20 Reasons for Your Itchy Scalp (Besides Head Lice), The Healthy

20 Reasons for Your Itchy Scalp (Besides Head Lice)

A little itch is nothing to be concerned about, but if you can’t stop scratching your head, here are some causes of an itchy scalp.

The itching is a symptom, not a condition

There it is again—that tingling feeling up top. How good would it feel to just reach up and rake your fingernails across that scalp of yours a few times? But you don’t dare because once you start, it’s so hard to stop. As Harvard-trained dermatologist, Khalil A. Khatri, MD admits, «Once you get into the «itch-scratch-itch cycle, it’s difficult to get out of it.» It’s vexing when your head itches not only because it’s so hard not to scratch, but also because it’s usually a symptom of something else. So what does it mean when your head itches? Fear not. There are many reasons for your itchy scalp, we were assured by Dana R. Brewer, PA, a physician’s assistant with a specialty in dermatology, and most of them are a cinch to treat. And if your hair is thinning, breaking or feeling brittle here are 8 other things your hair is trying to tell you about your health.

OK, let’s just get this one out of the way. Let’s say you’ve got school-age kids, and you find yourself asking, «Why does my scalp itch?» Is there any way you’re not going to wonder if it’s head lice? Head lice are tiny bugs that attach themselves to body hair, according to the Centers for Disease Control and Prevention. «Head lice can be seen in the form of eggs, aka nits, along the hair shaft,» explains Rhonda Q. Klein, MD, an associate clinical professor of dermatology at Yale-New Haven Hospital and West Haven VA Medical Center. Although the nits can be confused with dandruff, when you see adult lice moving around your head, that’s unmistakable. «You can use physical methods to remove the lice,» Dr. Klein says, «and you can try natural lice shampoos and natural lice removers, «although what you’ll probably end up needing to eradicate a lice infestation is an actual «insecticide like pyrethrin and permethrin,» depending on resistance patterns in your area. «Shaving the head is also an easy solution for boys.» Make sure you know how to spot the difference between dandruff and lice.


If it’s not lice, you might wish it were when you learn about scabies, which according to Dr. Khatri can cause itching not just on the scalp but also on the entire body. Scabies on the scalp isn’t common, and it usually affects those with compromised immune systems.

Scabies are an infestation of the «human itch mite» (aka s arcoptes scabiei var. hominis). The scabies mites burrow into the upper layer of the skin, where they live and deposit their eggs, according to the CDC. The microscopic scabies mite almost always gets passed along by direct, prolonged, skin-to-skin contact with a person who already is infested. Scabies in adults frequently is sexually acquired, although it can also be spread without sexual contact in crowded conditions, including households, nursing homes, extended-care facilities, child-care facilities, and prisons.


So, let’s say you’ve ruled out head lice and scabies. If you’re still asking «why does my scalp itch,» then dandruff is your most likely culprit. Or more specifically, seborrheic dermatitis, which is considered a severe form of dandruff caused by an overreaction the body has to normal yeast that lives on the skin, according to Jennifer Haley, MD, a board-certified dermatologist based in Scottsdale, Arizona. Dandruff affects about 40 percent of people and tends to come and go during one’s lifetime. «Weather changes, stress, and increased sugar in the diet can bring it out.»

Over-the-counter remedies include products containing the active ingredient, salicylic acid (such as Neutrogena T/Sal Shampoo) and products containing antifungals such as ketoconazole or selenium sulfide (Selsun Blue Shampoo contains the latter). Natural remedies for dandruff include tea tree oil. And a product called Scalpicin can help decrease itching, Dr. Haley advises. If over-the-counter remedies do not resolve the issue, then see a board-certified dermatologist, who can not only prescribe steroidal anti-inflammatories but also determine if some other condition is causing your itchy scalp symptoms. If you’re feeling itchy, learn about the 5 most common dandruff causes.

Allergic reaction

If you recently colored your hair, it’s possible that you’re experiencing an allergy to the dye. This is true even if you’ve used the product before without incident. «If the hair color is temporary or semi-permanent it can be washed out,» explains Joshua Zeichner, MD, a board-certified dermatologist and director of Cosmetic and Clinical Research at Mount Sinai Hospital in New York City, «but if it’s a permanent dye, that presents a more challenging situation, although there are products on the market that can remove permanent dye altogether.»

«People can have a reaction to anything they put on their scalp—from shampoo to hair dye to Rogaine,» points out Dr. Haley. «And don’t forget about those hair-smoothing keratin treatments, adds Dr. Klein.

To pinpoint the culprit product or ingredient suggests Tsippora Shainhouse MD, a board-certified dermatologist in Beverly Hills and Clinical Instructor at the University of Southern California, try using one product at a time for a week at a time, rather than combining many at the same time.» And then while your scalp is healing, choose only gentle and sensitive skin formulations.

Psoriasis or eczema

An itchy scalp can also be caused by inflammatory skin conditions such as eczema (aka atopic dermatitis, especially in babies, eczema can present on the scalp) and psoriasis (which is more likely to appear on the scalp of an adult). Dr. Zeichner says explains that these conditions arise when your immune system gets «angry» at your skin, leading to red, flaky, itchy patches.

Psoriasis looks similar to dandruff but is usually thicker and red, notes Esta Kronberg, MD, a dermatologist in Houston, Texas, but it can be treated the same way dandruff is treated. For both eczema and psoriasis, Dr. Klein recommends topical steroids, vitamin D analogues (calcipotriene), coal tar, salicylic acid, excimer laser, phototherapy, and immunomodulatory agents for severe cases. For more relief, try one of these all-natural psoriasis and eczema treatments.

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It’s possible that your itchy scalp is nothing more than a sunburn, Dr. Shainhouse suggests. If you’ve been out all day and forgot to wear a hat, think sunburn first, and get some relief with a cool shower and some hydrocortisone cream (available over the counter).

Dry scalp

The winter months can come with dry air, whether cold outdoor air or heated indoor air. The dryness strips the scalp of its protective oils, according to Dr. Shainhouse, who suggests that if your head becomes itchy in winter, your first plan of action could be to try a moisturizing hair conditioner or a once-per-week scalp and hair mask.

Dirt and sweat

«When you don’t wash your hair often enough, natural oils, dirt, and product residue build up on your roots and scalp, causing you to itch and scratch,» says Dr. Shainhouse. » Scalp skin is similar to face skin and need to be washed.» Dr. Shainhouse recommends washing every other day. If you think your strands are too dry for frequent washing, flip your head into the sink and focus on the roots only. Scrub your scalp and roots with shampoo and be sure that it lathers well before rinsing in order to dissolve the excess oils and debris.

Likewise, your scalp could itch because you simply skipped your shower after a «super-soaker spin class,» Dr. Shainhouse suggests. «When the sweat on your scalp dries, it can irritate the skin, leaving it feeling itchy.» The simple solution: Wash your hair every time you sweat/work out. Plus, these 9 hacks can help treat common summer skin problems too.


Rosacea classically presents as red flush and (sometimes) pimples on the face. Rosacea may flare in the heat, after eating spicy, hot, or caffeinated foods and drinks, or as a result of emotional stress, according to the American Academy of Dermatology. While it normally affects the cheeks, chin, and nose, says Dr. Shainhouse, it can potentially affect the scalp, causing an itchy or burning or stinging sensation. If you think that you might have rosacea, see your dermatologist to figure out the best management plan.


If your itchy scalp is accompanied by what looks like red pimples—with a hair in the center of each one—you may be looking at a case of folliculitis, according to Dr. Khatri. The pimples may have pus in them, and they may itch or burn. When the pimples break open, they may drain pus, blood, or both.

Most of the time, the symptoms disappear on their own within a week to 10 days. Topically, you can use an antibacterial cleanser, Dr. Kronberg suggests, but if it doesn’t seem to be clearing on its own, you may need a course of oral antibiotics. Folliculitis is just one of the many skin conditions that look like acne.

Fungus and ringworm

A fungal infection (not the same one that causes dandruff) can cause an itchy scalp as well, says Dr. Haley, although this is more common in children. It’s also called ringworm, or tinea capitis. A fungal infection can be caused by moisture remaining on the scalp for extended periods, says Dr. Kronberg. If you have one, you’ll know soon enough because it won’t respond to anything except oral antifungals, which only your doctor can prescribe.

If you have prolonged redness and scaling, especially if accompanied by pus, see your doctor. Here’s how to identify the 14 most common rashes.

A too-tight ponytail

Like ringworm, wearing a ponytail can cause both hair loss and scalp itching. «Wearing your hair up all day, or in overly tight or heavy hairstyles such as braids, buns, extensions, and weaves, can tug on the hair follicles, causing stress and scarring over time, leading to hair thinning and hair loss,» Dr. Shainhouse says. «However, this styling also pulls the hairs and surrounding nerves and muscles in an unnatural direction, leaving your scalp sore and sometimes itchy when you let your hair down.» Dr. Shainhouse’s simple solution? Stick to looser styles, keep hair in tighter styles only for short periods, and vary your hairstyles throughout the week.

Alopecia areata

Another cause of both scalp-itch and hair loss is alopecia areata. Dr. Zeichner explains alopecia areata as a condition where your immune system «gets angry at your hair, producing cells that attack it.» Patients may develop small bald spots, or in severe cases, experience complete hair loss. One of the earliest signs of alopecia areata is itching of the scalp. So, Dr. Zeichner suggests that if your scalp itching is accompanied by hair loss that can’t be explained by ringworm or an up-do (aka traction alopecia), make sure to visit a board-certified dermatologist for evaluation. These are the 10 other itches you should never scratch.

Lichen planopilaris

A far more rare cause of itching plus hair loss is Lichen planopilaris, according to Dr. Haley. Lichen planopilaris is a rare inflammatory condition that results in patchy progressive permanent hair loss mainly on the scalp. According to the American Skin Association, this condition affects around one percent of Americans, most of whom are over age 30. The aim of treatment is to slow the progression of the inflammatory process, which includes slowing the loss of hair.


Another unusual reason for scalp itchiness is sarcoidosis, according to Dr. Klein. Sarcoidosis is the growth of tiny collections of inflammatory cells (granulomas) in different parts of your body. Doctors believe sarcoidosis results from the body’s immune system responding to an unknown substance, most likely something inhaled from the air. Someone with an itchy scalp should not assume they have sarcoidosis, however, unless other symptoms are present, including:

  • Fatigue
  • Fever
  • Swollen lymph nodes
  • Weight loss
  • Persistent dry cough
  • Shortness of breath
  • Wheezing
  • Chest pain
  • A rash of red or reddish-purple bumps, usually located on the shins or ankles, which may be warm and tender to the touch
  • Disfiguring sores (lesions) on the nose, cheeks, and ears
  • Areas of skin that are darker or lighter in color
  • Blurred vision
  • Sensitivity to light

Phantom scalp itch

In rare cases, an itchy scalp has no organic cause at all, which is to say, it is accompanied by no other objective medical findings, Dr. Klein explains. This is known as scalp dysesthesia. It is often triggered or exacerbated by a psychologic or physical stressor and may be a manifestation of an underlying psychiatric issue or chronic pain syndrome. It is usually seen in elderly patients, and the key treatment is low-dose antidepressants, which Dr. Klein says can be life-changing for patients.

Cervical spine disease

Oddly enough, an itchy scalp that has no other cause could be a sign of cervical spine disease, which may be visible by imaging, says Dr. Klein. The mechanism here is thought to be related to chronic tension and nerve impingement. Treatment may include gabapentin (a drug used for nerve pain that also may be helpful in treating menopause-related symptoms), botox injection, and epidural injections. Here are the other diseases your itchy skin can reveal.


Lupus is a serious autoimmune disease that can present with itching as well as dry scalp, says Dr. Haley, but it also involves many other symptoms, which may include arthritis, photosensitivity, oral and cutaneous ulcers, and joint pains. A skin biopsy can be helpful in ruling out Lupus. For that dry scalp, you can try adding a few of these 21 dry skin home remedies to your daily routine.

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In very rare cases, an itchy scalp can be a sign of lymphoma, Dr. Haley says, specifically, a form called «Cutaneous T-Cell Lymphoma.» The itching with this form of lymphoma tends to be severe and is usually accompanied by a rash and enlarged lymph nodes. It affects more men than women and tends to appear after the age of 50. A skin biopsy will be helpful in diagnosis, as well as blood testing.

Skin cancer

Also very rarely, scalp itching will be caused by the presence of a skin cancer lesion, according to Dr. Khatri. In particular, melanoma can cause itching, but so can other forms of skin cancer. If your scalp is itchy, it’s a good idea to have someone take a look to see if there are any bumps or sores. Anything that is causing severe discomfort or that doesn’t resolve on its own within two weeks should be checked by a doctor. And make sure you never ignore these 10 scalp conditions.


Do you think you have lice when there’s nothing there?

Like millions of other parents, you’ll probably know all about head lice infestation and how exasperating it is to watch your child’s scalp scratching antics. However, if your own scalp suddenly starts itching even though there’s no sign of those nasty, pin-sized parasites that feed off human blood, it’s another issue altogether!

Strange scalp itch

Psychosomatic or psychogenic itch is a poorly understood affliction that can occur even though there’s no physical cause for the itch. However, while scientists describe it as “an excessive impulse to scratch, gouge or pick at normal skin due to possible psychological abnormalities”, they admit this “complex interaction between the skin and the brain is poorly studied”.

It’s believed the strange scalp itch is linked to a problem at a point along the sensory (afferent) pathway that moves impulses to and from different areas inside the central nervous system.

‘Scratch reflex’

All people sometimes experience an itching sensation and the urge to scratch explains Johannesburg clinical psychologist Shai Friedland, because “an initial stimulus ignites sensory neurons in our nervous system”.

He says one unconfirmed theory is that “observing someone scratching causes neurons to fire in the same body part of the viewing individual, inducing the same sensation”.

“This means if you see someone with head lice infection scratching their scalp, it can subconsciously cause a ‘scratch reflex’ that makes you feel an itching sensation in the same part of your body.”

Many unanswered questions

Scratching, remarks Friedland, can “often lead to relief or be pleasurable due to the release of dopamine”. However, it can also result in continuous scratching and itches in other parts of the body.

There are “many unanswered questions” about psychogenic itching. Even psychiatrists, dermatologists and psychologists of the French Psychodermatology Group (FPDG) say there’s no “clear and consensual definition and diagnostic criteria for psychogenic pruritus (itching)”.

Just because not much is known about it, doesn’t mean the itch is merely in your head. Psychologist Dr Juli Fraga of California Pacific Medical Centre says psychosomatic or psychogenic itching is a “genuine physical affliction caused by emotional anxiety”.

Friedland confirms its link to “many different psychological disorders such as obsessive traits and impulse control behaviours including depression, OCD (Obsessive-Compulsive disorder) and Attention Deficit Hyperactivity Disorder (ADHD)”.

Before you pull your hair out.

Before you assume the worst, remember many people scratch their scalp when concentrating, thinking or feeling stressed. Your itchy scalp could simply be a temporary symptom of anxiety and nervousness that will ease once the stressful situation passes. Many other factors like eczema, dandruff, hair dye allergies, dry skin, fungal infections, psoriasis, braids and hair extensions could cause an itchy scalp, says UK-based Public Health Medicine Environmental Group (PHMEG) in its report Head Lice: Evidence-based Guidelines.

Firstly, see your doctor or dermatologist to rule out any possible underlying physical or physiological cause. If they diagnose a physical condition, they might prescribe an anti-inflammatory topical agent containing steroids and calcineurin inhibitors that reducing skin inflammation by targeting your immune system.

However, if they suspect psychological factors are involved, you may need to see a psychiatrist or clinical psychologist. Friedland says that when Cognitive and Behavioural Therapy (CBT) is combined with relaxation techniques it may not only effectively treat depression, impulse disorders and obsessions/compulsions, but also be particularly helpful for individuals suffering from a psychogenic itch.

Read more:


Yosipovich, G and Samuel, L. S. (2008). Neuropathic and Psychogenic Itch. Dermatologic Therapy, 21, 32-41. http://www.ncbi.nlm.nih.gov/pubmed/18318883

Information supplied by Shai Friedland, Clinical psychologist in private practice, Johannesburg.


Do You Have an Itchy Scalp? 5 Common Problems and Fixes

If you’re constantly scratching your head because of an itchy scalp, it could be more than just dandruff.

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Many conditions can cause an itchy scalp ― from dandruff to ringworm or something more serious like a bacterial infection or autoimmune condition. Before you can stop the itch, you need to find out what’s causing it.

Here dermatologist Melissa Piliang, MD, explains five common causes and treatments for itchy scalp:

1. Dandruff and seborrheic dermatitis

These are the most common reasons for an itchy scalp.

“Your body’s inflammatory response to an overgrowth of yeast causes the itching and flaking associated with these conditions. Yeast normally lives on the scalp and other hairy areas of the body, but the problem arises when there’s too much yeast present,” says Dr. Piliang.

The fix: For mild cases, you can use an over-the-counter shampoo containing selenium or zinc pyrithione ― ingredients that help control yeast. For more serious cases, you may need a prescription-strength antifungal shampoo, topical cortisone or medicated foam, solution, cream or ointment.

2. Psoriasis

This is a chronic autoimmune disease that causes raised, reddish, scaly patches on the skin or scalp. You can’t get psoriasis from other people. Experts don’t have a clear understanding of what exactly causes this skin disorder, but you’re more likely to develop it if someone in your family has it.

The fix: Dr. Piliang recommends trying over-the-counter medicated shampoos containing coal tar or salicylic acid to control scalp psoriasis. If those don’t work, make an appointment with your dermatologist. He or she can prescribe stronger shampoos and topical cortisone.

3. Tinea capitis

This is a fungal infection commonly known as ringworm, which can infect the scalp. Tinea capitis extends deep into the hair follicle, causing round patches of hair loss that increase in size over time. The rash may appear raised and with black dots or a stubbly appearance.

The fix: If you have a ringworm infection of the skin, you can use an over-the-counter antifungal formulation to get rid of it. Not so with the scalp.

“Since the organism exists deep in the hair follicle, you’ll need to take oral anti-fungal medications to resolve the problem,” says Dr. Piliang. Your doctor will verify that this is actually what’s causing the problem before prescribing these powerful medications.

4. Head lice

Although most people think of schoolchildren when they hear about head lice, they can invade anyone’s scalp. Dr. Piliang says lice prefer clean hair, so having a case of head lice doesn’t mean you have poor hygiene.

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If you look closely, you can see tiny nits (eggs) attached to individual hair strands. They look a bit like dandruff, but they aren’t easily shaken off because they’re “glued” to the hair shaft. You might also be able to see adult lice moving around the head, but they’re harder to spot than the nits.

The fix: You can treat head lice with over-the-counter shampoos containing insecticides pyrethrin or permethrin.

“Each head lice shampoo formula has its own treatment protocol,” warns Dr. Piliang. “You must follow the instructions on the box exactly to get rid of the lice.” These work well ― if you use them as directed.

5. Allergic reactions

Hair dyes, eczema and atopic dermatitis are other, less common causes of itchy scalp.

The fix: Allergic reactions will generally go away on their own if you can identify and avoid the chemical to which you are allergic. This is challenging and specialized tests in a dermatologist’s office may be needed to sort out which chemical is causing the allergy.

When to worry about scalp itchiness

Most of the time, an itchy scalp isn’t cause for concern. But there are times when it can indicate something more serious. See your doctor when:

  • Over-the-counter shampoos don’t make any difference.
  • The itching keeps you up at night and affects your work or study.
  • You see lice or nits in your hair.
  • The itchy spots are very sore to the touch.

Dr. Piliang says that it’s always a good idea to see your dermatologist when you have a persistent itchy scalp – even if you think it’s just common dandruff. Your dermatologist can check it out and tell you which remedies will bring you some relief.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy


Why does the head itch — no lice, but itching only intensifies

Head Scratcher: Why Does My Head Still Itch After Lice Treatment?

Scratching the question you’ve been asking and tips on being itch-free

We get it — finding out you or your child has been exposed to lice is a stressful time. Once you find professional, knowledgeable lice treatment, you’ll experience a great amount of relief for you and your family. However, sometimes a bit of an itch may linger after treatment, causing great concern and anxiety surrounding the subject. Not to worry, though — this itch is completely normal. Here, we’ll break it down on possible causes for you post-lice itch and some treatments that may cause relief. If you still have questions, or saw a different lice professional and believe you still have active head lice, feel free to call us at (800) 319-8751!

Minimizing Your Itch with the Proper Treatment

Choosing the correct treatment prevents itching from the root cause

Much like proper skincare and haircare in general, it’s important to use products and treatments that are safe and effective for human skin. There’s a variety of lice treatments on the market, but the problem is that many of these lice treatments contain harsh chemicals or irritants to the scalp, which can be a cause of the itch in the first place.

Many medicated shampoos contain chemicals called pyrethrins, which both occurs in nature and can be man-made. Pyrethrins shut down a louse’s nervous system, which then kills the lice infestation. Not only is this a chemical — which can cause skin irritation itself — but many chemical treatments contain piperonyl butoxide, which the EPA classifies as a possible cancer-causing agent in humans. These chemicals are deemed to be in small enough quantities for children to use, but this could be vital knowledge in understanding the type of treatment you administer to yourself or your child.

That’s why the best treatment is a comb and nitpicking treatment by a professional. By using a specially-designed comb and best-practice lice removal techniques, a professional can safely and effectively remove lice from hair without harmful chemicals that irritate the scalp and cause itching.

Why You’re Still Itchy After Lice Treatment

If your itch still lingers after treatment, here could be a few reasons why.

It’s extremely normal for an itch to linger after lice treatment. Here’s a quick breakdown of why your itch could continue after treatment:

  • Ineffective Treatment

When not treated properly or in severe cases, you may not get rid of all the lice in the first go. The cycle of treatment for live lasts about two weeks — which is the amount of time it takes and remaining nits (louse eggs) to hatch and be sure treatment was effective. If your lice return, so does your itch in many cases.

  • Scalp irritation from treatment

As previously mentioned, using treatments with harsh chemicals — or even sodium chloride — can dry the scalp and remove natural oils necessary for a healthy, moisturized scalp and healthy hair.

Another source of itching could be louse bites causing irritation to the scalp. Although louse bites are harmless, they cause irritation and itching must like most bug bites do. However, excessive scratching could worsen the bites and cause bacterial infections, which may cause additional pain and itching.

How to Fix Your Itch

I still itch after lice treatment. so now what?

A great first step after treatment is following up with a lice check to see if you have fully killed the lice infestation. If not, another round of treatment is recommended. If a professional was not contacted the first time, it may be worth considering professional treatment to avoid further discomfort and stress caused by lice.

For itching caused by a dry scalp, try a deep conditioning treatment. Deep conditioning treatments can be found at drug stores, large retailers like Target, and at specialty beauty stores like Ulta and Sephora. These treatments restore moisture and oils essential for proper hair and scalp health to a dry scalp, causing relief (and really soft and pretty hair).

If your itch is caused by louse bites, it may be best to contact a doctor. It’s possible that your child could be having a minor allergic reaction to the bites themself, or infection could have occurred from scratching existing bites. In these cases, your doctor will be able to assess whether your child needs antihistamines to treat an allergic reaction or antibacterial medicines for an infection. Additionally, if your child is not responding to treatments and the lice persist, contacting a doctor is never a bad idea.
When it comes to lice, we understand that discomfort, treatment, and prevention can be a huge undertaking. While working through this stress, it’s important to ensure you are finding effective and safe treatment for you or your child. That’s why contacting a professional lice removal service is always your best bet. Their timely and expert service ensure that your children stay happy, healthy, and return to a normal life in no time. Hair Whisperers is proudly serving, Brentwood, Los Angeles, Hollywood, Pacific Palisades, Beverly Hills, Bel Air, Marina Del Ray, Playa Del Ray, Santa Monica, West Los Angeles, West Hollywood, and all surrounding areas! Call us to schedule an appointment today at (800) 319-8751!


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