Dry red itchy scalp: what to know

Flakes with mild itch may fit dandruff, while greasy scale around the hairline or ears can occur with seborrheic dermatitis. Thick plaques may suggest scalp psoriasis. Small tender or pus-filled bumps can occur with folliculitis. Intense itch, especially with visible nits or affected household contacts, raises the possibility of head lice. A new dye, shampoo, oil, or styling product can cause irritant or allergic inflammation.

The location matters too: itching limited to one area differs from widespread itch, and hair loss, broken hairs, crusting, or swollen glands deserve examination. Avoid diagnosing from a single flake or bump.

Stop recently introduced scalp products and rinse gently with lukewarm water. Do not scratch or scrape scale, since broken skin can become infected. If dandruff seems likely, ask a pharmacist about a medicated shampoo and follow its directions. Keep it away from the eyes and stop if the scalp becomes markedly more irritated.

Check the hair and scalp in good light if lice are possible, but avoid sharing combs, hats, pillows, or towels until the situation is clear. Do not use lice treatment as a precaution without checking or professional advice. Record triggers, affected areas, and any hair loss for the appointment.

Seek assessment if itch continues, interrupts sleep, returns often, or comes with thick scale, bleeding, pus, painful bumps, hair loss, or broken hairs. Get prompt care for rapidly spreading redness, fever, facial swelling, or a tender swollen area. Suspected scalp ringworm or lice in a child should be assessed so treatment is correctly selected.

Ask whether the findings fit dandruff, seborrheic dermatitis, psoriasis, folliculitis, or lice; whether testing is needed; how to use a medicated shampoo; and how to prevent spread if an infestation is confirmed.