An itchy scalp can be frustrating and sometimes even painful. While many assume dandruff is the main culprit, there are a variety of causes behind scalp itch, each requiring different treatments. Understanding the root of the problem is key to effective relief.

A dry scalp often results from harsh shampoos, overwashing, or cold weather. It typically causes flaking, tightness, and mild itching. Hydrating shampoos, reducing wash frequency, and using natural oils like coconut or jojoba can help restore moisture.

Dandruff and seborrheic dermatitis are common causes of itchy, flaky scalps, often triggered by a fungus called Malassezia. This leads to white or yellowish flakes and sometimes redness or oiliness. Anti-dandruff shampoos containing zinc pyrithione or ketoconazole can be effective when used consistently.

Scalp psoriasis, an autoimmune condition, leads to thick, scaly patches and sometimes hair thinning or bleeding. It usually requires medicated treatments like topical steroids or specialized shampoos, and more severe cases may benefit from phototherapy or systemic medication.

Allergic reactions, or contact dermatitis, are common with hair products containing dyes or fragrances. Symptoms include redness, swelling, and itching after using a new product. Stopping the irritant and using a gentle shampoo often brings relief.

People with eczema may also experience scalp involvement, especially during flare-ups. This presents as red, scaly, itchy patches. Treatment usually includes corticosteroid creams, gentle cleansers, and moisturizers.

Head lice, more common in children, cause intense itching behind the ears and at the back of the scalp. Tiny white nits may be visible. Treatment involves over-the-counter lice shampoos and combing out the eggs daily.

Tinea capitis, or scalp ringworm, causes round bald patches, broken hairs, and a painful scalp. Unlike other fungal issues, this condition requires prescription oral antifungal medication for effective treatment.

In some cases, stress or nerve-related conditions cause itchiness without visible symptoms. Called neuropathic itch, it’s often described as a crawling or tingling sensation and requires a different treatment approach, often involving stress management or neurological care.