Dry and Itchy Scalp: Causes and Treatment Options

Scroll to read

Have you ever had a dry, itchy scalp? Or do you currently have it? Well, in fact, this condition affects 13% of Singaporeans. If you’re currently experiencing this, you need to find the right treatments before your condition gets worse. 

However, finding the right remedy boils down to determining what is the root cause of the condition. Various factors can contribute to it, each needing a different approach to resolve. 

To help you out, we have listed some of the common reasons for dry, itchy scalps and the tips to prevent them altogether. Read on to learn more.

Why Do You Have an Itchy Scalp?

There are a variety of reasons for an itchy scalp. Finding out the reason behind why you’re scratching your head is important, as it helps you to find the right treatments.

Here are 9 possible causes for your itchy scalp:

 

Dandruff

Dandruff is a prevalent scalp condition that causes flakes of skin to appear on your head. It’s not contagious or dangerous but can be embarrassing and challenging to treat.

 

What causes dandruff?

Woman,With,Dandruff,In,Her,Dark,Hair.,Itchy,Head,Scalp

Dandruff can be caused by the secretions from your sebaceous glands. Sebaceous glands are the oil glands located just beneath the skin on your scalp. They produce sebum, a natural oil that helps keep your hair healthy and shiny. However, if these sebaceous glands become overactive or inflamed and over-secrete sebum, they can contribute to oily scalp and dandruff.

If your scalp is too oily, it promotes the growth of Malassezia, a form of yeast that infects your hair follicles and causes them to itch.

Other reasons for dandruff include fungal colonisation on the surface of your scalp, not shampooing enough or over shampooing and overdrying your scalp, overexposing your scalp to dust, dirt or sunlight, and excessive pressure on the scalp from hats, caps and helmets.

Dandruff symptoms can wax and wane throughout your lifetime and it may be helpful to keep a diary of what triggers seem to be associated with your flare ups. This can aid diagnosis, as your doctor formulates a comprehensive dandruff treatment and prevention plan.

Seborrheic Dermatitis

Seborrheic dermatitis may be developed from untreated dandruff condition and other causes. It’s when the Malasezzia yeast thrives and starts producing metabolites that irritate the skin. Inflammation then happens, further exacerbating the itchy scalp and can damage the hair follicles when it becomes severe enough, leading to hair loss.

You may be more prone to seborrheic dermatitis if you have oily skin, a family history of skin conditions (e.g. seborrheic dermatitis, psoriasis), high levels of emotional stress, or poor immunity.

How to differentiate seborrheic dermatitis from dandruf?

Dandruff is often mentioned interchangeably with seborrheic dermatitis. While they have similar origins, there are differences between the two. One can think of dandruff as the milder, non-inflamed version of seborrheic dermatitis.

Seborrheic dermatitis is an inflamed version of pityriasis capitis that is associated with severe yellow-white flaking and severe itch. With seborrheic dermatitis, the inflammation can get so bad that hair follicles are scarred and damaged, leading to hair loss.

How to get rid of dandruf and seborrheic dermatitis altogether?

Getting rid of your dandruff and seborrheic dermatitis altogether starts by regulating your scalp environment to prevent dryness and yeast overgrowth.

Here’s what you should do to improve your flaky, itchy scalp:

  • Change up your shampoo – Medicated shampoos on the market that contain zinc pyrithione or selenium can help to reduce the itch and flaking associated with dandruff. Those with seborrheic dermatitis might benefit from doctor-prescribed shampoo containing ketoconazole or salicylic acid which reduces yeast overgrowth and regulates oil production.
  • Practise good hygiene – Dirty hair also promotes the growth of dandruff. Unwashed dirt, including oil buildup, will eventually form into flakes. These flakes are often itchy, and scratching them causes inflammation. Therefore, washing your hair at least once a day or after exercising is a must.
  • Bring down inflammation – When skin is swollen, red, and itchy, healing becomes more difficult. An anti-inflammatory topical lotion like clobetasol, or an oral anti-itching medication, helps to control inflammation and promote healing.
  • Eliminate dairy from your diet – A diet containing a substantial amount of dairy can lead to bad reactions in the skin especially in the case of milk allergy. It will result in itchy and inflamed skin which will further worsen your scalp condition leading to a case of bad dandruff.
  • Reduce stress – Stress frequently causes hormonal imbalance, which can trigger Malassezia yeast overgrowth. 
  • Get enough sleep – Lack of sleep destroys your hormonal balance and triggers stress hormones more than you ever thought. Try to get at least 7 hours of sleep per night to get rid of dandruff and seborrheic dermatitis.
  • Limit the wearing of hats and caps – Wearing hats and caps for a prolonged time will trap heat and increase humidity around your scalp. This further disturbs your pH balance and triggers Malassezia yeast overgrowth.

Chemical Irritants

Itchy scalp may develop as a result of chemical irritants in someone who is sensitive to certain ingredients in products that they use on their scalp. 

These irritants can cause ‘contact dermatitis’ which is a condition where the skin becomes irritated and forms a red, itchy rash from direct contact with a substance or an allergic reaction to it. Some examples of these substances are:

  • Chemicals in hair styling products: Alcohol, turpentine, bleach, dyes, perming or straightening substances
  • Fragrances and phthalates: Found in hair sprays, shampoos, scalp treatments
  • Sulphates and soaps: Chemicals like sodium lauryl sulphate (SLS) help to create foam and lather but are irritating to skin; harsh soaps are alkaline and disrupt the acidic skin mantle
  • Certain topical scalp medications: Specific formulations may contain ingredients that trigger irritation in susceptible individuals.

How Can I Treat Contact Dermatitis Due To Chemical Irritants?

Just like how we avoid eating foods we know will make us sick (like cheese when you are lactose intolerant!), we know that treating contact dermatitis starts by avoiding the substance itself to allow the body to heal.

  • Avoid irritants – Look through all the products that you use on your hair and scalp, and bin those which are expired or seem to trigger your skin allergies. When in doubt, stay on the safe side and avoid any products that look like they contain the substances mentioned above. 
  • Bring down a flare – Thoroughly rinse off your scalp and hair using lukewarm water, as hot water can cause further skin inflammation. Avoid products that are too soapy or seem to lather a lot. Most importantly, contact your doctor so they can assess your scalp and identify if there are any concurrent yeast infections going on. They can prescribe topical or oral anti-inflammatory and anti-itching medication to calm your scalp down, as well as advice on the right shampoos to use. 
  • Prevent recurrence – Now that we’ve made progress, let’s not go back to square one. No matter how tempting a trending hair product may be, always look through the ingredient list to make sure that none of the offending chemical irritants are on that list. 

Skin Allergies

Skin allergies can occur in response to house dust mites, foods such as nuts or dairy, medications, or hair products. When these occur in your scalp, you may experience itching scalp, which can progress to flakes or scales. If left untreated, symptoms may last from days to weeks, and even lead to hair loss due to inflammation affecting the hair follicles.

How can I treat an itchy/flaky/sensitive scalp due to skin allergies?

Treating an itchy scalp due to skin allergies mainly requires you to identify your triggers and try your best to avoid them. 

  • Identify allergens and avoid them – Keeping an allergen diary can help if you are in the early stages of figuring out what your triggers are. If you know that dust mites are your Kryptonite, being extra careful to keep a dust-free environment with regular housekeeping will reduce the frequency of flare-ups. In areas where you can’t bring along your vacuum with you, carrying a face mask at all times will help. It is important to remember which medications you have had bad reactions to in the past so that any future doctors you may meet know not to prescribe the same class of medications.
  • Know when to get help – If you come into contact with a known allergen, rinse out the area thoroughly to prevent progressive symptoms. At times when it is too late and the skin redness has progressed to a severe rash, this is where you need to visit a doctor. Medications can be prescribed to calm the inflamed flare and reduce itching, as well as barrier creams to help healing. Not getting treated early can only make the skin condition worse and aggravate hair loss.
  • Stay vigilant – If you seem to be getting recurring symptoms even after constant treatment, observe and let your doctor know. Skin patch tests can be ordered by your doctor to identify anti-allergen proteins (IgE tests), which help to identify which substances you are allergic to in the environment. Antihistamine medication should be kept on standby for you to use in the event that you accidentally come into contact with the allergen, especially if the allergens are unable to be identified.

Folliculitis

Folliculitis occurs when your hair follicles are inflamed. Sufferers can experience symptoms like tenderness over the inflamed area, the feeling of a bump, itchy scalp, as well as the appearance of pus when the lesion ruptures.

It can be caused by infection, irritation of the skin, skin diseases or occlusion, when the pore where hair emerges from the skin is blocked. Folliculitis usually appears as a red spot with a pustule.

 

How to prevent folliculitis?

The prevention of folliculitis is primarily the same as dandruff, as they are both hyper-seborrheic conditions. The only difference is that folliculitis is usually caused by scalp bacteria, like propionibacterium acnes and Staphylococcus epidermidis, and not yeast.

Folliculitis can be particularly painful, itchy and difficult to treat if it is linked to the nosocomial methicillin-resistant staph aureus bacteria.

People seeking treatment for folliculitis may be prescribed an antibiotic regimen that spans between 6 months and a year. High levels of testosterone and hormones like DHEAS and DHT can increase sebum production on the scalp and lead to folliculitis.

These are some treatment options for folliculitis:

  • Exfoliation for hyper keratinisation, when follicle cells do not shed normally
  • Isotretinoin for suppressing sebaceous gland activity
  • Antibiotics like doxycycline and minocycline to eradicate folliculitis-causing bacteria
  • Steroid spray to directly treat inflammation.

Scalp Psoriasis

Scalp psoriasis is a chronic autoimmune disease (caused by your immune system) that can cause an itchy scalp. 

It causes your skin cells to multiply abnormally quickly, leading to thick, discoloured patches of skin (plaques) on your scalp and surrounding areas like your hairline, forehead, the back of your neck and around your ears.

What causes scalp psoriasis?

Scalp psoriasis is caused by the following factors:

  • Hereditary conditions
  • Environmental exposures (E.g. skin trauma from sunburn)
  • Medications
  • Stress
  • Inflammatory or autoimmune conditions.

How to prevent scalp psoriasis?

If you have scalp psoriasis, it will come and go throughout your life. It is, unfortunately, a chronic condition. However, leading an anti-inflammatory lifestyle and treating your scalp psoriasis with medications, such as corticosteroids, methotrexate and cyclosporine, can help make it less severe and less frequent. You can also consider treating psoriasis using ultraviolet (UV) light therapy. UV light therapy has been shown to improve symptoms of psoriasis by eliminating the cells responsible for the disease, reducing inflammation and increasing blood flow to the affected area.

Scalp Ringworm

Scalp ringworm is a contagious fungal infection that causes rashes on your scalp. Aside from causing an itchy scalp, it also results in scaly and bald patches on the head. Scalp ringworm gets its name from its circular shape (no actual worm is involved) and is most common in children.

 

What causes scalp ringworm?

Scalp ringworm is caused by a fungus attacking the outer layer of scalp skin, causing hair to break. Scalp ringworm can spread in the following ways:

  • Direct skin-to-skin contact with an infected individual.
  • Touching a ringworm-infected animal, including pets like dogs and cats.
  • Contact with objects or surfaces an infected person or animal recently touched, including clothing, towels, bedding, combs and brushes.

How to prevent scalp ringworm?

These are the measures you can practise to prevent scalp ringworm:

  • Shampoo regularly
  • Keep your scalp clean and dry
  • Stay away from infected animals
  • If you have pets or other animals that are prone to ringworm, have your veterinarian examine them for the infection
  • Do not share personal items like clothes, towels, hairbrushes, sports equipment, etc.

 

Atopic Dermatitis

Atopic dermatitis, also called eczema, causes itch, rash and dry skin. Atopic dermatitis usually affects people who are genetically more susceptible to allergic reactions like asthma, hay fever and food allergies.

 

What causes atopic dermatitis?

Atopic dermatitis has no known single cause and is most likely the result of multiple conditions. However, there are numerous theories about the underlying mechanisms. Currently, research is being done to examine the roles of the immune system, skin structural gene mutations, defects in skin cells (keratinocytes), the skin surface microbiome (bacteria, viruses and yeasts) and many other factors.

 

How to treat atopic dermatitis flares at home?

You can treat your flares at home by doing the following:

  • Bathe in oatmeal. A 2012 study found that colloidal oatmeal, the powdered form of oatmeal used by patients, can soothe itching
  • Make use of a humidifier. Increasing the humidity in the air can keep your skin from becoming dry and itchy
  • Avoid scratching your skin and scalp. Instead of scratching itchy areas, apply pressure to them and keep your nails trimmed. If you have children, you may want them to wear gloves or mittens at night to prevent them from scratching themselves
  • Wear loose headwear that will not irritate your skin

 

Find the professional advice you need for your itchy scalp, here at Terra Medical Hair & Aesthetic Clinic

An itchy scalp can be caused by a variety of reasons. Getting a specialist’s help can help you get the right diagnosis quickly and effectively for further treatments.

At Terra Medical Hair & Aesthetic Clinic, we have years of experience in scalp and hair diagnostics and treatment to provide you with a holistic and comprehensive solution for your itchy scalp – whether it’s a prescribed medication or products available from our shop.

Contact us today to book an appointment.

About Terra Medical

With years of experience and excellent patient care, Terra Medical is a dedicated hair loss clinic that specialises in innovative hair restoration techniques, as well as a holistic approach to overall hair wellness. The hair clinic is led by an internationally credentialed team of doctors, Dr. Joshua Chong & Dr. Jia Cheng Heng, and a team of experienced hair restoration technicians. The clinic aims to provide precision and care of the highest standards to achieve natural-looking and long-lasting results for our patients.

We cater to each of our patient’s individual needs and expectations through comprehensive consultations and personalised treatment plans tailored by the doctors. These treatment plans can be a combination of the following: FUE hair transplant, Regenera Activa (AMT), and more.

Beyond just our clinical expertise, we understand how challenging it is to face hair loss alone. As a leading hair restoration clinic, our specialised team provides compassion, empathy, and ongoing support throughout your journey, ensuring you feel heard, empowered, and informed every step of the way.

Rediscover the joy of fuller, healthier hair. Schedule a consultation with Terra Medical today.