What should you know about red flaky itchy scalp?

Dandruff and seborrheic dermatitis can cause flakes with itch and redness, especially around the scalp and hairline. Scalp psoriasis may produce thicker, more defined scale that can extend beyond the hairline. Head lice cause prominent itch and may leave attached eggs on hairs close to the scalp. Folliculitis tends to cause tender or itchy bumps around hair follicles. New dye, oils, dry shampoo, or fragranced products can irritate or sensitise the scalp. Itchy scalp is a symptom shared by several conditions, so the scale pattern and exposures matter.

Wash gently with lukewarm water and avoid scratching, tight hairstyles, harsh brushing, and newly added products. A medicated shampoo may help dandruff or seborrheic dermatitis when used exactly as its label directs, including contact time and frequency. If you see crawling insects or firmly attached eggs, avoid sharing combs, hats, towels, or bedding and ask a pharmacist or clinician about head-lice treatment. Do not scrape thick scale or use someone else’s prescription. Note whether flakes are greasy, dry, thick, or associated with bumps or hair loss.

Seek prompt care for pus, marked tenderness, spreading redness, fever, swollen glands, open sores, or patchy hair loss. Arrange a dermatology review when symptoms persist despite appropriate shampoo use, recur frequently, extend onto the face, or make sleep difficult. Suspected lice should be assessed when live insects are seen or household contacts develop itch.

Does the scale look more like dandruff, seborrheic dermatitis, psoriasis, lice, or folliculitis? Which shampoo should I use and how long? Could a product be causing this? Do I need treatment for household contacts?