Another possibility is psoriasis on your scalp. Eczema and psoriasis both cause patches of red, itchy skin, but they show up slightly differently. Unlike eczema, psoriasis is an autoimmune condition, and the inflamed skin patches that are caused by psoriasis tend to be thick and scaly, and they may be grayish in color. These thickened patches are referred to as “plaques” and may be triggered by things like stress or a bacterial or viral infection.
If you’re not sure whether your scalp issue is due to eczema, psoriasis, or something else, it’s best to check with a dermatologist. But you can help narrow it down by thinking about the products you’ve used on your scalp recently and what, if anything, helps your scalp feel better. For instance, if you know you used a new shampoo in the past week, that could be triggering eczema.
It also helps to know about your family history because both eczema and psoriasis can have a genetic component. So, if you have a family member with one condition or the other, that makes it more likely that you have it, too.
Here’s how to treat eczema on your scalp:
The first thing to do if you think you might have scalp eczema, is to get a proper diagnosis from a board-certified dermatologist. They might prescribe certain treatments like drugs to reduce inflammation and calm an overactive immune system, according to the Mayo Clinic.
But there are some things you can do at home to help soothe your eczema, particularly when it comes to your hair-washing habits:
Avoid over-washing. For instance, if you experience the symptoms of eczema on your scalp, you might assume you have an especially bad case of dandruff, which can result in itching, scaliness, and flakes that drift down onto your clothes. In response, you might decide to wash your hair more often, but that can actually make things worse because it strips the scalp and hair of their natural moisturizing oils and can contribute to dryness and irritation.
Wash only with gentle shampoos and conditioners. Eczema is often triggered or worsened by irritant or allergic reactions, including reactions to harsh hair or skin-care products. It’s possible for anyone to get this type of reaction—with or without eczema, Dr. Bailey says. But if you do have eczema, you are more susceptible to these reactions and they can trigger your eczema symptoms.
If a hair product might be causing contact dermatitis that worsens your eczema, your doctor will likely recommend that you ditch it and see where that gets you, New York City dermatologist Doris Day, M.D., author of Beyond Beautiful, tells SELF. They’ll likely suggest gentle shampoos, conditioners, and other hair products that won’t strip your scalp of moisture or otherwise make your eczema harder to handle.
Keep showers short and lukewarm. This is especially true if you take long, super-hot showers, are shampooing frequently to battle what you think is dandruff, or are scrubbing vigorously to do the same. Using anything hotter than warm water can worsen eczema, as can exposing yourself to water for more than 10 to 15 minutes at a time, according to the Mayo Clinic. Plus, scrubbing hard at scalp eczema can scratch your skin, which might just make your condition worse.
Plenty of products at your local drugstore might promise to help with an itchy scalp, but using something like an over-the-counter dandruff shampoo won’t treat your eczema. It could even make it worse, depending on what’s in it. It’s really best to talk to your doctor, Dr. Day says: “In most cases, only prescription-based treatments really work.” Even if you don’t have scalp eczema, your doctor can identify what’s going on, offer treatment, and make your itchy scalp one less thing hanging over your head.