The itchy head can appear suddenly. The first thing we think about, if we have children involved, are the famous and uncomfortable lice. But many times this is not the reason for our head itching. Did you know that stress can make our heads itch? Also dandruff, more common in men, may be responsible for us feeling this constant discomfort that leads us to scratch non-stop.
In an interview with Infosalus, the trichologist Sergio Vañó, a member of the Spanish Academy of Dermatology and Venerology (AEDV), explains that itching in the head can be due to multiple causes, from infections (lice, fungi), to inflammatory processes such as seborrheic dermatitis or dandruff, or psoriasis.
But it also warns that may be the first manifestation of some types of scarring alopecia that produce irreversible destruction of the hair follicle. For this reason, when faced with a patient with persistent itching of the scalp, medical assessment is always essential to carry out a correct diagnosis of the process, and thus avoid discomfort, but also to rule out that it is not the beginning of some type of scarring alopecia.
Although the scratching may initially alleviate the symptoms, the director of the Alopecia and Hair Transplant Unit of the Ramón y Cajal Hospital in Madrid considers that it can induce after that initial relief a worsening of itching by increasing inflammation in the area, so it is not recommended.
“The ideal when faced with an itchy scalp condition is to correctly identify the cause and select the specific treatment. In most cases, a specific shampoo or a product to apply to the scalp at night will suffice. However, the more serious cases may even require oral anti-inflammatory medication,” says Vañó.
For his part, Dr. Carlos Morales, also a member of the Spanish Academy of Dermatology and Venerology (AEDV), stresses to Infosalus that itching in the head is usually frequent in cases of dermatitis associated with the scalp, being the most frequent according to precise, seborrheic dermatitis.
According to the Fundación Piel Sana, seborrheic dermatitis is a chronic skin condition that presents 2 peaks: one in infants before 3 months of age and another between the fourth and seventh decade of life, affecting more men than women. . Furthermore, it indicates that it is one of the most common skin manifestations in patients with HIVwhere its presence would indicate the need to evaluate a possible infection in high-risk patients.
In this sense, Dr. Morales, also a specialist at the Ramón y Cajal Hospital in Madrid, points out that the most frequent form of seborrheic dermatitis among patients is common dandruff. “In these cases, it is indicated to use specific shampoos and, if it is not resolved, as with everything, you should always consult a specialist in case you have to use an anti-inflammatory product,” he remarks.
Other causes of itchy head, as he points out, can be dermatoses of the scalp, such as psoriasis, lichen planus (a frequent lesion characterized by multiple small, flat, polygonal, cobblestone-like violaceous lesions that produce a lot of itching), or folliculitis.
“In a non-negligible percentage of patients this itching head can occur due to neurodermatitisespecially at the neck level, mainly due to psychological factors such as stress, for example”, appreciates the expert.
In these cases, the expert sees fit to use mild shampoos, with compounds containing beta-bisabolol or menthol, active ingredients that soothe the scalp. If the itching symptoms are not resolved with these remedies or other associated symptoms appear, you should see a trichologist or dermatologist.
What to do in case of psoriasis or lice
To eradicate lice, the Fundación Piel Sana points out that it is always necessary to resort to scientifically endorsed products and it should run away home remedies since they lack effect, or can be toxic, such as mayonnaise, margarine, olive oil, kerosene or gasoline, among others. “Whenever a treatment with pediculicides is applied, it is important to follow some general recommendations and more specifically those of the product itself,” he points out.
Among others, he points out that, although its cosmetic tolerance is lower, lotions are more effective than shampoos, because they are fixed better and for a longer time to the hair shaft. In turn, it specifies that the hair should not be washed before applying the lotion, since the fat facilitates the fixation of the active ingredient. The washing will be carried out after the indicated contact time and can be done with normal shampoo or with pediculicidal shampoo to complete the treatment.
After rinsing with water, the Healthy Skin Foundation defends that another finish can be made with water and vinegar (one part vinegar and two parts water), since acetic acid helps break down the cementing substance that adheres nits to the hair, making it easier to remove them later with a nit comb (comb with very close teeth).
On the other hand, he maintains that all pediculicides are effective in eliminating adult lice but vary greatly in their ovicidal activity. In any case, he points out that the treatment must always be repeated between the seventh and tenth day to completely eliminate the nits, and even in case of massive infestations it is recommended to repeat it daily for 1 week.
In turn, the combs, hair ornaments says that they can be immersed for 5 to 10 minutes in an insecticidal lotion. Bed linen, towels and clothing in general, in case of body pediculosis, should be washed in hot water, since both nits and adult lice die after 5 minutes at a temperature above 50 degrees Celsius.
In the case of scalp psoriasis, the AEDV indicates that its treatment is often complicated by the presence of hair. First, it says that they must be remove the scales to later be able to apply a treatment for the psoriasis lesion itself.
As specified, the removal of scales includes softening through the use of oils or Vaseline, the application of products with keratinolytic action (salicylic acid, urea, vitamin D derivatives and tar derivatives) and final washing with shampoos. The products must be applied to the scalp and not to the hair.
Regarding the treatment of the inflammatory part of psoriasis, this basically includes the corticosteroids, alone or in combination with other active substances, administered in the form of gels, solutions or shampoos. “Treatments should be applied at night and the frequency of use will depend on the severity. In patients refractory to topical treatments and significant emotional affectation, the use of systemic treatments may be necessary,” he concludes.