Itchy, greasy scalp: what to know

An itchy, greasy scalp often fits dandruff or seborrhoeic dermatitis, although product irritation, psoriasis, and infection can look similar. Oil can hold scale against the scalp, making itching and visible flakes more noticeable.

Dandruff-type inflammation may cause white or yellowish flakes and itch, sometimes extending to the hairline, eyebrows, ears, or sides of the nose. A new dye, shampoo, dry shampoo, or styling product can cause contact irritation. Thick, sharply bordered plaques may suggest psoriasis. Tender bumps, pus, broken skin, or patchy hair loss need examination because infection or follicle inflammation may be involved.

Wash regularly with a gentle shampoo and rinse thoroughly; avoid scratching with nails. If flaking continues, a pharmacist or clinician may recommend a medicated shampoo chosen for the suspected cause. Follow its label directions, give it time on the scalp as instructed, and stop if it causes marked irritation. Pause newly introduced products, clean brushes, and avoid heavy oils that leave residue. Keep the scalp cool and dry after exercise.

Arrange review when symptoms persist despite appropriate scalp care, repeatedly return, spread to the face, or interfere with sleep. Seek prompt advice for pain, swelling, pus, thick crusts, fever, or areas of hair loss. A clinician can distinguish dandruff from seborrhoeic dermatitis, psoriasis, contact dermatitis, or infection and tailor treatment.

Does the scale and distribution fit dandruff or seborrhoeic dermatitis? Which medicated shampoo is suitable, how should I use it, and when should I expect improvement? Could a hair product or psoriasis be contributing?