feels itchy.
What causes it: Ingredients in some hair products can prompt an allergic reaction, says Maria Hordinsky, MD, professor and chair of dermatology at the University of Minnesota in Minneapolis. “The allergen is often fragrance, or a moisturizing agent called propylene glycol.”
How to get relief: Stop using these suspects for a week; if the irritation goes away, replace your old products with fragrance- or PG-free options (for the latter, try the Alba Botanica line, $18.99, amazon.com). Scorching temps from styling tools like blow-dryers, flatirons, and curling irons can also dry out the scalp and cause itchiness, so keep heat settings on medium.
3. Psoriasis
What it looks and feels like: Your itch is just in one spot, and you have raised, scaly patches.
What causes it: This is an autoimmune condition and it runs in families, according to the American Academy of Dermatology (AAD). Things like stress, an infection, some medications, and cold, dry weather can trigger flares, though.
How to get relief: If your dermatologist determines you have psoriasis, use a shampoo with coal tar—sounds weird, but it works—like Neutrogena T/Gel Therapeutic Shampoo ($5, amazon.com), says dermatologist Joshua Zeichner, MD, director of cosmetic and clinical research at Mount Sinai Hospital in New York City. Your doc can prescribe stronger remedies if needed.
4. Precancerous legion
What it looks and feels like: A crusty spot about a quarter-inch in diameter.
What causes it: It’s called actinic keratosis, and it’s the result of sun exposure over many years, says Dr. Hordinsky.
Next steps: About 10 percent of these become cancerous, so see your derm ASAP to have it checked and, if needed, removed. Ward off future damage by using a sunscreen specially formulated for the scalp, such as Banana Boat Sport Quik Dri Scalp Spray ($9.99, amazon.com)—yes, in the winter too.
5. Hives
What it looks and feels like: Red, itchy spots where the skin is raised.
What causes it: It’s usually linked to an allergic reaction to something, like your shampoo or a product you used, says board-certified dermatologist Ife J. Rodney, MD, founding director of Eternal Dermatology + Aesthetics.
How to get relief: “Take an oral antihistamine, like Benadryl or Zyrtec,” Dr. Rodney says. One thing you shouldn’t try is a topical antihistamine cream. “They can make things worse,” Dr. Rodney says.
6. Lice
What it looks and feels like: Lice create an itchy feeling that can be all over your head. You may also see the eggs of the parasites along your hair shaft (they can look like grains of rice), Dr. Rodney says.
What causes it: You get head lice from coming into contact with someone who has the condition, or from sharing things that they’ve used, like a hat, comb, or brush.
How to get relief: Permethrin shampoo is usually used to treat lice. While you can find it OTC, “you may need a prescription,” if you have a particularly intense case, Dr. Rodney says.
7. Scabies
What it looks and feels like: Dr. Rodney describes it as “really intense, annoying itching.”
What causes it: Scabies is caused by tiny mites that burrow in your scalp. Scabies isn’t very common, but people who do get the condition usually have had close contact with someone with scabies. They may have recently stayed at a motel or hotel that was infested, Dr. Rodney says.
How to get relief: “You need to see a dermatologist,” Dr. Rodney says. “Over-the-counter treatments don’t usually clear this up.” Like lice, scabies is usually treated with permethrin, she says.
8. Scalp ringworm
What it looks and feels like: Dandruff or scaliness, although it could be a round patch with raised borders.
What causes it: The contagious fungal infection is caused by direct contact with an infected person, Dr. Rodney says.
How to get relief: You’re probably going to need prescription-strength antifungal medications, like a lotion or ointment that you put on your skin, Dr. Rodney says. In some cases, you’ll need an oral antifungal medication. Meaning, you need to call your doctor.
9. Atopic dermatitis
What it looks and feels like: Atopic dermatitis on your scalp looks like itchy, red skin. It’s also likely to show up on your elbows and backs of your knees, Dr. Rodney says.
What causes it: It’s usually genetic, meaning you’re more likely to have it if someone else in your family has the condition.
How to get relief: Try to figure out your triggers, like scented or abrasive shampoos. “It’s super important to take short, warm showers, instead of hot showers,” Dr. Rodney says. You’ll also want to use a gentle conditioner to moisturize your scalp. Talk to your doctor if you’re still struggling.
10. Nerve issues
What it looks and feels like: You won’t see anything on your scalp, except for maybe scratch marks from you. “We can always tell when a patient has nerve issues because there’s no primary skin lesion,” Dr. Rodney says.
What causes it: Nerves in your scalp that are over-reacting and firing too often.
How to get relief: See your primary care physician—they’ll likely refer you to a neurologist, Dr. Rodney says. “Some medications can help,” she adds.
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