There are so many things that can make your scalp itchy. But if you’re constantly scratching (and it’s really starting to interfere with your life), you might want to consider scalp eczema as a culprit. Eczema is a super common skin condition—it affects roughly 30 million people in the U.S., according to the National Institute of Allergy and Infectious Diseases (NIAID). In addition to your scalp, it can commonly affect your hands, neck, inner elbows, and the delicate area around your eyes1.
On top of supreme itchiness, eczema can cause really dry, inflamed, scaly skin (which can appear brown, purple, or gray, depending on your skin tone). This, understandably, may go unnoticed on top of your head, especially underneath hair if you have it. Plus, if you only have some flakes and itchiness on your head, then you may simply attribute that to dandruff or a dry scalp. But it’s possible to just have scalp eczema, and in that case, using over-the-counter dandruff shampoos won’t cut it.
Ahead, dermatologists explain how to tell if scalp eczema might be fueling your skin symptoms, plus how to finally get some sweet relief for your head.
What causes scalp eczema?
Eczema (also called dermatitis) is a term used to describe several different skin conditions that cause skin inflammation, according to the U.S. National Library of Medicine (NLM). All forms of eczema are caused by a disruption in the skin barrier, which usually keeps irritants out and hydration in, according to the American Academy of Dermatology Association (AAD). If that barrier isn’t working properly, your skin can become dry, irritated, sensitive to allergens, or prone to infections2.
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There are numerous types of eczema, but the two that most commonly affect the scalp are atopic dermatitis and contact dermatitis.
Atopic dermatitis is the most common form of eczema that causes itchy rashes, according to the AAD. So, in the case of scalp eczema, you may have dry, itchy areas on your scalp that potentially bleed, ooze clear fluids, and develop a crust afterward. People generally develop atopic dermatitis as children but can be diagnosed with the disease as adults too. For about 60% of kids with atopic dermatitis, the condition clears up on its own by age 123. But other individuals may have atopic dermatitis their entire lives. Estimates show that roughly 11% of children and 7% of adults in the U.S. have this form of eczema4.
Although the condition is fairly common, the causes of atopic dermatitis are complex. Experts suspect that atopic dermatitis is partially caused by your immune system overreacting to irritants or allergens, leading to chronic inflammation, according to the Cleveland Clinic. In addition to age, the AAD says people with a family history of atopic dermatitis, allergies, and any form of asthma have a higher risk of developing this type of eczema. And individuals who have at least one of these risk factors and live in a cold climate may have their atopic dermatitis triggered by the weather, both for the first time and for subsequent eczema flare-ups.
Contact dermatitis, on the other hand, refers to either irritant contact dermatitis or allergic contact dermatitis. “Irritant contact dermatitis is when the skin is literally irritated by what it is in contact with, such as harsh or abrasive soaps that can damage the skin barrier,” Mary L. Stevenson, MD, a dermatologic surgeon at NYU Langone in New York City, tells SELF. This is different from allergic contact dermatitis, in which the skin has an allergic reaction. This comes down to an overreaction by the immune system to a particular substance like poison ivy or a fragrance in shampoo or soap, Dr. Stevenson explains. With contact dermatitis on the scalp, people typically get a rash on their head about 24 to 48 hours after their scalp skin comes into direct contact with an irritant or allergen. Generally, you can manage contact dermatitis symptoms by avoiding your particular irritants or allergens.
Source: SELF
