Itches anywhere, but particularly scalp itchiness, can be maddening. So many different problems could lead to persistent scalp itchiness. Doctors might diagnose lice, dandruff, psoriasis or a yeast overgrowth that causes seborrheic dermatitis. However, they may find it difficult to make a diagnosis and assign an appropriate treatment (BioMed Research International, Jan. 2019). Generally, we are thrilled to learn that a reader has found a way to manage an intractable condition. However, the drug this person is championing could have potentially serious side effects. We are reluctant to see it used for a disorder that is not life-threatening.
What Could Soothe Long-Lasting Scalp Itchiness?
Q. For 40 years, I have suffered with an itchy scalp. I have tried everything, including dandruff shampoos (though I didn’t have dandruff), cooling pillows, frozen gel packs and even prescription lotions. Nothing worked, though rubbing alcohol offered short-term relief when I was under intolerable stress.
Then I developed severe jaw pain that radiated to my ear. The doctor prescribed gabapentin twice a day for a week. My jaw and ear pain cleared up, and to my delight, so did the scalp itchiness. I am now taking gabapentin daily and am free of itching.
A. Gabapentin is an anti-seizure drug that is also prescribed for persistent nerve pain after a shingles attack. Jaw pain is not a use the FDA has approved. Neither is scalp itchiness.
We are delighted that you got relief for such a long-lasting problem. You should know, however, that gabapentin can cause some potentially serious side effects, including dizziness, depression and suicidal thoughts. Consequently, you should weigh the possible harms against the perceived benefit and make sure that the benefit is greater.
Other Approaches to Ease Scalp Itchiness:
You are certainly not the only person to be plagued with a persistently itchy scalp. If misery loves company, perhaps you will be relieved to learn that others have also struggled with this problem.
Q. I have been treating a scalp problem for many months. Prescription drugs such as clobetasol, ketoconazole shampoo and fluocinonide each help, but do not clear it up altogether. I still have itching and flaking.
I’ve tried lots of other remedies such as Head and Shoulders shampoo, organic baby shampoo, baby oil, jojoba oil, tea tree oil and Mane ‘n Tail shampoo for animals but none do the job. Do you have any ideas to clear this up?
Will Vinegar or Listerine Help?
A. Other readers have suggested remedies for itching and scaling that you may not have tried. One calls for rinsing the hair and scalp with dilute vinegar after shampooing. Another approach is to soak the scalp with amber-colored Listerine. Some people find that applying milk of magnesia to the scalp can be helpful. We don’t know if any of these would work when antifungal drugs have not, but they are all inexpensive and worth a try.
One reader reported his experience with a standard dandruff shampoo:
“Years ago, a dermatologist told me to leave zinc pyrithione shampoo (I use a generic one) on my scalp for a while.
“Three times a week, I put it on at the beginning of my shower and don’t rinse it off until I am done, which usually will be several minutes.
“No dandruff. I do use a tar shampoo once or twice a month to alternate, and no conditioner, as that causes scalp itchiness.”
Another woman’s husband used a more alternative approach:
“My husband had dandruff and he rinsed his hair with apple cider vinegar and it went away. It also made his hair soft. The only thing was his dark hair went white.
“After the second bout with cancer in which he lost his hair again, he used the cheapest mouthwash we could find and it worked great. He rinsed with it and didn’t wash it out. His hair was soft and best of all no dandruff and no scalp itchiness.”
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In a different situation, another reader reported:
“I am a female who just turned 60 yesterday. I have been plagued with scalp itchiness, no dandruff, for at least the past 20-25 years. It drives me crazy sometimes. I tried apple cider vinegar, but the itching continues. A topical solution that gives me excellent temporary relief is Scalpicin containing 3% salicylic acid. It soothes & cools, putting the itch at bay.
“I also find that Aveda Rosemary Mint Shampoo & Conditioner helps soothe the scalp. It leaves the scalp cool & tingling.
“Another thought might be to try Sea Breeze. When I was growing up, my aunt was a beautician. She poured Sea Breeze right out of the bottle & massaged it into the scalp after giving me a permanent. It felt so cooling & calming to the scalp & smelled wonderful. Back then, permanent waves were more harsh, so I’m sure the Sea Breeze took care of any potential irritation to the scalp. I just checked the ingredients for Sea Breeze; it has Salicylic acid & camphor. It’s worth a try.”
Unfortunately, a solution that works for one person does not always work for another:
“I’ve tried Sea Breeze (the blue one) on my itchy scalp with hair loss but no dandruff. The S/B does give me temporary relief from the itch but my hair is not growing back in.
“I have zero, fine, baby hairs and fear I’ll be a 58 y/o bald female at some point in time. I think it must be hormonal… but since I’ve had estrogen positive breast cancer in the past – I’m afraid to see a doctor for hormone treatment.
“The scalp itchiness is absolutely miserable and it seems to be worse at night. My dermatologist ran all kinds of tests and every one of them came back as normal. I did ask my MD for a short run of steroid tablets as I think my scalp is inflamed, but she refused. Sometimes I just want to scratch my hair out of my head! I’ll try just about anything to get rid of this itch!”
As with gabapentin, steroid pills such as prednisone is a very big cannon. Consequently, we are not surprised that the doctor balked.
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. Read Terry's Full Bio.
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Rattanakaemakorn P & Suchonwanit P, "Scalp pruritis: Review of the pathogenesis, diagnosis, and management." BioMed Research International, Jan. 2019. DOI: 10.1155/2019/1268430
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