What should you know about a very itchy scalp and hair loss?

Inflamed scalp skin can make hairs shed temporarily, while repeated scratching can break hairs or injure the surface. Dandruff and seborrheic dermatitis may cause scale and irritation; folliculitis can cause tender bumps or pustules; and scalp psoriasis can create thicker plaques. Head lice may lead to intense scratching and broken hairs. Smooth patches, short broken hairs, redness, scale, or scarring are useful details for a clinician. Itching and hair loss can also arise from separate conditions.

Photograph the scalp in good light and note whether shedding is diffuse or limited to patches. Wash gently, avoid tight hairstyles, extensions, bleaching, and harsh scratching, and pause products that burn or sting. Do not pick scales or squeeze bumps. A dermatologist may examine the follicles and choose treatment such as medicated shampoo therapy or a targeted treatment for lice when those findings are present.

Arrange a dermatology assessment for patchy loss, scalp pain, pus, crusting, bleeding, thick scale, broken hairs, or a shiny area where follicles seem absent. Seek prompt care for fever, rapidly spreading redness, facial swelling, or severe tenderness. Earlier assessment is useful when loss is progressing because some inflammatory scalp disorders can damage follicles.

Ask whether the loss is shedding, breakage, or follicle inflammation; whether the scalp needs testing; which hair practices should stop; how to treat itch safely; and what changes should trigger an earlier review.