Scalp pruritus: causes and treatment

Pruritus of the scalp, more commonly known as itchy scalpis a skin problem that can affect anyone at any time in their life. Often accompanied by sensations discomfort, irritation and even pain, this symptom can quickly become disruptive to everyday life. Although common, this itching can mask a variety of causes, some benign and others requiring special attention. Find out about main causes of scalp pruritus and available treatments to remedy the situation.

What is itchy scalp?

Scalp pruritus is an itchy sensation on the skin of the head under the hair. It is aa common symptom and not an illness in itself. This feeling of discomfort can vary in intensity, from mild irritation to unbearable itching that can interfere with daily activities.

This itching may be accompanied by other symptoms such as redness, skin rashes, scales or dandruff, dry or oily skin, and sometimes even lesions caused by scratching.

It is essential that identify the underlying cause and propose an appropriate treatment. In some cases, the itching may be temporary and disappear on their own, while in others, medical intervention or changes in hair care may be necessary.

What causes itchy scalp?

There are various causes of scalp pruritus and can include dermatological conditions, infections, allergic reactions and parasites such as lice.

Seborrheic dermatitis

Seborrheic dermatitis is a chronic skin condition which frequently affects the scalp, but can also appear on other areas of the body where there are numerous sebaceous glands, such as the face, chest or underarms. 

On the scalp, seborrheic dermatitis can manifest itself as :

  • Itching.
  • The formation of red, scaly patches, sometimes yellowish.
  • From dandruff which can be thin and white or thick and fatty.

Seborrhoeic dermatitis tends to occur mainly on the oiliest or seborrhoeic areas of the skin. The sebum accumulated in these areas encourages the excessive growth of malassezia yeast. These yeasts are present on most people's skin, but in some people they can overgrow and cause symptoms. 

The activity of these micro-organisms induces a specific form of inflammation, manifested by reddening of the skin. In addition, it accelerates the renewal cycle of skin and scalp cells, which are then renewed in just 5 to 14 days, as opposed to the normal 28-day cycle. This leads to abnormal desquamation of the skin.

Scalp psoriasis

Psoriasis is a chronic skin condition a non-contagious condition characterised by red patches covered with white or silvery scales. Although psoriasis can affect any part of the body, the scalp is one of the most commonly affected sites.

Lesions may be limited to the scalp or extend beyond the hairline, affecting the forehead, back of the ears and nape of the neck. Scalp psoriasis can cause intense itching, although this is not systematic.

Psoriasis is considered to be an autoimmune disease: the immune system attacks healthy skin cells, speeding up the skin's renewal cycle. People with a family history of psoriasis are more likely to suffer from it. In addition, infections, stress, certain medications, skin trauma and even climatic changes can trigger or aggravate psoriasis.

Even if the itching can be intense, it is important to avoid scratching to prevent infection or worsening of the lesions. 

Good to know: Certain hair products can aggravate symptoms, so it's important to pay attention to the composition of the products you use.

When faced with scalp psoriasis, it is essential to consult a specialist to obtain an accurate diagnosis and appropriate treatment.

Mycosis

Mycosis of the scalp also known as ringworm or "tinea capitis", is an infectious infection A fungal disease that mainly affects the scalp and hair. It is mainly caused by fungi of the Trichophyton or Microsporum genus. One of the most common manifestations of this infection is itching of the scalp. Circular bald patches often appear with broken hairs on the surface. There may also be scaling or flaking similar to dandruff, and in some cases, small purulent lesions may appear.

The treatment of ringworm, a fungal infection of the scalp, requires a rigorous medical approach. In general, treatment involves the use of oral antifungal medication. 

In addition to medicinal treatment, external scalp care is also necessary. The use of medicated antifungal shampoos containing active ingredients such as ketoconazole can help reduce the fungal load on the scalp. In addition, it is essential to maintain strict personal hygiene to prevent the infection spreading to others. This includes regular washing of bedding and clothing, and avoiding sharing personal items such as hairbrushes or hats. If symptoms persist or worsen, immediate medical attention is advised.

Allergic reactions

Allergic reactions are a common cause of itchy scalp. Such an allergic reaction can be triggered by a variety of factors, including hair products, hair dyes and environmental elements.

The treatment of allergic reactions of the scalp is mainly based on eliminating the underlying cause. If a hair product is suspected, its use should be discontinued immediately. Medication such as antihistamines may be prescribed to reduce symptoms. In more severe cases, a topical corticosteroid may be required to treat the inflammation.

Dry scalp

Dry scalp is a common problem that can cause itching or pruritus, a peeling and a general irritation. Understanding the causes and solutions can help to manage and treat this inconvenience.

Dry scalp can be caused by the following factors :

  • Environmental factors: exposure to dry, cold climates, or indoor heating in winter, can dry out the skin, including the scalp.
  • Excessive washing: washing hair too frequently or with shampoos containing sulphates and other harsh cleansing agents can strip the scalp of its natural oils, leading to dryness.
  • Reactions to hair products: some products can dry out the scalp, particularly those containing alcohol or other drying ingredients.

A proactive approach to keeping the scalp moisturised and avoiding irritants can help reduce itching and other associated symptoms. 

What treatments for scalp itch?

Before starting any treatment for scalp pruritus, it is vital to identify the underlying cause. A accurate diagnosis is essential in order to choose the most appropriate treatment.

Depending on the cause identified, medicated shampoos based on ketoconazole, pyrithione zinc or salicylic acid may be recommended. If pruritus persists, topical treatments such as corticosteroids may be prescribed. For deeper or more specific conditions, oral medications such as antihistamines, corticosteroids or antifungals may be required.

Once the cause has been identified, prevention is essential. This can include using gentle products, proper hygiene and protecting your scalp from the elements. Opt for air drying rather than using a hairdryer, as direct heat can intensify dryness and irritation of your skin. Avoid wearing bonnets, hats, caps and tight hairstyles to allow your scalp to breathe properly. When the urge to scratch arises, give your scalp a gentle massage. Using a soothing mask can also help calm itching and irritation.

Jean-François Cabos

Jean-François Cabos is the creator of a unique hair care method based on the research he coordinated, which led to the publication of the book "Cheveux, Racines de Vie" with Hélène Clauderer by Robert Laffont (Collection "Réponses/ Santé").

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