Itching of the head is a common symptom and most people experience the odd bout in life. Although many of use use the word head, it is actually the scalp that we refer to when we talk about itching of the head. The scalp is the skin where the hair on the head grows. Hair itself cannot feel sensation- neither pain not itching. Therefore itchy hair is an incorrect term. Scalp itching in most cases is not serious. It is usually temporary and often eases without the need for any medical treatment. However, in some instances an itchy scalp may be related to a skin problem or even systemic disease and medical intervention is therefore necessary.
Causes of an Itchy Scalp
Itching of the head and scalp is a symptom. The most common causes of an itchy scalp are related to skin dryness and poor hygiene. Simple measures like moisturising the scalp and frequently washing the hair may be sufficient to remedy the itching. In other cases an itchy scalp may be a consequence of skin diseases such as eczema, scalp ringworm, psoriasis, folliculitis and seborrheic dermatitis, known as dandruff in adults and cradle cap in children. However, an often ignored cause of itchy scalp these days can be attributed to hair styling and the use of hair care products. In these cases, an itchy scalp and any associated skin problems are avoidable.
Normally the skin has its own mechanism to ensure that it is properly moisturised. This is largely through sebum (skin oil) that is secreted from the sebaceous glands and empty out through hair follicles. As with skin anywhere on the body, the scalp is prone to drying under certain circumstances.
Some people may have naturally dry skin but in most instances it is related to poor skin care. With the head there is the added effect of hair care products which may dry the scalp as well as excessive washing with harsh shampoos. Abnormal dryness can also predispose the skin on the scalp to infections caused by fungi and bacteria.
The hair traps dust and microbes during the course of the day but many people do not wash their hair on a daily basis. The accumulation of oil, dead skin cells, hair care products like styling gel coupled with dust and microbes from the environment can act as an irritant to the skin of the scalp. Itching is a common symptom.
It is easily remedied by frequent, even if not daily, washing of the hair and scalp. The problem in many cases however, is that due to hair styling many people do not wash their hair frequently. This is particularly the case with people who straighten their hair or use braids and extensions as washing compromises the styling. An itchy scalp due to unwashed hair is therefore more likely in these instances.
There are number of different infections that can arise on the scalp as with skin anywhere on the body. The two major infections that do occur on the scalp are fungal and bacterial in nature. These infection can cause intense itching, along with pain, oozing from the scalp and even hair loss.
Fungi and Bacteria
Tinea capitis is a fungal skin infection of the scalp caused by dermatophytes, a type of skin fungus. It is commonly referred to as a scalp ringworm. Although the infection can spread to involve large areas of the scalp, it is usually not a serious infection with dangerous complications. Folliculitis is a bacterial infection of the hair follicles. It is can be a very serious infection and requires prompt medical treatment.
Less commonly, the scalp may become infested with parasites. Head lice is one common type of parasite that affects the scalp and it frequently spreads among children. Another rather uncommon scalp infestation is scabies where a tiny mite burrows into the skin. Here itching is mainly due to an allergic response to the presence of these insects.
Scalp Skin Diseases
The skin on the scalp may be affected with different diseases that also occur elsewhere on the body. Itching is a common symptom of most skin diseases. The three main skin diseases that can affect the scalp are eczema, seborrheic dermatitis and psoriasis. These are chronic skin conditions that can persist for months or even years.
Eczema is a commonly used term for atopic dermatitis, a type of allergic skin disease that often starts in early childhood. It is more commonly seen in the skin folds like the elbow and behind the knees but can affect the skin on any part of the body including the scalp. Another type of dermatitis that can affect the scalp is contact dermatitis, either allergic or irritant forms. It is more likely to occur with exposure to certain substances that irritates a person’s scalp or to which a person is sensitive to.
Psoriasis is a chronic skin disease where there is extensive inflammation of the skin. It causes the skin to become red, swollen and eventually develop thickened plaques. Typically the psoriasis rash appears silvery-white in colour with reddish borders. Psoriasis can also occur on the scalp and lead to hair loss in many instances. Although psoriasis may completely clear up at times, it tends to recur months or years later.
Seborrheic dermatitis is another skin condition that often affects the scalp but can also involve the face. It is a result of excessive oil production from the hair follicles and inflammation of the skin possibly due to a reaction to the Malassezia fungus, which is also known as Pitysporuam ovale. It is not an infection. Seborrheic dermatitis is typically worse in infants, particularly those who are born with it and is known as cradle cap in babies. It is usually milder in teens and adults and referred to as dandruff.
Various hair styling practices and the use of hair care products can contribute to an itchy scalp. The chemicals used for hair styling and hair care can act as irritants thereby leading to itching. In other cases, hair styling detracts a person from washing their hair on a regular basis and here the problem is largely due to hygiene.
Dyes and Tints
The worst offenders are bleaches and tints which lead to a hair dye allergy or irritation. This is a form of contact dermatitis as discussed above under eczema. Some people have a natural sensitivity to substances in hair dyes and react adversely when exposed to it. In irritant contact dermatitis, these substances are highly toxic and irritate the skin of any person irrespective of whether they have an allergy or not.
Braids and Extensions
Hair braids and hair extensions are usually long term fixtures that and easily damaged or undone with regular hair washing. Therefore many people with braids or extensions do not wash their hair for weeks or even months. At the same time, the use of hair care products for extensions and braids worsens the situation as the it mixes with the dust and skin cells on the scalp which irritates it and leads to itching. Sometimes the materials used to make an extension or braid acts as an irritant or even triggers allergic reactions on the scalp.
Straighteners and Relaxers
Hair straightening chemicals or relaxers are widely used in South Africa. However, these chemicals are very harsh and similar to hair dye, it can irritate the skin or trigger an allergy. Unfortunately this does not detract many people who straighten or relax their hair on a regular basis. Itching is usually the first symptom and the problem worsens over time culminating in hair loss. Using a straightening iron may also damage to scalp if use improperly.
Itchy Scalp Treatment
The treatment of an itchy scalp depends on the cause. Scalp infections and skin diseases need to be be properly diagnosed, assessed and treated by a medical professional. Other causes of an itchy skin can be treated with simple measures at home but the scalp should first be examined by a doctor to ensure that there are no underlying skin diseases or scalp infections. Simple measures that can help relive an itchy scalp includes :
- Washing the scalp and hair frequently with a mild shampoo like baby shampoo.
- Not using a hat or cap for prolonged periods.
- Use mild hair oils for a dry scalp but ensure that the hair and scalp are washed regularly.
- Avoid using hair gel on a regular basis and find brands that do not irritate the scalp.
- Stay away from the hair dyes and tints if it irritates your scalp.
- Braids and extensions may be fine for short periods of time only.
- Quit straightening or relaxing your hair if you are experiencing an itchy scalp, burning or hair loss.