Peer Reviewed
Feature Article Dermatology

The itchy scalp

Jonathan Ng, Alvin Chong, Peter Foley
Abstract

Many dermatological conditions can cause scalp pruritus of varying degrees, but it can be difficult to make an accurate diagnosis as signs are often nonspecific.

Key Points
  • Scalp pruritus may be a feature of many common dermatological conditions including seborrhoeic dermatitis, psoriasis, pediculosis, eczema and lichen simplex chronicus. In some patients, androgenetic alopecia is associated with itching and irritation of the scalp.
  • Scalp pruritus can also be a prominent feature of contact dermatitis and rare conditions such as dermatitis herpetiformis, lichen planopilaris and trigeminal trophic syndrome.
  • Psychological issues, particularly anxiety, may exacerbate or manifest as scalp pruritus.
  • Identifying distinguishing features in the patient’s history and examination to make an accurate diagnosis is important. Sometimes a therapeutic trial is required before the diagnosis is known.
  • A definitive cause for scalp pruritus may not be found in some cases, but empirical topical treatments may still help to alleviate symptoms.
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