Got an itchy head? Here’s what it could mean

Just typing the words “itchy head” makes me want to triple-wash my hair. But winter is high season for dry and itchy scalps, and odds are you’ve wrestled with both at some point already this year.

Whereas a dry scalp can result from the cold, dry air zapping moisture from your skin, an itchy scalp can be a sign of something much more worrisome.

“Since the scalp is rich in oil glands, dry skin alone is not a common cause of itchy scalp,” says dermatologist, Melinda Gooderham. “You should consider another scalp condition that causes itching and flaking.”

There are a slew of conditions that can result in an itchy scalp, and some are more severe than others. To help put your confusion at bay, I tapped Gooderham to explain the difference between itchy scalp conditions, and how to treat them.

Dandruff and seborrheic dermatitis

According to Gooderham, dandruff is typically associated with an itchy and flaky scalp. It is known as a subtype of seborrheic dermatitis, without the inflammation.

Seborrheic dermatitis is similar to dandruff, but comes with more redness and inflammation of the scalp.

“The scales are generally more greasy and thin than they are with dandruff,” says Gooderham. “It can occur on the face - on or between the eyebrows, in the creases of the nose, and the marionette lines - as well as the scalp, whereas dandruff just affects the scalp.”

She explains that both conditions occur due to an overgrowth of the yeast species, malassezia on the scalp. If you’re experiencing inflammation, your body’s immune response to this yeast likely isn’t adapting.

If you suffer from dandruff or seborrheic dermatitis, Gooderham recommends using shampoos with selenium sulfide, zinc pyrithione, or salicylic acid. If these don’t work, ask your doctor for a prescription for an antifungal shampoo containing ciclopirox or ketoconazole.

L'Oreal Professionnel Série Expert Volumetry Shampoo with salicylic acid. (L'Oreal Professionnel)

Scalp psoriasis

If you notice that your scalp has a thick red base and thicker white to silvery scales, you could have scalp psoriasis.

“Scalp psoriasis is a more severe condition where the scales are stuck on, but can also flake off,” explains Gooderham.

She says that all of these conditions can be quite embarrassing to those affected. If that’s the case for you, try avoiding dark coloured clothing to take focus away from the flaking.

You also might be able to treat cases of mild scalp psoriasis at home, using products containing salicylic acid or coal tar. However, for more extreme cases, a prescription for a topical steroid could be the key to relief as it will help reduce inflammation that causes plaque build up.

Ringworm and lice

Ringworm (tinea capitis) and lice (pediculosis capitis) are more commonly found in children, but Gooderham warns that they can be seen in adults too.

Where ringworm is caused by a fungal infection, lice is easily spread among those who carry it. If you, or especially your children, are scratching your scalp, you should check to see if lice or nits are present. Both of these conditions can be contagious to family members and classmates, so it’s crucial to get them treated as soon as you can.

For lice, the most effective way to get relief is with chemical treatments containing permethrin, but you can also try applying suffocating agents like dimethicone, petroleum jelly, or mayonnaise.

Gooderham recommends wet combing your hair with conditioner and a fine-toothed nit comb to help weed out the lice.

“Ringworm is more common in African American (Afro-Canadian) skin types due to the differences in hair types,” says Gooderham.

She explains that ringworm can be diagnosed by a physician by sending a scraping of the scales to a lab to identify what type of fungus is present. After this, an appropriate treatment can be started.

At home

With proper care, many of these scalp conditions can be remedied at home. But a word to the wise: Do not scratch! It can make your condition worse and even lead to infection.

Instead, Gooderham suggests cold packs, washing your hair with a scalp massage, and lightly tugging hair in the area where the scalp is irritated.

If these aren’t working and you feel like it’s affecting your quality of life, or if you notice patches of hair loss, take it to the doc.

Washing

If you you think you may have a scalp condition, it’s best to wash your hair daily, or every other day.

“When people develop these conditions they sometimes have a tendency to wash their hair less frequently, but that is not always effective due to a buildup of dead skin cells,” cautions Gooderham.

After washing, she recommends using a good conditioner and hair oil to moisturize the hair and scalp.

“Washing helps to remove the dead skin cells through massaging the scalp with the fingers, as well as rinsing the shampoo and dead skin cells away.”

Now, who’s got an itchy head?