ated with a desire to scratch [1] . Just like skin pruritus, its etiology may be of dermatological or non-dermatological origin. It is common for the dermatologist to encounter patients with no evident cause of scalp pruritus, making it a distressing situation for both the clinician and the patient. The aim of this paper is to review the clinical signs of the most common causes of scalp itch and other less common causes that must be considered in a systematic approach to scalp pruritus.
Materials and MethodsWe performed a MEDLINE search through PubMed (1975PubMed ( -2017, using the terms scalp itch and scalp pruritus and included clinical trials, review articles, case series, and case reports to search for the causes of scalp itch.
PathophysiologyAlthough various pathogenic etiologies contribute to scalp pruritus, the scalp itself has distinct neuroanatomy and vasculature, specific neuromediators and corresponding receptors, as well as the presence of scalp sebum and microflora, which are all properties that may explain its tendency to be implicated in patients who complain of itch.
Keywords
Scalp · Itch · Pruritus · Seborrheic dermatitis · Contact dermatitis · Anxiety · Lichen planopilaris · Lice · Pediculosis · Psoriasis · Trichoscopy
AbstractScalp itch is a frequent complaint in the dermatological setting. It is common for the dermatologist to encounter patients with no evident cause of scalp pruritus, making it a distressing situation for both the clinician and the patient. The aim of this paper is to propose a systematic approach to scalp itch, which classifies scalp pruritus into two types: (1) with or (2) without dermatological lesions, and presence or absence of hair loss. Also, it is important to think first about the most common causes and then rule out other, less common etiologies. The acronym SCALLP and the five steps for scalp evaluation (listen, look, touch, magnify, and sample) are useful tools to keep in mind for an assertive approach in these patients.