Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android



  • Scalp itch is a common entity with variable impact in the quality of life of the patient.

  • A systematic approach may help consider first the most common causes of scalp itch, and then less-common causes depending on clinical presentation and history.

  • Treatment must focus both on reducing pruritus and treating the cause when possible.


  • Ask the patient to try to indicate with one finger the area with most itching and start examining the scalp from that spot.

  • Examine first the scalp with the naked eye and then with dermoscopy.

  • In the case of biopsy, choose areas with dermatological lesions but not crusting related to scratching.


  • Treat the cause if you can identify it.

  • Adjust symptomatic treatment according to intensity of itch and quality-of-life disturbance.


  • Listen to the patient as he/she can often give important clues about the possible cause of pruritus.


  • Scalp itch may be related to more than one cause.

  • Possible causes range from very trivial dermatological conditions to systemic diseases.


  • Use the acronym SCALLP to remember the most common causes: seborrheic dermatitis, contact dermatitis, anxiety, lichen planopilaris, lice, and psoriasis.


  • Avoid scratching.

  • Brush hair without scratching the scalp.

  • Wash hair daily with a hypoallergenic shampoo.

  • Avoid hot water or hot air directly on the scalp.


Itch or pruritus is the presence of an uncomfortable tingling or uneasy sensation, which is associated with a desire to scratch. Scalp itch can greatly alter the patient’s quality of life.


Scalp itch is a frequent complaint in the dermatological setting, its prevalence ranges from to 13% to 44.6%.1,2 Since its causes are numerous and of different nature, demographics vary depending on the cause. For example, scalp itch due to lice is more prevalent in children, while pruritus due to xerosis is more common in older adults.


Scalp pruritus may be as old as humanity itself. Even our closest mammalian relatives, the chimpanzees, may be observed scratching their scalps or the scalps of other members of their group rather frequently.3 Its possible causes are multiple and sometimes can occur as an epidemic as in the case of lice infestations.


When encountering a patient with scalp itch, the patient’s greatest desire is to stop the itching. However, for the clinician, finding the cause must be equally important. Following a systematic approach may help the clinician rule out causes from the most common to the most uncommon in the most difficult cases. SCALLP (seborrheic dermatitis, contact dermatitis, anxiety, lichen planopilaris, lice, psoriasis) is a proposed acronym to help recall the most common ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.