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Heather Hanks
Written by Heather Hanks

Reviewed by Dr Angelica L Dumapit and Physician Brandon Yew on July 22, 2022

What’s Causing Your Itchy Scalp?

Is your itchy scalp due to an underlying health condition, such as eczema or psoriasis? Find out here.

Itchy head min scaled

Although an itchy scalp isn’t usually a sign of poor hygiene, it can still be embarrassing to deal with. Dandruff flakes may appear on your clothes, making your condition obvious to those around you.

Additionally, an itchy scalp can sometimes be a symptom of an underlying health condition. Examples include psoriasis, eczema, or other autoimmune condition.

In this guide, we’ll explain some possible causes behind your itchy scalp and how you can finally get some relief.

What Are The Characteristics Of An Itchy Scalp?

Dandruff is usually caused by an oily scalp that sheds skin cells too fast.

A flaky scalp could be a sign of several skin conditions. To determine if it’s the result of an underlying health condition, ask yourself the following questions:

How often does it occur?

Mild dandruff that crops up occasionally from time to time usually stems from an especially oily scalp, which causes the skin cells on your scalp to shed skin faster.

This results in the formation of dead skin flakes. Shampoos can easily treat dandruff due to this occasional overproduction of sebum. 

Dandruff is considered a mild form of seborrheic dermatitis, which is a type of eczema. Eczema is an overreaction of your immune system’s response to otherwise normal pathogens on human skin, such as Malassezia (yeast).

Another cause of chronic flaky scalp is psoriasis. It is also an autoimmune condition, but it is different from eczema.

If you have psoriasis, your body renews skin cells too quickly for no apparent reason, making your skin unnaturally thick with scalpy patches, leading to flaking. 

Do the flakes only occur at the scalp area?

The main difference between mild dandruff and the other more serious skin conditions is that dandruff is only on your scalp.

Seborrheic dermatitis, on the other hand, can be apparent on your scalp, eyelids, eyebrows, face, neck, and other parts of the body. Dandruff can be a nuisance and a source of embarrassment, but it is rarely overly itchy or inflamed.

Severe seborrheic dermatitis can become so red and itchy that you might scratch until your skin is inflamed and even bleeds. Similarly, flaky scalp due to psoriasis can also be accompanied by similar skin plaques forming elsewhere, but the itching can be milder.

Those who suffer from psoriasis may also be in great pain when the abnormally thickened skin breaks and bleeds. The condition can also be accompanied by grooved, cracked nails, and sometimes joint pain. In some cases, this can be a sign of a condition known as psoriatic arthritis.

Does sun exposure help or hurt the itching?

Protecting your scalp from sun exposure may help reduce itching.

If your scalp starts flaking and getting itchy, accompanied by a lot of sweating when you are outdoors with the sun out, it could well be typical dandruff. This is especially true if it happens only occasionally.

If you have existing red patches of itchy skin and the redness and inflammation severely flare up when you get hot, you might be among eczema sufferers who are also sensitive to heat.

Meanwhile, with psoriasis, the UV rays in sunlight can help slow down the overproduction of new skin layers and may provide you with relief instead. 

Itchy Scalp Treatment Options

While the occasional dandruff problem can be addressed with over-the-counter shampoos, treatments for eczema and psoriasis require specific medical evaluation, diagnosis, and intervention by a doctor.

Some people also find great relief and success by working with a licensed and professional Traditional Chinese Medicine (TCM) practitioner. 

Western medicine

Western medicine treats skin conditions using medications. They help fight pathogens that make the condition worse. They also help reduce symptoms arising from your own body’s attacking of its own cells.

These include dandruff shampoos that contain antifungal or antibacterial agents or low concentrations of chemicals like salicylic acid. This help shed the dead skin cells and smoothen the outermost surface of the skin.

Moderate to severe eczema or psoriasis may be treated with topical corticosteroids. They are anti-inflammatory and suppress the immune response.

Severe psoriasis is sometimes treated with systemic drugs that affect your entire body. Symptoms temporarily calm, but side effects include lowered immunity and organ damage. 

Some doctors may describe psoriasis flakes to be more silvery in color, although to most of us, it would be quite hard to differentiate with just the naked eye.

TCM treatments for itchy scalp

According to TCM Physician Brandon Yew, TCM views an itchy scalp as a symptom of internal imbalances associated with Heat, Wind, Dampness, and Blood Deficiency. Specific types of flaky scalp arise due to different patterns of disharmony within the body, namely: 

  • Flaky scalp with skin redness is caused by Heat toxins 
  • Flaky scalp with red and itchy rashes is caused by Wind and Heat pathogens 
  • Itchy and oily scalp is caused by Wind and Dampness pathogens 
  • Flaky, dry, and pale scalp is caused by Wind pathogen and Liver Blood Deficiency 

“The above pathologies arise from pressure-cooker work stress, poor work-life balance, unhealthy dietary habits, prolonged and direct exposure to air-conditioner at the head and regular usage of harsh chemical hair products,” Physician Yew shares.

The first order of business is to assess the behaviors or environmental factors that create the “perfect” conditions for these pathologies to form.

Avoid the triggers mentioned, but more importantly, those with flaky scalp must try to manage stress, both physically and mentally, get adequate rest, eat healthy, and exercise regularly.

Best TCM Remedies For Itchy Scalp

“TCM can help treat flaky scalp through herbal medications, acupuncture, cupping, moxibustion, tuina (Chinese manual therapy), and blood-letting. These are formulated carefully by the TCM physician to address specifically the unique body constitution of every individual patient. Hence, it is best to always consult the TCM physician for proper assessment and treatment,” Physician Yew further elaborates. 

Herbal remedies

You can try TCM supplements that improve health such as essence of chicken with Angelica sinensis (Dang Gui) and tuber fleece flower (He Shou Wu). Work with your TCM practitioner who may also consider the following herbal formulas: 

  • Qiang Huo Sheng Shi Tang: Dispels Wind and Dampness; suitable for flaky and oily scalp
  • Si Miao Yong An Tang: Regenerates Liver Blood, cools the Blood and dissipates clots, neutralizes Heat toxins; suitable for flaky scalp with redness 
  • Xiao Feng San: Dispels Wind and Heat; suitable for flaky scalp with red and itchy rashes 
  • Dang Gui Yin Zi: Regenerates Liver Blood, promotes Blood circulation to dispel Wind; suitable for flaky with dry and pale scalp

Acupressure

Massaging certain acupressure points can also provide mild symptomatic relief by directly dispelling Wind, Heat, and Dampness within the scalp. This helps restore and enhance localized Qi and Blood circulation. Examples include Bai Hui (DU 20), Jiao Sun (SJ 20), and Feng Chi (GB 20).

For acupoints that restore and enhance Blood circulation to the scalp, try Nei Guan (PC 6) and Xue Hai (SP 10) to dispel Heat and Dampness, Feng Shi (GB 31) to dispel Wind, Yin Ling Quan (SP 9) to dispel Dampness, and Tai Chong (R3), which soothes Liver to dispel Heat and Wind and regenerates blood to nourish the Liver. 

Pay attention to the nature of your flaky scalp. Our bodies are very adept at signaling to us if we need to address imbalances. Utilize both Western and TCM approaches to understand your specific condition on your way to a flake-free and disease-free existence.

References

  1. Cleveland Clinic. 2020. Psoriasis.  
  2. Cleveland Clinic. 2020. Seborrheic Dermatitis.   
  3. Journal of Clinical and Investigative Dermatology. 2015. Seborrheic Dermatitis and Dandruff: A Comprehensive Review.  
  4. Dermatology Research and Practice. 2012. A Nonimmunosuppressant Approach on Asia Psoriasis Subjects: 5-Year Followup and 11-Year Data Analysis.  
  5. Penn Medicine. 2022. Eczema vs. Psoriasis: Similarities, Differences and Treatments. 

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