What should you know about chronic itchy scalp?

Flaking without major inflammation may occur with dandruff, while greasy scale and redness can occur with seborrheic dermatitis. Thick, well-defined scale may suggest scalp psoriasis. Tender spots or pustules can fit folliculitis. Head lice can cause intense itch and visible nits attached close to hair shafts. New dye, shampoo, oil, or styling product may irritate or sensitise the scalp. These conditions can look similar, so scratching alone does not identify the cause.

Keep a short record of products, washing frequency, flaking, sores, and whether anyone close to you is itchy. Rinse shampoo thoroughly, avoid scratching with nails, and pause a newly introduced product if symptoms followed it. A medicated shampoo may help selected flaking conditions when used as directed, including the recommended contact time. If lice are suspected, check close contacts and use a suitable head lice treatment rather than relying on ordinary shampoo. Persistent symptoms need a diagnosis before stronger treatment is chosen.

Arrange a review for itch that persists, disrupts sleep, causes bleeding, or comes with hair loss, thick scale, pustules, or painful cracks. Seek prompt care for spreading redness, swelling, fever, or drainage. A child with suspected lice should be checked and treated according to age-appropriate advice. Do not share combs, brushes, hats, or pillows while contagious lice remain possible.

Ask what the scalp findings suggest, whether a product allergy is possible, and which shampoo or leave-on treatment fits your diagnosis. Ask how long to try it, what improvement should look like, and whether close contacts need assessment for lice. Mention any hair loss, broken skin, or new medicines.