Sensitive Scalp Conditions: Types, Causes, and Treatments

When it comes to skin care, the skin on our head often goes unnoticed compared to the skin on other parts of the body. It's no surprise considering the desire to achieve long, luscious locks tends to overtake the need to maintain a healthy scalp.

However, when scalp problems begin to set it they could lead to issues like hair loss, itching, dandruff, and a tender scalp.

If the question "Why does my scalp hurt?" is a bit of a head-scratcher for you, keep reading for more info on various scalp conditions and how you can treat them.


Psoriasis is a skin condition that results from an overactive immune system producing skin cells too rapidly. This overproduction of skin cells begin to pile up on the skin resulting in thick, scaley patches of skin known as plaques. These plaques can pop up anywhere on the body, but they are most commonly located on the elbows, knees, and, the focus of this article, the scalp.

According to the National Psoriasis Foundation, about 45-56% of people with psoriasis experience symptoms on their scalp, and it's commonly linked to psoriatic arthritis.

Scalp Psoriasis Treatment

Scalp psoriasis is tricky to treat, but topical steroids, medicated shampoos, biologic injections, and lasering can help reduce plaques. Lifestyle changes can also help such as stress reduction to lower inflammation, and limiting how often you wash your hair

Seborrheic Dermatitis

Seborrheic Dermatitis is a type of eczema that is the result of excess Malassezia yeast, a bacteria commonly found on the skin. Due to this overgrowth, the immune system overreacts and causes an inflammatory response resulting in itchy, red patches and greasy scales on your skin as well as white or yellow powdery flakes on your scalp.

Symptoms mostly occurs in areas that produce a lot of oil such as the scalp, upper back and chest, forehead, the creases of your knees and elbows, behind your ears, etc. Because of this, those with oily skin are more likely to experience this type of dermatitis.

Difference Between Dandruff and Seborrheic Dermatitis

Similar to the way that a square is a rectangle, but a rectangle is not a square: Dandruff is seborrheic dermatitis but seborrheic dermatitis is not dandruff.

Dandruff is one of the factors of seborrheic dermatitis, but dermatitis can occur anywhere on the body, while dandruff is limited to the scalp. Dandruff is also a more mild, typically only causing flakey skin on the scalp, whereas seborrheic dermatitis is more severe, causing not only flaking, but also scaly, red patches of skin, inflammation, and swelling.

To breakdown the specifications of this condition even further, when babies get seborrheic dermatitis on the scalp it is referred to as cradle cap.

Scalp Seborrheic Dermatitis Treatment

Treatment varies depending on the location of the symptoms and severity of the condition. For milder forms of dandruff, over-the-counter dandruff shampoos that contain selenium, zinc pyrithione, or coal tar can lessen symptoms. If symptoms don't subside with over the counter treatments, it's best to see a board certified dermatologist for a prescription treatment

In babies with cradle cap, symptoms typically go away over time, but using a gentle shampoo and a soft brush can help. If it doesn't subside by the time the baby is 8-12 months old, see their pediatrician who may recommend an over-the-counter dandruff shampoo or prescribe a shampoo or lotion treatment.

For more severe seborrheic dermatitis, medical shampoos or topical ointments may be prescribed.


This inflammation of the hair follicles most often occurs on the beard, arms, back, buttocks and legs. It occurs as a reaction to bacteria, mites, and yeast in the hair follicles of the scalp and causes itchy, red pimple-like bumps that often break open and become sore and crusty. If you shave, folliculitis may be more common as it can develop from ingrown hairs.

Scalp Folliculitis Treatment

Mild cases of folliculitis often clear up on their own if you continue to use a gentle shampoo, but if they do not, antibiotics or anti fungal agents can be prescribed for treatment.

Lichen Planus

Lichen planus is an inflammatory disease that causes an itchy rash on the skin and mouth. On the scalp, redness, irritation, and tiny bumps can form, and it may cause hair loss or thinning.

Lichen Planus Treatment

It's important to treat lichen planus on the scalp to prevent further hair loss, and help ensure that any lost hair grows back.

Antihistamines can be prescribed for itchy scalp, and topical steroids can help with the other symptoms.


Alopecia areata is an autoimmune disease that affects the skin where the immune system attacks and shrinks the hair follicle leading to hair loss on the scalp, arms, legs, face, and other parts of the body. Alopecia is most likely genetic, and factors like stress, medications, a restrictive diet, and childbirth can further trigger hair loss.

There's no known cure for alopecia, but treatments include steroid injections and topicals, and hair growth treatments like minoxidil.

Emu oil has also been shown to help with hair loss in some cases.

Scalp Acne

Pimples on your scalp could be the result of folliculitis, but it could also be the result of clogged pores, resulting in acne. Acne on the scalp is not common, but if you do not wash your hair often or wear compressive headwear, dead skin cells and sebum can begin to clog the pores. Using harsh hairsprays, shampoos, conditioners, and hair products can also cause acne breakouts known as acne cosmetica, acne that occurs as a reaction to a cosmetic product.

Scalp Acne Treatment

Scalp acne can be treated similarly to the acne on your face (read our tips for treating acne here) with topical creams, cleansers, and by using hair products designed for sensitive skin.

Tinea Capitis

RIngworm of the scalp (tinea capitis) is a fungal infection that affects primarily children. It's caused by direct contact with the fungi called dermatophytes that thrive in warm, moist environments so it is more common if you neglect hair washing, have scalp injuries, or sweat heavily on the scalp.

Symptoms include temporary hair loss, bald patches with small black dots where hair has broken off, swollen areas of skin, pus-filled sores, and itching.

Scalp Ringworm Treatment

Your doctor can prescribe an oral medication to treat ringworm. While treating the condition you should keep your scalp clean and dry and avoid sharing hair tools, products, hats, pillowcases, and towels with other members of your family.

Hair Products for Sensitive Scalp

If you have a scalp condition you are treating, it is best to use the shampoo or treatment that your doctor or a board certified dermatologist has prescribed or recommended, but generally speaking, you should avoid hair care products with harsh ingredients like alcohol, fragrance, and sulfates that can further exacerbate irritation, inflammation, and other negative symptoms.

Cleure's full range of hair products is free of fragrance, sulfates, parabens, and harsh alcohols, and is recommended by dermatologists for sensitive skin.

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