The Itchy Scalp: An Overview of Scalp Pruritus and Its Management
July 2018
in “
Elsevier eBooks
”
scalp pruritus seborrheic dermatitis scalp psoriasis antifungal shampoos topical corticosteroids vitamin D analogues systemic therapies atopic dermatitis dermatomyositis scarring alopecias lichen planopilaris hydroxychloroquine central centrifugal cicatricial alopecia tetracyclines tinea capitis pediculosis capitis antifungal agents topical ivermectin topical ketamine amitriptyline lidocaine trichotillomania habit reversal training itchy scalp dandruff psoriasis antifungal shampoo steroid cream vitamin D cream tetracycline ringworm head lice ivermectin ketamine cream hair-pulling disorder
TLDR Up to half of people experience itchy scalp, often due to skin conditions like seborrheic dermatitis or psoriasis, and treatments vary based on the specific cause.
The document from 2019 provided an overview of scalp pruritus, a symptom affecting up to 50% of individuals, with a higher prevalence in the aging population. It outlined the categorization of scalp pruritus, with and without primary cutaneous findings, and discussed common causes such as seborrheic dermatitis, which affects 66% of patients, and scalp psoriasis, reported by 58% of 195 surveyed patients. Treatments for these conditions include antifungal shampoos, topical corticosteroids, vitamin D analogues, and systemic therapies. The document also covered other conditions like atopic dermatitis, dermatomyositis, and scarring alopecias, including lichen planopilaris, which has a 55% response rate to hydroxychloroquine, and central centrifugal cicatricial alopecia, treated with steroids and possibly tetracyclines. Tinea capitis and pediculosis capitis are treated with antifungal agents and topical ivermectin, respectively. Pruritus without skin findings may be managed with topical ketamine, amitriptyline, and lidocaine, while chronic pruritus in the elderly requires multifactorial approaches. Psychiatric conditions like trichotillomania are managed with habit reversal training and medications. The document emphasized the importance of addressing the underlying condition for effective treatment of scalp pruritus.
