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QUESTION OF THE WEEK


Scalp pain, itching and burning: What are the drug-free options?

Practical non drug options for treating scalp symptoms

Scalp symptoms such as itching, burning and tenderness are common in a variety of conditions. Patients with seborrheic dermatitis, psorasis, scarring alopecia and telogen effluvium all can experience scalp symptoms. A variety of conditions (totalling well over 100) can cause patients to experience higher than normal levels of various scalp symptoms:

see The 6 D’s of Scalp Symptoms

Non drug options for scalp symptoms.

Treatments for scalp symptoms depend on the cause. If a patient has itching from psoriasis, the best option for the patient involves specific treatment for psoriasis. If the itching is due to an allergy, the best treatment is avoiding the suspected allergen altogether.

In some cases, the precise reason either can not be found and strategies are needed to reduce scalp symptoms. In other cases, the cause is known but treatments are not possible for the patient on account of side effects, cost, or ineffectiveness. A variety of non-specific drug-free treatment options can also be considered in such situations.

1. Ice packs or Cool water

Ice packs, frozen peas and cool towels are useful for many individuals with challenging scalp syndromes. These are safe to use provided they are not too cold and not left on too long.

2. Apple cider vinegar

Apple cider vinegar rinses are helpful for individuals with many different scalp syndromes including itching, burning and pain. Most often the apple cider vinegar is diluted 1:4 in water and applied to the scalp for 5-10 minutes before rinsing off.

3. Witch hazel

Several herbal ingredients are proposed to have an anti-irritant tendency and can be helpful in scalp pain syndromes. These include chamomile (Marticaria chamomilla), heart seed (Cardiospermum halicacabum), peony (Paeonia lactiflora), and the virginian witch hazel (Hamamelis virginiana). Witch hazel in particular has received great attention. We generally recommend application of pure witch hazel with a cotton ball for periods of 5-10 minutes before rinsing off. Many patients find relief from these agents.

See previous “Witch Hazel for Scalp Symptoms”

4. Allergen free shampoos

Although contact allergy must be considered in patients with scalp symptoms, a variety of allergen free shampoos can be considered even in the absence of any evidence of a true scalp allergy. A list of helpful low allergen shampoos is provided in the link below

LOW ALLERGEN SHAMPOOS

5. Vitamin C

Vitamin C or ascorbic acid occasionally helps some individuals with scalp nerve and pain syndromes. The dose is 500 mg daily.

6. Low level laser therapy.

Low level laser therapy (LLLT) involves the application of red light therapy to the scalp. The treatments were originally designed for use in androgneetic alopecia but have helped many patients with scalp dysesthesia. Some patients, however, find that the warmth of these devices makes their scalps feel worse. Therefore LLLT is not helpful for everyone.

Reference

Carr AC, et al. The role of vitamin C in the treatment of pain: new insights. Review article J Transl Med. 2017.


This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.



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