Q: Why is my scalp so itchy? Any tips to get rid of an itchy flakey scalp?

Q: Why is my scalp so itchy? I have exfoliated it to get rid of the flaking and itchiness but it didnt help. I have a dry scalp. Any tips to get rid of an itchy flakey scalp?

It is difficult to know why exactly, without knowing a bit more, or seeing the area.
It could be caused by a variety of things: you may be reacting to a harsh surfactant in your shampoo or ‘build-up’ from hair styling products, or you may have seborrheic dermatitis (eczema) and psoriasis can cause these problems too. These would require different treatments.

I’m not sure how effective ‘exfoliating’ is until the cause is established. If you have used something with a gritty texture, like sugar or salt, it shouldn’t harm your scalp in the long-term, but could further inflame an already irritated surface. If you used an alpha hydroxy acid (AHA) or salicylic acid, again, it can be irritating, and I wouldn’t recommend this sort of treatment until you have established what is causing the problem.

The easiest first… check your shampoo ingredients, this will contain at least one, and possibly three or four surfactants, and these can be responsible for the symptoms you report.

Surfactants
Surfactants have one end that attracts to water and the other end to oil. When there are enough in a solution, they are drawn together to make a ‘micelle’ (hence micellar water). These then are attracted to dirt suspended in oil and in water, so both are washed away in water when rinsing the shampoo. There are several types: anionic, nonionic, cationic or amphoteric.

Anionics are frequently used in shampoos as they give a nice foam, take away dirt effectively and are relatively cheap…but they can cause irritation. Look at the ingredients’ list on your regular shampoo. If it contains sulphates or sulfonates in the name, they are in this category. These are usually mixed with nonionic surfactants as these are particularly good at removing oil, these are generally not abrasive and include: cocamides and ethoxylates. Cationic surfactant won’t be mixed with anionics but could be in with nonionic and these include: dequalinium and phenamylinium chlorides, cetrimonium and cethexonium bromides. As these are positively charged and damaged hair gives off a negative charge, they can cling to the hair strands and cause build-up and irritation. They also make the scalp more oily (they bind to keratin), which in turn attracts grease more readily. (They are useful for anti-static and as disinfectants, so if you are choosing shampoo that promises either, there may be cationic in there).

Formulators are looking to find the ‘sweet spot’ between cleaning effectively without irritation and it’s not an easy balance. The very gentle surfactants don’t clean very well and people tend to like a foam (I don’t know why, they just do!) and they don’t really do mega-bubbles. They are also much more expensive.

Seborrheic dermatitis.
If you have patches of skin on other parts of your body that are itchy, dry, and scaly, it could still be a reaction to a surfactant (don’t forget that if you are putting something on your hair in the shower, it will also wash over your face and body) -see above. This would be a condition that might easily worsen if you used an AHA to exfoliate - I certainly wouldn’t recommend it. If you have seborrheic dermatitis and you will find this quite uncomfortable. You should get a diagnosis confirmed by a nurse or doctor before attempting to treat it yourself. There are dietary factors, but a number of ways to calm this using topical treatments too - steroid creams are effective, but really a last resort.

Affected skin often has an impaired barrier and surface lipids, especially ceramides, degrade faster. You can treat skin (on your body or head with a simple home-made pack including aloe vera, colloidal oats and vitamin E oil). In the long-term increasing vitamins A and C in your diet can also help strengthen the skin barrier, (when it is damaged skin is more susceptible to irritants). Dimethicone has been demonstrated to help and is often used in both shampoos and conditioners, so look out for this too.

Psoriasis
This is much more difficult to manage as it seems to be caused by an over-enthusiastic immune response. As with eczema, you should get a diagnosis before attempting to treat it. Although aloe vera and colloidal oats are unlikely to worsen either and may well alleviate symptoms. This is where a mask containing salicylic acid would be worth trying (although I wouldn’t rub anything abrasive into your scalp, whatever is causing it, but especially with psoriasis.) It can be worsened by increased yeast in the skin (as can eczema), so reduce anything in your diet containing yeast. You could try using well-diluted geranium or rosemary essential oils topically. I would recommend using a calendula or rosemary hydrosol, as a hair rinse, to improve the scalp condition. These have anti fungal properties and have done well in trials to help psoriasis.

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