12 Reasons Your Scalp Itches and How to Get Sweet Relief

Scalp reactions to hair dyes tend to be dramatic, Kim says, causing a “rip-roaring … almost poison-ivy type rash.”

Other hair products, including shampoo ingredients, sometimes cause allergic reactions or irritation, Piliang says. If there’s any doubt about the cause, a dermatologist can test your sensitivity to common culprits.

What to do about it: Once you know the cause, the cure is to stop using the product. That can be tough, Piliang concedes. A colleague with a hair dye allergy, she says, was unwilling to give up her dark hair — so now goes twice a week to her hairdresser for wash-and-wear coloring.

4. Pinched nerves

Osteoarthritis and other conditions can lead to spinal stenosis: a narrowing of the spinal canal that can compress, pinch or irritate nerves branching out from the spinal cord. When that happens in your neck area, the nerves that reach your scalp can be affected, resulting in an itch, Piliang says.

What to do about it: There’s no evidence spinal surgery will help the itch, Yosipovitch says. Piliang agrees and says, “many of my patients get better with just physical therapy.”

5. Diabetes

Just as diabetes can cause trouble with the nerves in your feet and hands, it can affect the nerves in your scalp, leading to itchiness, Yosipovitch says. Dry skin and poor blood circulation also can contribute to skin itchiness in people with diabetes, according to the American Diabetes Association.

What to do about it: Medications used for nerve pain, such as gabapentin and pregabalin, may help with this type of itch, Yosipovitch says. However, he says, these drugs can have side effects such as drowsiness, so need to be used carefully in older adults.

6. Shingles

Shingles, a nerve infection that causes a painful, itchy rash, can affect your scalp — not just during the initial rash, which can last weeks, but in the aftermath, which can last years. While the best-known symptom is pain in the areas where the rash occurred, “interestingly on the scalp, some of it is actually itch rather than pain,” Yosipovitch says. When he sees someone with unexplained scalp itching and no rash, he says, he always asks if they’ve had shingles on their head.

What to do about it: Some people take medications for nerve pain during their initial outbreak, and that may help prevent longer-term pain and itching, Yosipovitch says. Those medications also can be tried if the itch returns, he says. Anti-itch shampoos and steroid creams won’t work, he says.

7. Other nerve problems

Many older adults who have red, itchy scalps but no true rash and no obvious condition explaining their symptoms likely have some form of nerve deterioration, Kim says. The decreasing ability to interpret sensations as we age may make us more prone to itching, including on the scalp, he says. “As you age, you actually lose the ability to suppress itch,” he says.

What to do about it: If a full medical investigation turns up no obvious cause, you might try drugs for nerve pain, like gabapentin, Kim says. He says he gives some patients an opioid drug called butorphanol.

8. Anxiety and other mental health problems

Conditions such as anxiety, depression and obsessive-compulsive disorder can lead some people to scratch their heads, creating irritation, which leads to more itching and scratching, Yosipovitch says.

What to do about it: Treatment of the underlying condition, with medications, cognitive behavioral therapy, or other mental health interventions, is the best approach, he says.

9. Autoimmune conditions

A rare disorder called dermatomyositis, which causes muscle weakness and rashes, sometimes starts with an itchy scalp, Piliang says. Other autoimmune diseases, such as lupus, can also cause scalp itching, she says.

What to do about it: Make sure you tell your doctors about all your symptoms, so you can get the right diagnosis and treatment.

10. Hair loss conditions

Some types of hair loss that occur mostly in women can cause scalp itching, Piliang says. One, lichen planopilaris, causes scarring and patchy hair loss, along with itching and burning, often in postmenopausal women. Another, central centrifugal cicatricial alopecia, most often happens in Black women and starts with hair loss in the center of the head.

What to do about it: These conditions are treated with anti-inflammatory drugs and other medications.

11. Infestations

It’s rare for an older adult’s itchy scalp to be caused by lice, which mostly afflict children, Piliang says. Those in group settings like nursing homes do sometimes get scabies, an itchy ailment caused by mites, but skin folds are more common trouble spots, she says. Scalp infestations can happen, though, she says.

What to do about it: Use prescription creams or pills that kill the mites.  

12. Skin cancer

Your itchy scalp probably isn’t cancer and the most serious form of skin cancer, melanoma, usually doesn’t itch, Yosipovitch says. But basal cell and squamous cell skin cancers can get itchy and irritated and can develop on your scalp, he says.

What to do about it: If you find an itchy or irritated spot on your head, get it checked by a dermatologist.