Dry and itchy scalp: what should you know?

Fine flakes with mild redness can occur with dandruff or seborrheic dermatitis. Thick, well-defined scale may suggest scalp psoriasis. Head lice cause itching and attached nits near the hair shaft, while folliculitis can produce tender or itchy bumps around hairs. A new dye, shampoo, oil, or styling product can trigger irritation or contact dermatitis.

Look at the hairline, behind the ears, and the back of the neck. Note scale colour, greasy or dry texture, sores, crusting, hair breakage, and whether itching affects anyone who shares close contact.

Use lukewarm water and a gentle shampoo, rinse thoroughly, and avoid scratching, vigorous brushing, and fragranced products while the scalp is irritated. Wash pillowcases and combs if lice are suspected, and avoid sharing hats, brushes, or hair accessories until checked.

A medicated shampoo may help when dandruff or seborrheic dermatitis is the cause, but instructions vary by product. Suspected lice need a specific assessment and treatment plan. Do not pick crusts or squeeze scalp bumps.

Arrange an examination if itching persists, scale is thick, bumps recur, or there is hair loss or broken hair. Seek prompt care for spreading redness, warmth, pus, severe tenderness, fever, facial swelling, or eye involvement. A child with suspected lice should be assessed so close contacts and treatment can be handled correctly.

Ask: Does this look like dandruff, seborrheic dermatitis, psoriasis, lice, or folliculitis? Should I use a medicated shampoo? How should I clean combs and bedding? What signs would mean the scalp needs reassessment?