The itching is a symptom, not a condition
namtipStudio/ShutterstockThere it is again—that tingling feeling up top. How good would it feel to just reach up and rake your fingernails across that scalp of yours a few times? But you don't dare because once you start, it's so hard to stop. As Harvard-trained dermatologist, Khalil A. Khatri, MD admits, "Once you get into the "itch-scratch-itch cycle, it's difficult to get out of it." It's vexing when your head itches not only because it's so hard not to scratch, but also because it's usually a symptom of something else. So what does it mean when your head itches? Fear not. There are many reasons why your head itches, we were assured by Dana R. Brewer, PA, a physician's assistant with a specialty in dermatology, and most of them are a cinch to treat. (And here are eight other things your hair is trying to tell you about your health.)
Andrey Popov/ShutterstockOK, let's just get this one out of the way. Let's say you've got school-age kids, and you find yourself asking, "Why does my scalp itch?" Is there any way you're not going to wonder if it's head lice? These are the signs of head lice you need to know about.
Head lice are tiny bugs that attach themselves to the hair. "Head lice can be seen in the form of eggs, aka nits, along the hair shaft," explains Rhonda Q. Klein, MD. Although the nits can be confused with dandruff, when you see adult lice moving around your head, that's unmistakable.
"You can use physical methods to remove the lice," Dr. Klein says, "and you can try natural lice shampoos and natural lice removers, "although what you'll probably end up needing to eradicate a lice infestation is an actual "insecticide like pyrethrin and permethrin," depending on resistance patterns in your area. "Shaving the head is also an easy solution for boys."
Chuck Wagner/ShutterstockIf it's not lice, you might wish it were when you learn about scabies, which according to Dr. Khatri can cause itching not just on the scalp but also on the entire body.
Scabies are an infestation of the "human itch mite" (aka sarcoptes scabiei var. hominis). The adult female scabies mites burrow into the upper layer of the skin, where they live and deposit their eggs, according to the Centers for Disease Control and Prevention. The microscopic scabies mite almost always gets passed along by direct, prolonged, skin-to-skin contact with a person who already is infested. Scabies in adults frequently is sexually acquired, although it can also be spread without sexual contact in crowded conditions, including households, nursing homes, extended-care facilities, child-care facilities, and prisons.
Did you know that the Zika virus is another insect-borne illness that can be spread through sexual contact?
Pimonpim w/ShutterstockSo, let's say you've ruled out head lice and scabies. If you're still asking "why does my scalp itch," then dandruff is your most likely culprit. Or more specifically, seborrheic dermatitis, which is considered a severe form of dandruff caused by an overreaction the body has to normal yeast that lives on the skin, according to Jennifer Haley, MD, FAAD a board-certified dermatologist based in Scottsdale, Arizona. Dandruff affects about 40 percent of people, and tends to come and go during one's lifetime. "Weather changes, stress, and increased sugar in the diet can bring it out."
Over-the-counter remedies include products containing the active ingredient, salicylic acid (such as Neutrogena T/Sal Shampoo) and products containing anti-fungals such as Ketoconazole or Selenium Sulfide (Selsun Blue Shampoo contains the latter). Natural remedies for dandruff include tea tree oil. And a product called Scalpicin can help decrease itching, Dr. Haley advises. If over-the-counter remedies do not resolve the issue, then see a board-certified dermatologist, who can not only prescribe steroidal anti-inflammatories but also determine if some other condition is causing your symptoms.
Robert Przybysz/ShutterstockIf you recently colored your hair, it's possible that you're experiencing an allergy to the dye. This is true even if you've used the product before without incident. "If the hair color is temporary or semi-permanent it can be washed out," explains Joshua Zeichner, MD, a dermatologist and director of Cosmetic and Clinical Research at Mount Sinai Hospital in New York, "but if it's a permanent dye, that presents a more challenging situation, although there are products on the market that can remove permanent dye altogether."
"People can have a reaction to anything they put on their scalp—from shampoo to hair dye to Rogaine,"points out Dr. Haley. "And don't forget about those hair-smoothing keratin treatments, adds Dr. Klein. (Here are some other healthy hair tricks to try!)
To pinpoint the culprit product or ingredient, suggests Tsippora Shainhouse MD, FAAD, board-certified dermatologist in Beverly Hills and Clinical Instructor at the University of Southern California, try using one product at a time for a week at a time, rather than combining many at the same time." And then while your scalp is healing, choose only gentle and sensitive skin formulations.
Psoriasis or eczema
Claudia Pylinskaya/ShutterstockAn itchy scalp an also be caused by inflammatory skin conditions such as eczema (aka atopic dermatitis, especially in babies, eczema can present on the scalp) and psoriasis (which is more likely to appear on the scalp of an adult). Dr. Zeichner says explains that these conditions arise when your immune system gets "angry" at your skin, leading to red, flaky, itchy patches.
Psoriasis looks similar to dandruff but is usually thicker and red, notes Esta Kronberg, MD, a dermatologist in Houston, Texas, but it can be treated the same way dandruff is treated. For both eczema and psoriasis, Dr. Klein recommends topical steroids, vitamin D analogues (calcipotriene), coal tar, salicylic acid, excimer laser, phototherapy, and immunomodulatory agents for severe cases. There are the best all-natural psoriasis and eczema treatments.
loginovworkshop/ShutterstockIt's possible that your itchy scalp is nothing more than a sunburn, Dr. Shainhouse suggests. If you've been out all day and forgot to wear a hat, think sunburn first, and get some relief with a cool shower and some hydrocortisone cream (available over the counter). Next time, don't forget your hat and sunscreen, and think about trying one of these apps for sun protection smarts.
Adam J/ShutterstockThe winter months can come with dry air, whether cold outdoor air or heated indoor air. The dryness strips the scalp of its protective oils, according to Dr. Shainhouse, who suggests that if your head becomes itchy in winter, your first plan of action could be to try a moisturizing hair conditioner or a once-per-week scalp and hair mask. These are the 13 commandments for using hair conditioner. For dry scalp, you could also try adding sugar to your shampoo.
Dirt and sweat
Werayuth-Tes/Shutterstock"When you don't wash your hair often enough, natural oils, dirt, and product residue build up on your roots and scalp, causing you to itch and scratch," says Dr. Shainhouse. " Scalp skin is similar to face skin and need to be washed." Dr. Shainhouse recommends washing every other day. If you think your strands are too dry for frequent washing, flip your head into the sink and focus on the roots only. Scrub your scalp and roots with shampoo and be sure that it lathers well before rinsing in order to dissolve the excess oils and debris.
Likewise, your scalp could itch because you simply skipped your shower after a "super-soaker spin class," Dr. Shainhouse suggests. "When the sweat on your scalp dries, it can irritate the skin, leaving it feeling itchy." The simple solution: Wash your hair every time you sweat/work out.
But just for argument's sake, here are the reasons you might wish to consider showering less often.
Lipowski Milan/ShutterstockRosacea classically presents as red flush and (sometimes) pimples on the face. Rosacea may flare in the heat, after eating spicy, hot, or caffeinated foods and drinks, or as a result of emotional stress. While it normally affects the cheeks, chin, and nose, says Dr. Shainhouse, it can potentially affect the scalp, causing an itchy or burning or stinging sensation.
If you think that you might have rosacea, see your dermatologist to figure out the best management plan. In addition, think about trying these helpful rosacea diet hacks.