What should you know about tender itchy scalp?

Itch with loose flakes may occur with dandruff or seborrheic dermatitis. Thick, well-defined scale can fit scalp psoriasis. Sore spots or pustules around individual hairs can indicate folliculitis. Itching that affects household contacts, with nits or crawling insects, raises concern for head lice. A new shampoo, dye, oil, or styling product can also irritate or sensitise the scalp.

The pattern matters: look for scale, crust, hair breakage, sores, hair loss, swollen glands, or a rash beyond the hairline. A scalp examination is more useful than repeatedly changing products when tenderness persists.

Stop any newly introduced product and wash gently with lukewarm water. Avoid scratching, picking crusts, tight hairstyles, and vigorous brushing over sore areas. Keep combs, brushes, hats, and pillowcases personal until head lice have been ruled out. A pharmacist or clinician can guide you toward medicated shampoo treatment when flakes or inflammation suggest it, or head lice treatment when live lice are found.

Do not combine several medicated products at once without advice. Follow the product directions and allow time for the scalp to be assessed if symptoms do not improve.

Arrange medical review for persistent tenderness, pus, thick crusting, patchy hair loss, broken hairs, or a spreading rash. Seek prompt care for fever, rapidly increasing redness or swelling, severe pain, or swelling around the face or neck. Sudden widespread blistering or breathing difficulty after a product requires emergency help.

Do the scale and sore areas fit dandruff, seborrheic dermatitis, psoriasis, folliculitis, lice, or contact irritation? Should I use medicated shampoo treatment or another medicine? What should I stop using, and how soon should the scalp be reassessed?