What do you do when a patient complains about an itchy scalp?
I first examine him to see if he has seborrheic eczema or psoriasis,
both of which are common. These scalp disorders show extensive redness and scaling of the scalp. However, I most often see simple, fine and adherent dandruff with a little redness, caused by skin irritation due to external products. It could be a simple case of lice, which is why I systematically look for nits.
When there is nothing visibly wrong, how do you explain the itchiness?
This itchiness may be caused by skin that is generally sensitive.
I ask my patients how often they wash their hair and what type of shampoo they use. Washing your hair too often with inappropriate shampoo can cause chronic irritation, which is a source of itchiness. This becomes a vicious circle: scratching the scalp provokes inflammation. Drying hair with a hair dryer that is set too high can also harm the scalp. And, don’t underestimate stress, which often triggers itchiness.
What do you recommend?
First, you must treat the cause.
There are highly effective treatments for the scalp disorders that I just described. If the source of irritation is external, I explain to the patient that it is very important to use gentle shampoo, thoroughly rinse the hair and not use keratolytic shampoo on a daily basis. There are also cosmetic products that can be applied after washing hair to soothe overly sensitive scalps. Blow drying and styling hair must be done gently. I also explain that it is important to avoid stressful situations as stress can trigger increased sensitivity.