Anyone with an itchy or sensitive scalp knows how annoying it can be. Luckily, the problem can often be easily solved once you figure out what’s causing it.

1. Excess Oil

The most common cause of itching is excess sebum (oil) which, when broken down by yeast that live on the scalp, causes irritation. There are two simple solutions to this problem – shampoo daily with regular shampoo (preferably with a pH of 5.5), and use a medicated shampoo twice a week to kill the yeast that breaks down the sebum. Sometimes patients suffering hair loss reduce the frequency of their hair washing and then start to suffer from an itchy scalp. I always reassure these patients that shampooing daily won’t increase the amount of hair they lose, but it will reduce the itching.

2. Lice

Lice can cause severe scalp itching, usually at the back of the scalp. Children suffer from lice a lot more than adults, probably because lice are easily spread in schools. The lice are like vampires; they feed off your blood, and their saliva irritates the scalp and causes itching.

3. Lichen Simplex

Another itch problem is lichen simplex, which is also called neurodermatitis. The cause of the initial itching can be irritated nerves in the nape area, which leads to scratching, inflammation and more itching, further aggravating the problem to create a vicious cycle. Two chemicals in the skin, nerve growth factor and substance P, can cause itching and are increased by stress, so this can actually be a stress response. Constant scratching causes the skin in the affected area to eventually become dry, scaly, hard and leathery.

4. Female Pattern Hair Loss (Genetic Thinning)

Many women suffering female pattern hair loss complain of sensitivity in the top area of their scalp. This is caused either by localized sensitivity to male sex hormones or is a result of inflammation around the hair follicles, which is common with this problem. Anti-androgen therapy and/or treatment to reduce the inflammation often solves the problem.

5. Inflammation

Inflammation is most commonly caused by white blood cells attacking the skin or hair (an autoimmune problem). Such autoimmune problems, as seen with psoriasis, alopecia areata and some scarring alopecias, are often associated with itching. Controlling the autoimmune reaction is therefore crucial to treat the underlying problem and stop the itching. Sometimes these conditions are also associated with proliferation of mast cells, which produce itch-inducing histamine, in the skin. Antihistamine medication can help provide relief.

6. Chemicals

One obvious cause of itching comes from the chemicals we apply to the scalp, which can lead to contact dermatitis. This might range from a minor irritant contact dermatitis from shampoo to a full-blown allergic contact dermatitis from permanent color applied to the hair and scalp. When considering the history of the problem, you should be able to draw a connection between the onset of itching and what has been applied to the scalp.

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