Many people get itchy scalp, often accompanied by dandruff, and we don’t really know the cause of that, says Dr. Joseph Fowler, a clinical professor of dermatology at the University of Louisville. There might be some genetic factors, and people with other skin conditions such as seborrheic dermatitis, psoriasis, and eczema are especially prone to it. Contrary to popular belief, an itchy, flaky scalp is not necessarily a sign of dryness. “The scalp is loaded with oil glands, and what people sometimes think of as dry scalp is actually inflammation from the dermatitis, which produces the scaling and flakiness,” Dr. Fowler says.
Most people with mild cases of dandruff and seborrheic dermatitis can control their symptoms with over-the-counter shampoos, says Dr. Fowler. Of all the dandruff shampoos, those containing tar are the most effective, but they tend to be the least cosmetically appealing due to the strong smell. Itch-relieving products such as Scalpicin can also be helpful in reducing scalp inflammation and redness, and scalp oils help soften and hold in the flakes, reducing the appearance of dandruff.
More severe cases of itchy scalp and flakiness might need to be treated with stronger prescription products and cortisone medications. Severe scaling, itching, and redness can also be a sign of an allergic reaction to a hair product. Switching to a different brand might not help since most brands have similar ingredients. “In that situation we recommend a skin allergy test to try and identify what you’re allergic to,” Dr. Fowler says.