Itchy scalp conditions and solutions

An itchy scalp is a common and annoying problem that is often accompanied by visible white flakes (dandruff) and occasional soreness. Dr Sarah Brewer investigates.

The skin on your scalp is made of normal skin cells that are continually replaced like skin elsewhere on the body. Dead cells that fall off are usually washed or brushed away without any problem. If the cells are replaced at a faster rate, or if the scalp is excessively dry, greasy or inflamed, however, dead cells may clump together to form larger, visible flakes which often itch.

• Seborrhoea
• Psoriasis
• Head lice

Seborrhoea
The most common cause of itchy scalp with flaking is a hypersensitivity to the skin yeast, Pityrosporum ovale, which lives on everyone's scalp. When yeast cell numbers are low, few problems occur. When their numbers increase, however, they can trigger a low-grade inflammatory reaction with itching and excessive flakiness - a condition known as pityriasis capitis.

If a more severe inflammatory response occurs, with redness and the formation of large dry, or greasy scales, it is known as seborrhoeic dermatitis. This reaction often spreads to involve the ears, eyebrows, nose and chest as well as the scalp. In severe cases, yellow crusts may form, especially around the hairline - for example in cradle cap which often affects newborn babies. Seborrhoeic dermatitis seems to be most common in young, adult males, and may also cause inflammation of the eyelids (blepharitis).

Treatment involves using an anti-fungal shampoo containing ketoconazole, which reduces flaking and helps to control the number of yeast cells present. If scales are stuck to the scalp, you can usually loosen them by gently rubbing a simple baby oil or olive oil into the affected area, and leaving it overnight - wear a cap to protect your pillow cases - and then wash off the following day along with the loosened crusts. After a few treatments, most seborrhoeic scales should have been removed. Brushing the hair with a clean soft-bristled brush will also help. For a natural approach, try rubbing your scalp with a solution of 7 drops Tea Tree and 7 drops lavender essential oil, diluted with 1 tablespoon (15 ml) carrier oil before washing your hair.

Inflammation in seborrhoeic dermatitis is sometimes linked with lack of essential fatty acids, and it is a good idea to take regular evening primrose, and omega-3 fish oils supplements, as well as eating more oily fish, nuts, seeds and wholegrains. Cut back on your intake of processed foods.