My head itches

March 31, 2006 2:32 AM

My scalp itches terribly in one spot. I'm not sure how to tell wether it's dandruff, dry scalp, an allergy or some silly nervous condition that makes me scratch it.

Basically, there is a large spot behind my right ear, down by the neckline, that itches. It has for, I'd say, several years. When I scratch it, usually vigirously, flakes fall out onto my right shoulder, though I suspect these are just skin cells. I scratch it until I come up with red beneath my fingernails on a regular basis.

Info that may or may not be relevant... I've never noticed flakes or itching in other areas of my head. I've been told a few times by different hair cutters that I have unusually thick hair down in that area between my ears. It's difficult to see much of the scalp by parting the hair there. Also, a few years ago, I became suddenly allergic to something in makeup, don't know if whatever that was could be in shampoo too. The weird thing is that any sudden stressful, nervous, anxious situation will cause the area to itch overwhelmingly, and pretty much if I become stressed, I am immediately vigorously scratching this spot on my head. I'm right handed and this is the most convenient spot on my head to reach.

If I'm scratching it when I'm nervous, does that mean there's nothing really wrong and that it's irritated because I'm scratching it, not the other way around? If that's the case, I'm worried there's nothing to help it. It's very hard not to scratch an itch.

Over the years, I've tried dandruff shampoos, dry scalp shampoos, hypoallergenic shampoos, tea tree oil, deep cleaning, deap conditioning, etc., with no improvement. I pay very special attention to rinsing this area, since it's more difficult than the top of my head, to make sure that there isn't a buildup of stuff happening there.

Also, I'm not really sure who has domain over your scalp. Does a dermatologist deal with hair issues? Would I be laughed out of the office and told to go get selsun blue? Can they help at all if it's a nervous condition?

posted by FortyT-wo to health & fitness (13 comments total)

Definitely see the dermatologist. Completely out of my sphere of knowledge, but it sounds like something that should be checked out pronto. If it is minor or nervous, they should still be able to help.

I had similar problem that I found was caused by places where leave-in conditioners were contacting my skin. Wasn't so site-specific though.
posted by Manjusri at 2:42 AM on March 31, 2006

Could be psoriasis or eczema. See the Dermatologist.
posted by Kirth Gerson at 3:02 AM on March 31, 2006

As someone who is actively treating chronic ezcema on my scalp this very second, (I kid you not. Gross, huh?) I second the dermatologist.

After confirming it's something more chronic than just dry skin, ask them, and I stress this IN ALL CAPS, about Beta-Valerate Lotion (Beta-Val).

It is alcohol-based, with an applicator-like tip, so it smells, at worse, like rubbing alcohol. It doesn't make your hair greasy, its alcohol vehicle evaporates in hardly any time at all, and you can use it after applying whatever hair stuff you use.

It burns like hell for just a few seconds, but dammit, that's how you know it's working. And it works wonders. I have flakes all sorts of the time, because of how itchy it can get, and I definitely have it on more of my scalp than you, (see also: behind ears, eyelids, etc.) but this stuff works fantastically. (Don't scratch just before applying ANY topical meds, if you weren't already aware.)

It's prescription only, and you need to specify the "lotion," though one would think it's common sense. (Try applying ANY sort of ointment to your scalp, and you'll see what it just doesn't work and makes you absolutely miserable.)

It's been a great source of relief for me, and it's absolutely not bothersome at all to use. Alcohol-based is a godsend.

Good luck!
posted by disillusioned at 3:13 AM on March 31, 2006

On a quick re-read of your question, there's a decent chance (though by decent I mean, really, hardly at all) that your general practitioner could just diagnose and prescribe for such a small case.

If you can call them direct and see, that'll work. Otherwise, to the dermatologist, or perhaps get a referral from your GP first.
posted by disillusioned at 3:16 AM on March 31, 2006

I have psoriasis just like that (in flaky patches behind my ears). It also manifests on my knees and elbows, and initially in red spots on my lower leg. I control it with steroid cream (Betnovate) and diet (less wheat seems to help). Turns out half my brothers have it too.
posted by b33j at 3:36 AM on March 31, 2006

I had a spot like that at the back of my head--the irritation seemed to be exacerbated by cold weather and blow-drying.

When I mentioned it to my dermatologist, she almost immediately identified it as dermatitis. She prescribed a cortisone cream that stopped the itching and flaking within a week; occasional flareups disappear in just a day or two with the cream, as long as I don't scratch.
posted by serialcomma at 4:29 AM on March 31, 2006

I have the same problem, only it's all over my scalp. It's gotten steadily worse over the years and flares up in the winter. I get comments from stylists all the time that I have more hair than anyone they've ever seen. There's obviously a connection there, I know a few more people with this problem who also have thick hair.

My solution? Jojoba oil. It's awesome on skin and hair. First of all, don't wash your hair daily, it only makes things worse. (If you need to rinse sweat or something out, don't use shampoo every day, just lots of water). I wash once or twice a week, and apply jojoba oil on my scalp the night before I'm going to wash my hair. I use jojoba shampoo and conditioner too, just for good measure. The itching has all but disappeared. I can't skip a treatment though or the itching starts up again. I discovered this last winter in the middle of the worst flare up ever, it was in my eyebrows too. This winter has been great, no problems at all. One small bottle of jojoba oil cost me about $7 and lasted me a year, so it's definitely the cheaper way to go too! (All of the above only applies in the winter months, I don't need it during warmer, more humid times). Good luck!
posted by Buck Eschaton at 5:40 AM on March 31, 2006 [1 favorite]

You can try something called Scalpicin which can be found at your local drug store. I'm not sure if it will help your particular problem but at least the itchiness may go away until you can see a dermatologist.
posted by JJ86 at 5:46 AM on March 31, 2006

Any joint pain? I have exactly the same thing behind one ear (it makes wearing dark suits a crapshoot due to flakage). My first dermatologist completely misdiagnosed it (as dermatitis, which I think is what dermatologists say when they mean "huh, no idea".)

It turns out to be (probably) psoriatic arthritis which is pretty obscure, but if you have only one small patch of psoriasis-like symptoms its a possibility. Oddly, a rheumatologist was the first doctor to properly diagnose my spot and the dermatologist confirmed it. The bad news is that, for me at least, I haven't found anything that works on the spot. I have good days and bad days and the bad days just suck.

P.S. The MeFi spellchecker likes "psoriatic" but not "rheumatologist". Huh.
posted by The Bellman at 8:08 AM on March 31, 2006

1. Your general practitioner can determine whether you need to see a specialist or not. Eczema and the like are common problems, and I doubt you'll need anything beyond a trip to your primary care doc.
2. Okay, you've got your scrip. Get it filled, treat the problem spot.
3. Buy a bottle of Nature's Gate Rainwater Tea Tree Oil Conditioner (skip the shampoo, it's got overdrying sodium laurly sulfate. In fact, skip any shampoo with sodium laurly sulfate). Every time you wash your hair, follow up with a generous amount of the conditioner, focussing on rubbing it into your scalp, and let it set there for a couple of minutes before you rinse. It has an immediately cooling effect, and has helped me to prevent itchiness and flaking on my scalp better than anything I've ever tried.
posted by Sara Anne at 9:03 AM on March 31, 2006

IANAD, but I strongly suspect it's seborrheic dermatitis. I have a little spot that does the exact same thing from time to time. Since the tea tree oil and other solutions didn't work (they didn't for me either!) check with a dermatologist. You can get a prescription for shampoo or a steroidal ointment to bring it under control before it spreads and becomes chronic. (Don't use the ointment continually, though -- usually not more than once or twice a day for a week or two at a time.)
posted by scody at 9:03 AM on March 31, 2006

Everyone's answers seem far more likely but here's my 2 cents. I have this issue on one spot on the back of my scalp. I found out when I shaved my head (ah, being a 19yr old punk rock girl) that I still have the scar from running into a wall when I was 5. Low and behold, that's where all the itching was centered.
posted by nadawi at 9:14 AM on March 31, 2006

I'm going to go with psoriasis or eczema as well. I have a similar problem. These areas can be sensitive to harsh chemicals so I would warn against the Scalpicin. From my experience if it is eczema the spray will only worsen the condition.
posted by arruns at 12:53 PM on March 31, 2006