Dry and Itchy Scalp

 

Causes of Dry, Itchy, Flaky and Sensitive Scalp

There can be several causes of a dry and itchy scalp:

  1. Dandruff
  2. Seborrheic dermatitis
  3. Chemical irritants
  4. Skin allergies – to food, dust, medications or hair care products
  5. Scalp infections

Dandruff and Seborrheic Dermatitis

Dandruff

Seborrheic Dermatitis

Dandruff and seborrheic dermatitis are a spectrum of the same condition that causes a dry and itchy scalp. Dandruff is the milder, not inflamed version of the condition.

When you suffer from dandruff, scales form on the scalp and flake off due to an imbalance in oil secretion and the presence of skin yeasts called malassezia. These yeasts produce chemicals that cause skin irritation. In seborrheic dermatitis, the condition is worsened by the presence of inflammation, causing the skin of the scalp to be red and itchy, possibly leading to hair loss.

You may be more prone to seborrheic dermatitis if you have oily skin, a family history of seborrheic dermatitis, psoriasis, high levels of emotional stress or poor immunity.

How do I treat dandruff and seborrheic dermatitis?

You can help improve the condition of the skin and reduce symptoms of a dry and itchy scalp by using a mild shampoo and condition that protects the skin barrier and control oil secretion. A few commercially available preparations which contain selenium are available to control the growth of the yeasts.

Our doctor may prescribe some medication such as ketoconazole shampoo or salicyclic acid to get rid of the yeast and scaly skin. If the skin is red, inflamed and itchy, your doctor might prescribe an anti-inflammation cream (e.g. clobetasol) and oral anti-itch medication to control the itch. Usually, a combination of the methods work best.

Before hair can start to grow again in severely affected areas, the skin has to be in good condition. If you’ve experienced hair loss due to seborrheic dermatitis, certain medications – such as 5% minoxidil spray – can improve hair growth. These should not be used if you still have active skin irritation. 

Chemical Irritants

Some chemical irritants can give you a dry and itchy scalp. They include:

  • Some components of hair dye
  • Hair bleach
  • Certain topical scalp medications
  • Fragrance in perfume
  • Solvents such as alcohol or turpentine
  • Sodium laurel sulphate also known as SLS (This is commonly found in shampoos that lather strongly)
  • Alkali substances e.g. soap (The skin is slightly acidic (pH 5.5) so an alkali may irritate the skin by changing its natural pH value)

How can I treat contact dermatitis due to chemical irritants? 

Prevention: Avoid contact with chemicals that are known to cause the problem (see above).

First aid: Wash off the offending agent with plain, roomwater temperature. Make sure that you get a thorough rinse. Avoid using soap.

Seek medical help: Consult your doctor who can make a diagnosis using tools available in the clinic such as a magnifying videoscope and certain laboratory tests such as skin scraping to rule out other causes.

Control the symptoms: The doctor may prescribe you with some topical anti-inflammation cream or oral anti-itch medications to control the symptoms. He may also suggest that you use a gentle shampoo and conditioner without any of the triggering chemicals.

Prevent recurrence: If you have identified the offending chemical, try not to use that particular product again. You may not be able to tell which chemical is causing the irritation, so it’s best to check all the ingredients for any of the mentioned triggering chemicals. If you’re still unable to find out what caused the irritation in your case, consult your doctor.

Skin Allergies

Allergies to food, house dust mites, medications or products can all cause symptoms of a dry and itchy scalp. When a substance causes an allergic reaction, the substance is called an ‘allergen’, and the condition is called allergic contact dermatitis.

Allergic contact dermatitis is common and can occur not just on the scalp but other areas of exposed skin too.

The symptoms are usually an itchy scalp with dryness and scales, sometimes involving flakes. Dermatitis refers to an inflammatory condition by which the skin turns red, swollen and warm to touch. Symptoms can last for days to weeks if undiagnosed and untreated. Significant inflammation that affects hair bearing portions of the scalp may cause hair loss.

How can I treat an itchy/flaky/sensitive scalp due to skin allergies?

To help with your dry and itchy scalp, firstly, avoid allergens that are known to you. For example, if you’re allergic to house dust mites, keeping your environment dust free by frequent, regular housekeeping can reduce flare ups. If you’re allergic to a type of food, try to avoid it. Medications that cause you to have an allergic reaction should be reported to any doctor that you see, so that the same type or class of medication is not repeatedly prescribed to you.

If you suspect that you have been in contact with an allergen, wash the affected area thoroughly with tepid water.

See a doctor if there is a rash and the itch is severe – this is to determine the cause of the allergic reaction and to control the symptoms. The doctor may prescribe you some medication to calm the affected area down, including a barrier cream, an itch-controlling tablet and an inflammation-controlling cream.

If the condition recurs, your doctor might order some tests to identify the culprit allergen. These tests include a skin patch test or a blood test to detect anti-allergen proteins (IgE tests).

Once you’ve identified the allergen, it would be best to avoid contact with it. If the tests are unable to identify which allergen is the culprit, which happens occasionally, avoid the usual suspects and your doctor may prescribe you some standby medication to use when there are flare ups.

As much as possible, try to avoid treating yourself with new medication or creams or herbs because an important aspect of controlling this disorder is the correct diagnosis and allergen avoidance. Allergies can progressively get worse with repeated flare ups, to the point of full blown life-threatening allergies, so early diagnosis and treatment is essential.

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