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Dr Sarah Marshall

Medically reviewed by:

Dr Sarah Marshall - Medical Officer

Updated: Aug 18, 2021
Next review: Aug 18, 2022
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An itchy scalp is something that people who aren’t medical professionals seem happy to have a guess at diagnosing. From questionable haircare advice to made-up allergies, there are so many theories out there that it can be hard to know what to believe.

Dandruff

Dandruff can be very itchy and unfortunately, scratching your scalp can cause flakes to be more noticeable, either in dark hair or on your clothes.

This is naturally a little embarrassing and the bad news is the more you scratch, the worse it’ll be. If you’re feeling self-conscious about your dandruff, or the skin on your scalp becomes crusty or scaly, a doctor will be able to suggest ways you can treat it. However, first you need to know why it’s happening.

What Causes Dandruff?

Dandruff occurs when your skin cells renew too quickly, leaving the old, dead skin with nowhere to go. It can be the result of dermatitis, which makes the skin oilier than normal, or other conditions such as psoriasis and eczema (see below).

Not washing your hair often enough can be a factor, as dead skin is left in your hair, while washing your hair too often can irritate your scalp and bring on an outbreak of dandruff. Other triggers include heat, cold, stress and certain hair products.

How is Dandruff Treated?

The most common treatment is an anti-dandruff shampoo. There are many to choose from, so consult with a doctor in order to make an informed choice.

You can also review your hair washing technique. For example, digging your fingernails into your scalp can cause flaky skin, while you should also leave shampoo to set for five minutes before rinsing.

Finally, if you think a hair product might be to blame, stop using it and see if that helps control your dandruff. This is also necessary to give your anti-dandruff shampoo a chance to work.

Psoriasis causes the skin to become dry, red and scaly, with the scalp often among the worst-affected areas. Scratching the itch can make skin sore, while it might also bleed or crack. In serious cases, you may suffer from temporary hair loss in patches.

What Causes Psoriasis?

Similarly to dandruff, psoriasis occurs when skin cells are replaced too quickly. This process should normally take up to four weeks, but psoriasis sufferers can produce a new layer of skin every three days.

It’s down to a problem with your immune system, with cells that are normally used for fighting bacteria instead attacking healthy cells and prompting the skin to produce a new layer much earlier than required. This is often passed on genetically, while triggers can include alcohol, smoking, stress and injuries such as cuts and grazes.

Treating and Managing Psoriasis


Psoriasis often requires a careful plan in order to keep it under control. This is something a doctor can help you with. There are many possible treatments for psoriasis, including:

  • Creams and ointments
  • Phototherapy - involves exposes the skin to certain kinds of light
  • Tablets and injections - these are often a last resort, as the side effects can be unpleasant

A doctor may wish to refer you to a specialist dermatologist after your initial consultation.

Eczema is a fairly common skin condition causing itchy, red, dry and cracked skin on many areas of the body, including the scalp.

The itching varies in severity, but one thing is certain - the worse it is, the more you’ll scratch. This can lead to infection if your skin begins to crust, ooze or becomes sore.

What Causes Eczema?

Eczema occurs especially in people with dry skin. The reasons for this are often genetic - you are more likely to have eczema if one or both of your parents have it.

There is a lengthy list of possible triggers for eczema:

  • Cold
  • Heat
  • Soap/detergent
  • Dust
  • Allergies
  • Material
  • Sweat
  • Stress

How can you treat eczema?

If you can identify a trigger for your eczema, you might be able to remove this trigger from your lifestyle. This is more practical in some cases than others - for example, it’s easier to stop wearing a particular material or using a certain soap than it is to avoid hot or cold weather.

As eczema is caused by dry skin, a doctor will be able to recommend a moisturiser or cream that will help you manage the itching.

While normally associated with young children, head lice can affect people of any age. You might notice lice or their eggs in your hair, while itching is often caused by them crawling across your scalp.

How do you catch head lice?

There are a lot of myths around head lice. Contrary to popular belief, they are not always an indicator of poor hygiene, nor do they have a preference for dirty or clean hair. The truth is, they’re not fussy.

The only way to pass them on is via head-to-head contact with someone. Head lice can’t fly, so there has to be physical contact between two people for them to transfer.

How do you deal with them?

If you’re concerned about head lice, there are special nit combs that will help you detect them. A doctor can also recommend a good specialist shampoo to help kill off the lice. Because the eggs can take up to a week to hatch, these shampoos will usually need to be applied twice over the course of a week to ensure you get rid of everything.

By discussing your problem with a trained medical professional, you can pinpoint genuine potential reasons why you might have an itchy scalp. A doctor can use this diagnosis to provide practical advice on how to treat it.