What To Do If Your Scalp Is Itchy And Hair Is Falling Out
Itchy scalp with hair shedding usually signals irritation or inflammation, not just “dry skin.” Start by stopping new products, washing gently, and trying an anti-dandruff shampoo with ketoconazole, zinc pyrithione, or selenium sulfide. Seek medical advice fast for patchy bald spots, scaling with pain, oozing, fever, or symptoms lasting over two weeks.
Why Itch And Shedding Often Happen Together
When the scalp barrier is irritated, you tend to scratch, and the skin becomes more inflamed. That inflammation can increase shedding, while scratching can snap hairs and make hair loss look worse. The good news is that many causes are treatable once you identify the trigger.
Common Causes Of Itchy Scalp With Hair Loss
- Seborrheic Dermatitis (Dandruff / Scalp Eczema): Often causes greasy or yellowish flakes and itch. Yeast overgrowth and inflammation can drive shedding.
- Contact Dermatitis (Product Allergy Or Irritation): A reaction to shampoos, dyes, fragrances, or styling products can inflame the scalp and increase shedding.
- Scalp Psoriasis: Thick, scaly plaques can itch intensely. Hair loss is usually temporary and related to inflammation and scratching.
- Fungal Infection (Tinea Capitis): Can cause scaly patches with broken hairs or bald areas. This often needs prescription treatment.
- Lice: Severe itch, especially behind the ears or at the nape. Scratching can damage hair and skin.
- Dryness And Over-Cleansing: Hot water, frequent washing, and harsh shampoos can strip oils and trigger itch and breakage.
- Stress-Related Shedding (Telogen Effluvium): A stressor can push more hairs into the shedding phase. The scalp may feel tender or “tingly” in some people.
What You Can Do Now
If symptoms are mild and you feel well otherwise, you can take a few low-risk steps while you arrange care. Aim to calm inflammation, reduce scratching, and avoid anything that keeps the scalp irritated. If you have open sores, pus, or a rapidly spreading rash, skip self-treatment and get medical advice.
Step 1: Pause Possible Triggers
Stop any new shampoo, scalp serum, hair dye, or styling product you started in the past 2–4 weeks. Avoid fragranced oils and “tingling” treatments that can sting an already-inflamed scalp. Keep hairstyles loose and avoid tight braids, heavy extensions, or aggressive brushing.
Step 2: Switch To Gentle Washing
Use lukewarm water and a mild, fragrance-free shampoo. Massage with your fingertips rather than nails, then rinse thoroughly. If you wash daily, try every other day for a week and see if itch improves.
Step 3: Try A Medicated Anti-Dandruff Shampoo
For flaking and itch, many dermatology guidelines recommend anti-dandruff shampoos. Look for ketoconazole, zinc pyrithione, selenium sulfide, or salicylic acid. Apply to the scalp (not just hair), leave on for several minutes, then rinse.
Use it 2–3 times per week for 2–4 weeks, alternating with a gentle shampoo. If burning or worsening redness occurs, stop and switch to a bland cleanser until you can be assessed.
Step 4: Soothe Without Clogging
If your scalp feels tight or dry, a light, fragrance-free moisturizer or a few drops of non-comedogenic oil may help. Patch test first, because oils and botanicals can irritate some people. Avoid heavy, sticky applications that make buildup worse.
What A Dermatologist May Check
A clinician will look at the pattern of loss (diffuse shedding vs. patchy bald spots) and the condition of the scalp. They may examine hairs with a dermatoscope, do a gentle pull test, or take a scalp swab/scraping if infection is suspected. In some cases, blood tests help rule out iron deficiency, thyroid disease, or vitamin D deficiency.
Treatment Options By Cause
Seborrheic Dermatitis
Medicated shampoos with antifungal ingredients such as ketoconazole are commonly used. Some people need a short course of prescription anti-inflammatory scalp solutions for flare control. Maintenance washing once symptoms settle helps reduce relapse.
Contact Dermatitis
The main fix is removing the trigger. Your doctor may suggest a short course of topical anti-inflammatory treatment to calm the scalp. If reactions repeat, patch testing can identify the specific ingredient causing trouble.
Scalp Psoriasis
Treatment often includes medicated shampoos and prescription topical therapies that soften scale and reduce inflammation. Hair usually regrows once inflammation is controlled and scratching decreases. If plaques are thick or widespread, see a clinician rather than relying on home remedies.
Tinea Capitis (Scalp Ringworm)
This usually needs prescription antifungal medicine, often taken by mouth, because topical shampoos alone may not clear infection in hair shafts. Prompt treatment matters, especially with painful swelling, pus, or tender lymph nodes.
Lice
Over-the-counter lice treatments can work, but correct timing and combing are key. Wash bedding and hats, and treat close contacts if advised. If you are unsure whether it’s lice, get confirmation before treating.
Stress-Related Shedding
Telogen effluvium often improves once the trigger resolves, but it can take several months. Focus on gentle scalp care, adequate protein intake, and sleep consistency while you address the underlying stressor or medical change. If shedding is heavy or ongoing, a clinician can check for contributing deficiencies or thyroid issues.
When To Seek Medical Care
Book a medical appointment if itch lasts longer than two weeks, if shedding is sudden or severe, or if you see bald patches. Get urgent care for fever, pus, spreading redness, severe pain, or a rapidly enlarging tender lump on the scalp.
Quick Home Checklist
- Stop new hair/scalp products and avoid dye until symptoms settle.
- Wash with lukewarm water and a gentle fragrance-free shampoo.
- Try an anti-dandruff shampoo (ketoconazole, zinc pyrithione, selenium sulfide) 2–3 times weekly for 2–4 weeks.
- Do not scratch—trim nails and use cool compresses if needed.
- Seek medical advice fast for patchy loss, oozing, pain, or worsening redness.
FAQs
Can scratching cause hair loss?
Scratching can break hairs and irritate follicles, which makes shedding look worse. If the underlying cause is inflammatory, scratching can also prolong the flare.
Is itch always dandruff?
No. Dandruff is common, but allergy, psoriasis, fungal infection, and lice can cause similar symptoms. Patchy hair loss or painful scaling deserves medical assessment.
Will hair grow back once the itch is treated?
Often, yes. Hair commonly regrows once inflammation or infection is controlled, though timelines vary from weeks to months.
Do “natural remedies” help?
Some people find aloe soothing, but essential oils and vinegar rinses can irritate sensitive scalps. Patch test first and stop if burning or redness increases.
