What should you know about a very itchy scalp?

Loose white flakes with mild irritation often occur with dandruff. Greasy scale around the scalp, hairline, ears, or eyebrows can occur with seborrheic dermatitis. Thick, sharply defined plaques may suggest scalp psoriasis. Small tender bumps or pustules around hairs can fit folliculitis. Lice cause itching and attached nits near the scalp, especially behind the ears and at the nape. Hair dye, sprays, oils, and fragranced products may cause contact irritation.

Pause newly introduced hair products and avoid scratching with fingernails, which can break the skin. Wash according to the instructions for a suitable gentle or medicated shampoo, allowing it to contact the scalp as directed. Do not share combs, brushes, hats, or pillows if lice are possible. A clinician can inspect the scalp and recommend medicated shampoo treatment or a specific head lice treatment when indicated.

Arrange an examination for pus, crusting, painful swelling, fever, thick plaques, or itching that continues despite sensible shampoo use. Seek prompt care for facial swelling, breathing difficulty, widespread blistering, or a rapidly worsening infection. See a dermatologist if the diagnosis is uncertain, because treating psoriasis, dermatitis, lice, and folliculitis requires different approaches.

Ask whether the scale, bumps, or nits identify a particular cause; which shampoo ingredients suit your scalp; how long to try treatment; whether household contacts need checking; and how to protect scratched skin from infection.