What should you know about extremely itchy scalp and hair loss?

Hair may break from scratching, tight styles, or inflamed skin, while shedding can also occur when a scalp condition disrupts the normal hair cycle. Seborrheic dermatitis and dandruff can produce scale and itch; scalp psoriasis can cause thick plaques that are easily disturbed. Folliculitis may cause tender bumps around hairs. Head lice can lead to scratching and breakage. Scalp ringworm is another possibility when there are scaly patches, broken hairs, or areas that are becoming visibly sparse.

Describe whether hair is falling from the root or snapping close to the scalp. Photograph the area in consistent light, and note pain, crust, pus, redness, plaques, nits, recent illness, chemical treatments, and tight hairstyles.

Wash gently, avoid picking, vigorous brushing, bleaching, and tight hairstyles, and pause new products. Keep nails short and use a cool compress briefly for itch. Do not pull at crusts or try to scrape off scale. A clinician or pharmacist can guide a medicated shampoo when dandruff or seborrheic dermatitis is suspected, and can advise on head lice treatment if live lice are found.

Do not share combs, brushes, hats, pillows, or towels while an infectious cause is being considered. Book a dermatology appointment if hair loss continues, forms a patch, or occurs with a painful or inflamed scalp.

Seek prompt care for rapidly enlarging bald patches, pus, fever, painful swelling, spreading redness, thick crusts, or swollen glands. Arrange an appointment soon for scalp tenderness, broken hairs, persistent scale, or hair loss that is easy to see when parting the hair. Early examination can help prevent ongoing scratching and identify infections that need targeted treatment.

Ask whether the hair is breaking or shedding, what scalp signs point to infection or inflammation, and whether testing is needed. Discuss shampoo choice, lice precautions, hair-care changes, medicines, recent illness, family history, and how progress will be monitored.