Quick help for itching on the head
Head itch is usually an expression of skin irritation caused by illness, psychological stress or chemical-cosmetic or mechanical irritation of the scalp. Frequent hair washing, hair spray and hair gel, like head lice or fungal infections, can cause an itchy scalp. Itching often occurs as a harmless side effect of a dry scalp, but under certain circumstances there may also be a serious illness, which is why a doctor should be consulted urgently if symptoms persist. Furthermore, we explain possible causes, home remedies and tips for scalp itching.
Symptom scalp itch
Itching of the scalp is triggered by certain messenger substances, such as histamine, which cause a signal to be passed on to the brain via the nerve fibers of the skin. The natural reaction is scratching, which can damage the skin and lead to an increase in symptoms. A distinction must be made between the itching of the scalp according to the possible causes of the symptoms. Roughly, it can be divided into itchy scalp due to skin diseases, parasite infestation, allergic reactions, external skin irritation and psychosomatic complaints.
Causes of itchy scalp
Possible triggers of itching on the scalp include various (skin) diseases, allergies, as well as an infestation with mites, head lice or fleas. Hair loss may also be accompanied by increased itching. You can read about the general skin diseases that can cause the itching of the scalp in the article “Itchy rash”. At this point, however, the focus is more on the diseases that cause itching that is limited to the scalp.
Scalp sensation disorders
A until recently largely unexplored cause of itching is the so-called trichodynia. The name is based on the Greek terms “trichos” (hair) and “dynê” (pain). The itching is due to sensory disorders on the scalp. The disease is probably triggered by stress and corresponding tension in the scalp. The sensation can range from a slight tingling sensation to a painful burning sensation. The increased sensitivity of the scalp is usually accompanied by hair loss and possibly tension headaches.
As a result of the complaints, many sufferers suffer from growing psychological problems, which in the worst case manifest themselves in depression. Trichodynia does not usually reveal any changes in the skin's appearance, except for the consequences of scratching in response to the itching sensation. No signs of disease on the scalp can be determined microscopically. According to current knowledge, around 30 percent of women and ten percent of men with hair loss suffer from trichodynia - the so-called hair pain.
Head itch due to parasites
Infestation with head lice is often the cause of the annoying head itch, especially in children in this country. Head lice are the most common infectious disease in children in Germany and cause an intense itching in the area of the head hair.
The tiny parasites feed on human blood. They scratch the scalp, suck the blood and use their saliva to prevent blood from clotting. The head lice repeat this suction process every two to four hours. If the supply is interrupted for a day, the animals usually do not survive. The life expectancy of the head louse is a maximum of 30 days. However, the animals reproduce extremely quickly, since each female can lay hundreds of eggs in the course of its short life. The little insects stick their eggs, the so-called nits, to the human hair.
The itching caused by head lice is caused by the tiny injuries the animals cause when they suckle blood or by the immune response to the saliva of the lice. The movement of the animals on the scalp is also sometimes perceived as an itch.
In the case of a head louse infestation, the scalp shows a typical efflorescence (pathological skin change) in the form of small, strongly itchy, reddish swellings. If the urge to scratch is given in, bacteria can penetrate through the corresponding skin injuries and further worsen the symptoms. At worst, ulcers and persistent inflammation form.
In addition to the head lice, other ectoparasites (external parasites) can colonize the human scalp and cause considerable itching. The best known are fleas, but also mites, which, for example, trigger a scabies disease.
Rash that focuses on the face and scalp is called seborrheic dermatitis (also called seborrheic dermatitis). Like all eczema, this is characterized by skin reactions such as reddening of the skin, blistering, subsequent oozing when the blisters burst, and scab and dandruff formation. The disease is often accompanied by severe itching. Seborrheic eczema in particular is more likely to affect newborns and people with immunodeficiency. In infants, the disease is often mistaken for the so-called cradle cap.
In the course of the disease, a scaly rash forms on the hairy scalp and possibly on areas of the nose, chin, eyebrows, eyelids and ears. If the itching is given in, there is a risk of skin injuries that favor additional inflammatory processes. Seborrheic eczema is favored by a genetic predisposition, but according to current knowledge is also related to other risk factors. Because of the increased incidence in Parkinson's and AIDS patients, a connection to the central nervous system and immune defense is suspected.
Sweating, but also clothing that is not breathable, and the so-called occlusion (air and water impermeable covering of the skin, e.g. with oily skin care products) exacerbate symptoms. Exactly how the rash and the associated itching of the scalp are triggered has so far not been clarified. There is probably a connection with the pathological multiplication of special yeasts, which occur as natural colonizers of the skin in every person.
Numerous different skin fungal diseases can affect the scalp and trigger a considerable itching sensation here. The fungal diseases summarized under the generic term dermatomycosis mostly affect the horny substance such as (horny) skin, hair, fingernails and toenails, but can also penetrate deeper into the organism and cause serious diseases up to and including sepsis (blood poisoning).
A fungal infection usually manifests itself on the scalp through increased itching, reddening, scaling and blistering. In order to avoid further skin injuries, the itching sensation should be avoided if possible. Especially since the fungal spores can penetrate into deeper layers when the skin is injured. The spores also stick to the fingernails when scratched and may therefore be transferred to other parts of the body or to other people. Furthermore, the injuries when scratching favor the occurrence of secondary infections by bacteria.
Skin fungal diseases that cause head itching can be caused both by fungi that are already present on the human body and by those that originate from pets or farm animals. They are relatively often the cause of increased dandruff formation and should be treated by a specialist, whereby consistent therapy offers high chances of success.
Psoriasis can affect the scalp and cause severe itching. Typical features of psoriasis are rounded, reddish, strongly flaky skin irritations. The skin renewal process in the disease is permanently disrupted. The formation of skin cells is greatly accelerated. As a result, dandruff is loosened and the underlying, heavily circulated, reddish-looking border to the dermis becomes visible. Occasionally, the deeper cell layers also loosen, causing slight punctiform bleeding.
Although psoriasis is not contagious, it can spread to other organs in the affected patient. Due to the clearly recognizable dandruff formation, it often causes a significantly reduced self-esteem and psychological problems of the patients. It also applies to psoriasis that the itching should not be relentless to avoid worsening of the symptoms.
Other causes of itchy scalp
External irritations of the scalp or hair roots are also to be mentioned among the possible triggers of the symptoms. Both mechanical impairments, for example by wearing hats, caps or helmets, and chemical-cosmetic impairments can cause an increased itch in the head. In most cases, mild inflammatory processes are the immediate cause of the itch. The skin may also show allergic reactions and signs of hives (nettle fever).
The most common chemical-cosmetic triggers of itching are shampoos and hair dyes. But hairspray, hair gel and the like also cause allergic reactions in some people, which can be accompanied by a considerable itching of the scalp. In the case of external influences, which can lead to complaints of the scalp or the hair follicles, combined with the corresponding itching, hot blow-drying should be mentioned.
Treating head itch
The treatment should always be based on the causes of the symptoms. Therefore, a thorough medical diagnosis is required before starting therapy. If the itchy head is caused by generally dry skin, moisturizing treatments are recommended, using special emulsions that reach the scalp without any problems despite the hair.
The scalp can also be rubbed with olive oil to minimize itching. The same applies to tinctures made from juniper berry oil, rosemary oil and evening primrose oil. In addition, in the case of a dry scalp, the use of particularly gentle shampoos and hair care products is recommended in order to avoid unnecessary stress on the scalp.
Therapy for trichodynia
Since the cause of trichodynia is suspected to be scalp tension, methods of muscle relaxation are usually the focus of the treatment. (Scalp) massages and the injection of muscle-relaxing medications are used more frequently here. The muscle relaxant drugs inhibit the transmission of signals between the nerve and muscles, thereby interrupting the constant contraction of the muscles. The muscle relaxant is injected directly into the tense scalp muscles. Often, the symptoms are relieved fairly soon after the treatment and the itching of the head disappears. The muscle-relaxing medication should only be injected by an experienced specialist.
Due to the presumed connection of scalp tension and the corresponding hair pain with psychological stress and stress, relaxation methods are also a frequent component in the treatment of trichodynia. One of the most common relaxation exercises that are relatively easy to learn is autogenic training, but so-called progressive muscle relaxation, hypnosis, yoga and meditation can also help to overcome the psychological tension and thus the cause of the itchy head.
Biofeedback can be mentioned as another approach to relaxation techniques, as well as movement exercises from the area of Qigong or Tai Chi. Some naturopathic therapists also use acupuncture to treat trichodynia to relieve scalp tension. In addition, homeopathic remedies can help relax the scalp muscles, whereby the selection of suitable substances should be left to experienced naturopaths.
What helps with parasite infestation?
Depending on whether fleas, head lice or mites are the cause of itching, different treatment methods can be considered. However, disinfestation (removal of animals in the human environment) is in any case a crucial part of therapy.
In this country, fleas mostly jump from pets like dogs or cats to humans, so that the removal of the tiny bloodsuckers should also include pets and their sleeping and lying areas. The fur of the animals can be treated with special anti-flea shampoos and sprays to eliminate the fleas. Chemical agents are also available for use in the home, for example on carpets.
However, regular vacuuming often already has a clear effect against the spread of the tiny nuisances. If the infestation in the living environment is massive, a exterminator can be called in to treat the parasites with insecticides. In addition to eliminating flea infestations, treating the symptoms is also possible. For example, the inflammation of the stings caused by allergic reactions to the flea saliva is rubbed with anti-allergic or anti-inflammatory ointments. This promotes the healing process and also serves to relieve the itching. If the stitches are scratched open, there is a risk of bacterial inflammation, which can also be treated with anti-inflammatory but also antibacterial agents.
Head lice are much more difficult to eliminate than a flea infestation, not least because the tiny eggs (nits) are attached to the hair of the head in a relatively protected manner. The nits cannot be removed by simple hair washing. However, it is possible to separate them from the head hair with the help of a special lice comb, although under certain circumstances not all eggs are captured and the head lice may spread again. Therefore, the local use of head lice remedies is often part of the therapy.
The head lice remedies can act chemically or physically. The chemical head lice remedies are mostly insecticides that destroy both the eggs and the adult animals. When applied, the physical agents enclose the head lice and, due to their special flow properties, can also penetrate the tiny respiratory openings of the animals, causing them to die. However, their effect on the nits varies greatly depending on the preparation.
Herbal preparations for head lice are also a very effective weapon against the unpleasant parasites and the associated itchy head. The plant-based agents usually consist of a combination of different plant extracts, whereby both chemical and physical mechanisms of action are assumed. Essential oils of coconut and ylang ylang can be mentioned here as possible ingredients as well as the insecticide pyrethrum obtained from chrysanthemums.
It is also advisable to remove animals from the patient's environment when treating head lice. Pillows, hats, and other clothing that may be infected with lice should be washed thoroughly. However, head lice only survive relatively short away from the human body, which is why disinfestation only plays a minor role here.
Australian tea tree oil, among others, has proven to be an effective home remedy for lice. This has a slightly disinfecting and germicidal effect, inhibits the inflammation and ensures that the itching disappears. The oil can be used as an additive for shampoo, hair tonic and / or detergent as part of the treatment, but must never come into contact with the eyes and mucous membranes.
Mites cause the so-called scabies, which can also appear on the scalp as an itchy rash. Disinfestation should also take place here at the beginning of treatment, i.e. an environment that is as free as possible from mites. Clothing and bed linen should be washed at at least 60 degrees Celsius. Alternatively, potentially contaminated items can be packed in a plastic bag and frozen in the freezer. The mites die in frost. If the plastic bags remain closed long enough, they will perish naturally without frost.
The tiny arachnids are directly controlled with the help of ointments or emulsions (for example permethrin ointment) which contain anti-mite agents. After the parasite infestation has been remedied, the itchy head usually disappears relatively quickly.
Treatment for seborrheic eczema
Since seborrheic eczema is essentially due to genetic disposition, a cure based on the current medical treatment status is not possible. The symptoms, which include itching of the head, can be alleviated with the help of various procedures and long, symptom-free periods can be achieved for the patients. Due to the suspected connection with an increased spread of yeasts, antifungals (e.g. ketoconazole, ciclopirox or octopirox) are used locally as part of the therapy.
In addition, there is the use of anti-inflammatory drugs (for example the immunomodulators tacrolimus or pimecrolimus), which can also have a positive effect in the treatment of seborrheic dermatitis. Antifungal hair shampoos containing the active ingredient selenium disulfide are also used successfully. Even simple anti-dandruff hair shampoos can help alleviate the symptoms of mild forms of the disease.
Furthermore, various cosmetic creams containing the active ingredient urea are available, which can help in the treatment of acute symptoms. Creams and ointments based on glucocorticoids (usually cortisol) can also be considered, although their use can be associated with considerable side effects.
Patients are also recommended to wash the affected areas regularly with water and a gentle peel. The cleaning should be done with a washcloth. Sometimes the use of a saline solution can provide additional relief.
To prevent seborrheic eczema, the experts recommend regular stays in the sun, which can also help with the healing of existing eczema. Artificial UV light is also said to have a positive effect here, since it inhibits the growth of the yeast Malassezia furfur, which presumably plays a major role in the occurrence of skin irritation. A preventive effect is also attributed to frequent hair washing and short hairstyles.
Natural help for seborrheic eczema
Phytotherapy (herbal medicine) offers different approaches to the treatment of seborrheic eczema. In particular, the pansy herb (Viola tricolor) is said to have an extremely positive effect. This has an anti-inflammatory effect (anti-inflammatory) and shows a similar effect to the use of cortisone - but without comparable side effects.
The positive effect of pansy herb is clearly scientifically proven, at least for mild forms of seborrheic eczema. The medicinal plant is used as a tea infusion internally but also externally. Furthermore, shampoos, creams and skin oil based on the medicinal plant are available as finished medicinal products.
Therapy for dermatomycosis
If a fungal disease causes the unpleasant head itch, the treatment is usually based on the use of so-called antifungals, such as miconazole, bifonazole, naftifine or benzoic acid. Lavender oil can also help against various yeast and thread fungi. In addition to the selection of suitable antifungals, consistent use is of particular importance for the success of the therapy.
Because of the hair growth, treatment on the scalp is more likely with liquid agents, such as bifonazole, than with conventional ointments. Since the fungal infections are usually very persistent, the treatment usually lasts for several weeks or even months. Even after the obvious symptoms have disappeared, treatment continues for some time, otherwise the infection may flare up again.
At the same time, treatment is often recommended to change the diet, which provides a particularly large number of foods with a high content of the trace element silicon, such as millet. If the antifungals are used consistently, the disease usually heals without a problem even without changing the diet.
If treatment is not done, the fungal infection can become critical, as complications such as an additional infection with bacteria or the spread of the fungal disease to other organs are imminent. At worst, potentially life-threatening sepsis can develop. Therefore, if you suspect mycosis, a doctor should always be consulted.
If the head itch is due to psoriasis, various therapeutic approaches to relieve the symptoms can be considered. Many therapists rely on alternative medical procedures, for example from traditional Chinese medicine (especially acupuncture) or homeopathy. Nutritional therapies are also often part of the treatment of psoriasis.
At the same time, psychotherapeutic methods are often used, since psoriasis is thought to be related to psychological influences such as stress. Accordingly, relaxation methods such as autogenic training or yoga are used to treat the disease.
If psoriasis is less pronounced, symptoms can usually be significantly alleviated with external treatment. Creams, ointments and tinctures with different ingredients are used here. In conventional medicine, corticoids (cortisone) are usually part of the agents used.
Naturopathy tends to use plant-based ingredients such as sandalwood extract or evening primrose oil. In the case of severe forms, conventional medicine usually relies on the internal use of special active ingredients, such as methotrexate, retinoids, corticoids or certain immunosuppressants. However, there are considerable side effects here, so that it can only be used for a limited time.
Fumaric acid ester is more suitable for long-term therapy due to its fewer side effects, but it only improves the complexion in 50 percent of the cases. In addition, slight side effects such as abdominal pain or diarrhea can also occur here.
Good treatment results for psoriasis can also be achieved on the basis of light therapy. Irradiation with UV light has an anti-inflammatory effect, which can help alleviate the symptoms and temporarily heal. However, due to possible negative effects with regard to skin aging, the use of light therapy is only possible to a limited extent. The hair also complicates application in the area of the scalp. Another alternative psoriasis treatment is the so-called bath therapy, in which the patients bathe in sulfur-containing natural fango and volcanic water.
Relief from itchy scalp
Different home remedies can help relieve itching, regardless of the cause. For example, salt water is said to have a positive effect. Bathing in the sea can therefore counteract the itching. If the sea is not at the front door, there is the possibility to buy a solution with salt from the Dead Sea in the pharmacy and bathe in it twice a week. After the salt water bath, the application of St. John's wort oil is recommended. But a superficial application of evening primrose seed oil can also have a positive effect. Those affected should avoid scented shampoo or shower gel if possible.
Naturopathy for an itchy scalp
Olive oil for itchy scalp has proven to be an effective home remedy for naturopathy to relieve symptoms. If other causes such as fungal infections or head lice have been excluded, it is very likely that the scalp is irritated and dry. The olive oil is applied to the scalp once a week in the evening with a pipette or small syringe. The following morning, the oil is washed out with a mild natural cosmetic shampoo. Before the natural remedy is used, serious skin diseases should be excluded by a dermatologist.
Given the multitude of causes that can cause head itching, patients should consult a specialist or dermatologist if symptoms persist, in order to obtain a clear diagnosis. (fp)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters
- Dorothea Terhorst-Molawi: Dermatologie Basics, Elsevier / Urban Fischer Verlag, 4th edition, 2015
- Norbert Suttorp: Infectious Diseases, Thieme Verlag, 1st edition, 2003
- Mercedes E. Gonzalez: Seborrheic Dermatitis, MSD Manual, (accessed 02.09.2019), MSD
- Shinjita Das: Psoriasis, MSD Manual, (accessed 02.09.2019), MSD