Dear Alice,

I am suffering from an itchy and dry scalp. Is there like a shampoo or solution that I can use to reduce the dryness and irritation? At the same time, I don't want the shampoo to make me lose hair. God only knows how little I have left! Thank you very much for your help.

— Flaky

Dear Flaky,

Hats off to you for seeking to get to the root of your itch! An itchy, dry scalp is typically a sign of dandruff, a harmless and common (yet irritating) condition in which dead skin is shed from the scalp, leading to the production of white flakes. Dandruff is usually caused seborrheic dermatitis, a type of skin rash. However, other causes of your discomfort may include: psoriasis, a skin disorder that comes with dry red skin and silvery scales; ringworm of the scalp, or tinea capititis; a fungal infection that may lead to red, itchy patches on your scalp and cause hair loss; or something more common, such as allergies or skin irritations from perfumes, hair products, or laundry detergent. Itching caused by head lice could also be bugging you — their eggs, or nits, are easy to mistake for dandruff. If you think you see a louse or a nit, you might consider an at-home lice removal treatment (more on that in the Go Ask Alice! Q&A Lice: How do I get it?). As for how to scratch that itch, there are a number of itch relieving techniques and shampoo ingredients that can help improve dandruff. 

Because of the large variation in the causes and treatments for dry or itchy scalp, a chat with a health care provider may help you solve this head scratcher. If you’re looking for immediate relief, you might consider some at-home techniques for alleviating itchiness.

  • Scrapping the scratch: This may be easier said than done, but scratching may make the area worse and cause further damage to your scalp. Keeping your fingernails trimmed and wearing gloves at night may help prevent you from scratching both when you're awake and asleep.
  • Cooling down: Applying cool, wet compresses to your scalp may soothe the itchiness for a bit. As a bonus, the compress on your scalp may protect it from being scratched.
  • Getting soaked: Oatmeal is often used to soothe itchiness and dryness (as anyone who has ever had chicken pox might remember!). Taking a bath and soaking your head in water with some uncooked oatmeal may help soothe the itch. If you find bathing with food unappetizing, you may look for specially formulated bath products that have colloidal oatmeal in them instead.
  • Staying fragrance-free: Dyes and perfumes in shampoo, conditioner, and other hair products and toiletries may be the cause of skin irritation. You may try using fragrance-free or hypoallergenic labeled formulas and monitor whether your condition improves. Make sure you rinse thoroughly after applying the products to help ensure that no residue stays behind, which may also contribute to the itchiness.

List adapted from the American Academy of Dermatology.

If your itch is dandruff-related, you also have some over-the-counter shampoo choices. Check the bottle for the following itch-reducing ingredients:

  • Pyrithione zinc: Pyrithione zinc is an antifungal and antibacterial treatment that can help reduce some of the common causes of dandruff and seborrheic dermatitis.
  • Coal tar: It may sound odd, but shampoo containing coal tar helps alleviate conditions such as dandruff, seborrheic dermatitis, and psoriasis. While the medical community generally considers coal tar to be safe for dermatological use, it isn't advised for people with sun sensitivity or for pregnant or breastfeeding people. Note that if you have light colored hair, it may cause discoloration.
  • Selenium sulfide: Selenium sulfide can slow down the process of skin cell overturn, which can make flakiness less frequent. Like coal tar, selenium sulfide can also cause discoloration in light or color-treated hair.
  • Ketoconazole: Another antifungal ingredient that's sometimes effective when other shampoos don’t do the trick.
  • Tea tree oil: Some smaller studies show that tea tree oil (which you can find in shampoo form) can help reduce dandruff. Note that more research is needed on this topic and that tea tree oil may cause allergic reactions.

List adapted from Mayo Clinic.

If you experience a rash, burning sensation, or any type of discomfort (or if you’re not seeing results after a few weeks), connecting with a health care provider can help you navigate prescription options that may be safer and more effective for you. Here’s to smooth sailing toward a soothed scalp!

Alice!

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