My scalp is always itchy: what should I know?

Dandruff or seborrheic dermatitis often brings flakes, greasy scale, and irritation around the scalp, hairline, ears, or eyebrows. Scalp psoriasis may create thicker, sharply outlined scale that extends beyond the hairline. Head lice can cause persistent itching, with nits attached close to individual hairs. Folliculitis may appear as tender or itchy bumps centred on hairs. Hair products, dye, heat, sweat, or frequent scratching can also irritate the scalp without producing much visible scale.

An examination can distinguish loose flakes from firmly attached scale, nits, crust, or inflamed follicles. It also helps identify whether the problem is limited to the scalp or affects other skin.

Use lukewarm water and a gentle cleanser, rinse products thoroughly, and avoid picking at scale. Keep a record of new shampoos, dyes, oils, or styling products. If a clinician recommends a medicated shampoo, follow its contact time and frequency rather than leaving it on longer. Do not use a lice treatment unless lice or nits have been identified or a professional advises it. Wash combs and avoid sharing them while lice are being considered.

Book a review when itching lasts despite gentle care, repeatedly returns, disrupts sleep, or causes sores. Seek prompt care for painful swelling, pus, spreading redness, fever, thick crusts, or patches of hair loss. Urgent help is needed for facial swelling, breathing trouble, or a rapidly spreading rash.

Ask whether the scalp shows dandruff, seborrheic dermatitis, psoriasis, lice, folliculitis, or product irritation; whether testing is needed; and how to use any shampoo or treatment safely. Mention dye exposure, household itching, skin conditions, and recent medicines.