An itchy scalp is like back pain; until now, no one seemed to know just what to do. It is pervasive, dreadfully annoying, and yet not taken particularly seriously by the professional community.
We do know that there are many culprits at the root of an itchy scalp, from stress to environmental irritants, but the inflammatory nature of the condition is the common denominator. This isn’t new and it’s the reason steroids, the problematic workhorse of medical anti-inflammatory drugs, are often prescribed.
It’s always helpful to baseline, so here’s the woefully inadequate “Top 6” hit-list of things I commonly find on the internet or hear dermatologists recommend in order to alleviate an itchy scalp.
Steroids: the most powerful and common prescription option used by dermatologists. While they may offer temporary relief to those with itching from scalp inflammation, there are many people who are steroid-resistant; in other words, the steroids don’t help. In addition, long term use of steroids can thin the scalp and create steroid dependency. There’s even steroid induced inflammation — a poorly understood but real syndrome.
Salicylic acid: a common over-the-counter option. Acids remove the outer layer of the scalp. This may help “dissolve” flakes before they form, but it leaves your scalp more vulnerable to sun damage and often more inflamed — the opposite of what you need.
Coal tar: In addition to the just awful smell, it leaves your scalp and face profoundly vulnerable to sun damage — one of the things that causes damage and itching in the first place.
Shampoos: Yes, zinc pyrithione (the active ingredient in many brand name shampoos) does help some people, which partly validates the theory that Malassezia yeast can cause inflammation and itching, but again, falls way short for those who continue to scratch away.
Ketoconazole: Similar to zinc pyrithione, it helps some but is largely inadequate for most as a stand-alone solution.
Home remedies: · These are all over the place… and, unfortunately, largely not helpful for most people.
What’s new are treatment options to fight inflammation that are actually healthy for your hair and scalp.
If you scour the clinical literature, you’ll find that we humans are not the only organisms that have to contend with inflammation from environmental and internal stressors to our outer layers. Plants, for example, are bombarded with damaging sun exposure, pollution, changing environments, and biological competition. Yet, leaves do not protect themselves by stripping their outer layers of defense (as many of our treatments for some reason do) or exacerbating internal damage (see “Top 6” above). Rather, leaves support and maintain effective outer barriers as well as highly active antioxidant and anti-inflammatory internal mechanisms.
Rather than a single mechanism, plants use a combination of capabilities and active molecules (phytochemicals) to address the challenge. This is an important fact and consistent with many of the success stories in modern medicine such as management of everything from hypertension, diabetes, HIV, Hepatitis C, and cancer by combining medicines. The same is true for management of itchy scalp.
"Reminder: modern medicine mimics nature by using a combination of ingredients to achieve the best results."
New approaches to skin and scalp care don’t strip the few defenses we have, but rather reinforce our natural defenses. They prevent and repair damage, especially via anti-oxidation and anti-inflammation. Such natural reinforcement led to perhaps one of the most important clinical studies in sun damaged skin to date (remember, your scalp is part of your skin), demonstrating a meaningful reduction in skin cancer by the natural sun-protective supplement, Vitamin B3 (nicotinamide). Several other natural ingredients such as caffeine, resveratrol, glutathione, and more, many directly from plants, are emerging as the basis of this new scientific paradigm.
"New approaches reinforce the natural defenses that prevent and repair damage."
Look for products that contain the ingredients above, for example, my company, Alon Labs was founded in 2014 to provide exactly this kind of solution. We’ve been following the convergence of the scientific literature and the general understanding from nature in how to treat your skin and scalp most effectively.