An itchy scalp can be incredibly annoying and uncomfortable. And while dandruff is the most well-known culprit, it’s not the only one. A fungal infection like ringworm, allergic reaction to certain materials, or another type of inflammation can also be to blame. The good news? Conditions that trigger an itchy scalp are usually easily treatable. But it’s still a good idea to visit your dermatologist to pinpoint the exact cause. The symptoms of some of these conditions can be very similar, but the treatment options differ.
As many as 50% of Americans struggle with dandruff and its frustrating symptoms, including dry, itchy scalp and telltale white flakes. The condition is usually caused by a yeast-like fungus called Malassezia, although dry skin or a reaction to certain hair products can also be to blame. Treatment options abound: there are a variety of dandruff shampoos available over the counter at your local pharmacy. Flake-fighting ingredients include ketoconazole, zinc pyrithione, and coal tar; so if one formula doesn’t work for you, try switching to a product with a different active ingredient. (One caveat: if you have light hair, skip coal tar—it may darken strands.) Another option is to try home remedies for dandruff like coconut oil, apple cider vinegar, or aloe vera, which may also help nix flakes.
In infants, seborrheic dermatitis is known as cradle cap, and causes thick, scaly patches on baby’s scalp. But adults can get the skin condition, too, in which case it’s an inflammation of the hair follicles and is considered a severe form of dandruff. “Seborrheic dermatitis is the result of inflammation of the hair follicles, and is very common,” says Bruce E. Katz, MD, founder of the Juva Skin & Laser Center in New York City. No one knows exactly what causes seborrheic dermatitis, he adds, but it can be treated with prescription steroid creams (such as hydrocortisone and fluocinolone) or medicated shampoos.
Common in children, lice can cause itchiness and a crawling sensation on the scalp. The little buggers can be removed with the nitpicking and combing technique, which involves carefully pulling them from the hair with a special comb. Or you can opt for a shampoo that contains pyrethins/pyrethrum, such as RID ($15; target.com). “It’s a compound that works by attacking the nervous system of lice to get rid of them,” says Debra Jaliman, MD, a New York City-based dermatologist. Other lice treatment options include permethrin lotion 1% and natural remedies like olive oil and mayonnaise.
This is common skin reaction that’s caused by contact with a material you’re allergic or sensitive to, such as nickel, latex, or certain kinds of makeup. The result is a rash that may be irritated, itchy, cracked, or inflamed. On the scalp, Dr. Katz says the most common culprit is paraphenylenediamine (PPD), an ingredient in some hair dyes.
The good news: Stopping use of the offending material will usually clear things up, and if it doesn’t, there are treatment options available. “It can be treated with a topical steroid preparation, or by targeting (and getting rid of) the agent that is causing the allergy,” says Dr. Jaliman.
In addition to the body, feet (where it’s called athlete’s foot) and genitals (jock itch), the fungal infection ringworm can also appear on the scalp. Ringworm of the scalp is most commonly seen in young children (it is highly contagious and can spread easily in schools), and can cause a scaly, itchy rash as well as patches of hair loss. A topical anti-fungal treat ringworm, and Dr. Jaliman says you can also take oral anti-fungal pills if the reaction is particularly bad.