This article is a translation of the original French article “Perte de cheveux et démangeaisons du cuir chevelu : causes et solutions” and is intended for the French market. Treatments, availability and prices may differ at our London clinic.
Why is my scalp itchy and my hair falling out?
Have you noticed that your hair is falling out and your scalp itches constantly? These two problems can be linked, and understanding why is essential to finding an effective solution.
Scalp itching, also known as pruritus, can be a sign of several conditions that also cause hair loss. For example, fungal infections such as ringworm can cause intense itching and damage the hair follicles, leading to hair loss. Similarly, allergic reactions to certain hair products can irritate the scalp and weaken the hair.
But that's not all. Chronic skin conditions such as psoriasis or seborrhoeic dermatitis are often accompanied by itching and can also cause temporary hair loss. These inflammatory conditions create a hostile environment for the hair follicles, making them more likely to shed.
Autoimmune diseases such as alopecia areata may also be involved. In this case, the immune system attacks the hair follicles, causing bald patches and itching. Folliculitis, an infection of the hair follicles, can also cause itching and lead to hair loss if left untreated.
So what should you do if you are experiencing these symptoms? The first step is to see a dermatologist. An accurate diagnosis is crucial to determine the exact cause of your itching and hair loss. Once the cause has been identified, specific treatments can be prescribed, ranging from topical medications to medicated shampoos.
While you wait for your appointment, you can try a few simple measures to relieve the itching and minimise hair loss. Use gentle shampoos and avoid harsh hair products. Scalp massages can also help stimulate blood circulation and soothe itching.
However, to better understand how to treat these symptoms, it is important to know the specific causes of an itchy scalp.
Why does an itchy scalp cause hair loss?
An itchy scalp can be more than a simple discomfort. It can actually signal deeper problems that lead to hair loss. But why does this itching lead to hair shedding?
It often all starts with inflammation. Itching can be caused by micro-inflammation around the hair follicles, often triggered by androgen hormones. This inflammation alters the structure of the follicles, weakening them and making them more likely to fall out. Think of your follicles as little plants: if the soil around them is constantly irritated, they will struggle to take root and grow properly.
Fungal infections, such as ringworm, are also frequent culprits. They cause intense itching and can damage the hair follicles, resulting in hair loss. Allergic reactions to certain hair products can also irritate the scalp and weaken the hair. A recent change of shampoo could also be to blame.
Then there are chronic skin conditions such as psoriasis and seborrhoeic dermatitis. These inflammatory conditions create a hostile environment for the hair follicles. Psoriasis, for example, causes red, scaly, itchy patches, and this inflammation can disrupt hair growth. Seborrhoeic dermatitis, for its part, causes dandruff and itching, and although hair loss is less common, it can occur if the condition is left untreated.
Autoimmune diseases such as alopecia areata are another major cause. In this case, the immune system attacks the hair follicles, causing bald patches and itching. Folliculitis, an infection of the hair follicles, can also cause itching and lead to hair loss if it is not treated promptly.
So what can be done? The key lies in treating the underlying cause of the itching. If you suffer from psoriasis or seborrhoeic dermatitis, topical treatments such as corticosteroids or antifungals can be effective. For fungal infections, specific antifungals are required. If an allergic reaction is to blame, identifying and avoiding the allergen is crucial.
Causes of an itchy scalp
An itchy scalp can have many causes. First, there is micro-inflammation of the hair follicles, often triggered by androgen hormones. This inflammation weakens the follicles, making the hair more likely to fall out. Next, fungal infections such as ringworm are frequent culprits. They cause intense itching and can damage the hair follicles, leading to hair loss.
Allergic reactions to certain hair products should also be considered. A new shampoo or styling product can irritate the scalp and weaken the hair. Bacterial or fungal inflammation, such as folliculitis, can also cause itching and, if left untreated, lead to hair loss.
Autoimmune diseases such as alopecia areata may also be responsible. In this case, the immune system attacks the hair follicles, causing bald patches and itching. Finally, chronic skin conditions such as psoriasis, atopic dermatitis and seborrhoeic dermatitis create a hostile environment for the hair follicles. These inflammatory conditions can not only cause itching but also disrupt hair growth.
Specific scalp conditions
The scalp can be affected by various conditions, each with its own characteristics and impact on hair health. Some of these conditions, such as androgenetic alopecia, psoriasis or seborrhoeic dermatitis, are particularly common and can lead to itching and hair loss. Let's explore these conditions in detail to better understand their causes and possible treatments.
Androgenetic alopecia
Androgenetic alopecia, often referred to as baldness, is a form of progressive hair loss influenced by genetic and hormonal factors. It mainly affects men, but women are not spared. In men, it often shows as a receding hairline at the temples and thinning on the crown. In women, hair loss is more diffuse and can be exacerbated by hormonal events such as the menopause or the use of oral contraceptives.
The main culprit behind this condition is dihydrotestosterone (DHT), a derivative of testosterone. DHT is formed through the action of the enzyme 5-alpha reductase and accelerates the growth cycle of hair that is sensitive to this hormone. Essentially, it ages the hair follicles prematurely. Think of your hair as plants: if the soil is depleted, the plants do not grow well. DHT also causes excessive sebum production, which can thicken the scalp and disrupt the blood supply to the hair roots.
The areas most affected by androgenetic alopecia are the frontal area, the temples and the vertex of the scalp. You may have noticed that these areas are often the first to show signs of baldness in men. In women, hair loss is more subtle but just as concerning.
If medication is not enough, other options exist. Hair transplants, injection treatments and even trichopigmentation (a kind of scalp tattoo) can offer lasting solutions. Good nutrition and suitable hair care are also essential to maintaining healthy hair.
Finally, it is crucial to see a dermatologist for an accurate diagnosis. This specialist can guide you towards the treatment best suited to your situation. In short, androgenetic alopecia is a complex but manageable condition with the right tools and the right advice.
Scalp psoriasis
Scalp psoriasis is a chronic skin condition that can be very debilitating day to day. Red, thick, scaly patches that itch constantly can appear. It is not only uncomfortable but also embarrassing. This inflammatory disease affects men and women of all ages, but it is particularly common between the ages of 20 and 40.
The symptoms are fairly characteristic: well-defined patches, often covered in white scales, which can appear anywhere on the scalp, including the nape of the neck, around the ears and on the crown. These patches can cause intense itching, and if you scratch, you risk making things worse, or even losing hair temporarily.
So how can you tell if you have scalp psoriasis? A dermatologist can usually make a diagnosis simply by examining your scalp. Sometimes they will use a score called the PASI (Psoriasis Area and Severity Index) to assess the severity of the disease.
Now let's look at the treatment options available. Unfortunately, there is no miracle cure for psoriasis, but several options can help relieve the symptoms:
- Topical corticosteroids: these topical medications are often the first line of treatment. They reduce inflammation and itching.
- Vitamin D derivatives: applied locally, they can help slow down the growth of skin cells.
- Immunoregulators and biological therapies: used in more severe cases, these treatments act on the immune system to reduce inflammation.
To avoid aggravating the symptoms, a few precautions should be taken. Use gentle shampoos and avoid water that is too hot. Let your hair air-dry rather than using a hairdryer, and avoid tight hairstyles that can irritate the scalp. If you like colouring your hair, opt for plant-based products free from chemicals and always do an allergy test first.
During a flare-up, it is crucial not to scratch the lesions. Use local treatments to reduce the itching and, if necessary, take an antihistamine. Tips such as spraying cool thermal spring water or massaging with a soothing cream can also help.
Seborrhoeic dermatitis
Seborrhoeic dermatitis is a chronic inflammation of the scalp that can cause dandruff, itching and, if left untreated, hair loss. You may have noticed white or yellowish flakes on your shoulders, or a feeling that your scalp is oily and irritated. These symptoms are often due to the proliferation of a microbe called Malassezia globosa, which breaks sebum down into oleic acid. If your skin is sensitive to this acid, it reacts with inflammation.
This situation can become very embarrassing, especially when you need to scratch your scalp in public. What's more, the itching can cause physical damage, weakening the hair and making it more likely to break.
What should you do in this situation? The first step is to recognise the symptoms: flaking, redness, greasy scales and inflamed areas. If you notice them, it is time to act. Medicated shampoos are often the first port of call. Look for those containing active ingredients such as selenium sulphide, salicylic acid, zinc pyrithione, ketoconazole or coal tar. These ingredients help reduce inflammation and control the proliferation of the Malassezia microbe.
For example, a selenium sulphide shampoo can be particularly effective. Use it according to the instructions, generally two to three times a week, to see an improvement. If symptoms persist, it may be time to see a dermatologist. This specialist can prescribe stronger treatments, such as topical corticosteroids or antifungals.
In the meantime, a few precautions can help minimise the symptoms. Use gentle shampoos and avoid harsh hair products. Let your hair air-dry rather than using a hairdryer, and avoid tight hairstyles that can irritate the scalp. If you like colouring your hair, opt for plant-based products free from chemicals and always do an allergy test first.
It is crucial to resist the temptation to scratch the lesions, even if that can be difficult. Use local treatments to reduce the itching and, if necessary, take an antihistamine. Tips such as spraying cool thermal spring water or massaging with a soothing cream can also help.
Treatments and care for itching and hair loss
There are several effective options for treating itching and hair loss. To begin with, topical medications are often a good option. Corticosteroids can reduce inflammation and itching, while antifungals are useful in cases of fungal infection. Moisturising creams can also soothe a dry, irritated scalp.
Medicated shampoos are also a common solution. Look for those containing active ingredients such as selenium sulphide, salicylic acid, zinc pyrithione, ketoconazole or coal tar. These ingredients help fight infections and reduce inflammation.
In terms of hair care, opt for gentle shampoos and avoid harsh products. Scalp massages can stimulate blood circulation and reduce itching. Adopt gentle styling methods, avoid rubbing your hair vigorously with a towel and let it air-dry rather than using a hairdryer.
