Scalp Pruritus: Review of the Pathogenesis, Diagnosis, and Management

Scalp pruritus, or itchy scalp, was a prevalent and distressing symptom linked to various dermatological and systemic conditions, significantly affecting patients' quality of life. Its pathophysiology was complex, involving prurioreceptive, neuropathic, neurogenic, and psychogenic pathways, with factors like histamine and scalp flora contributing. Seborrheic dermatitis was the most common condition associated with scalp pruritus, but it was also linked to cicatricial alopecia and systemic conditions like diabetes. Diagnosis required a thorough history and examination, while management was challenging due to its multifactorial nature. Topical treatments, such as corticosteroids, calcineurin inhibitors, and capsaicin, were primary, though systemic therapies were rarely used. Despite advancements, scalp pruritus remained a difficult area for research, highlighting the need for further studies to develop more effective treatments with fewer side effects.