If you’ve followed me for a minute, you know I’m obsessed with hair.
Specifically: Hair texture. Hair health. Frizz. Styling ingredients. The bends and swaves. Why your waves do the things they do. Why they suddenly refuse to do the things they did yesterday. And how to help them be their very best, the easiest way possible (hint: I can help you with that).
But recently, I’ve been forced to become interested in something I honestly didn’t want to become an expert in:
my scalp.
More specifically, my increasingly flaky, crusty, sometimes tight, itchy scalp. In other words, it snowed all summer, y’all. In Texas. On my shoulders.
I think you get the picture.
I’ve long been interested in learning more about the scalp, more advanced ways to help my clients—even considered becoming a clinical trichologist. And I considered myself lucky to have an itch-free scalp.
No longer.
And y’all know when I am faced with a problem, I’m like a dog with a bone. I will not rest until I have it all figured out.
Also. Many of my clients struggle with their unhappy scalp every single day. Maybe you’re one of them.
And so, instead of wearing a baseball cap and nothing but white shirts and just pretending everything is fine (although I admit I did do some of this), I’m diving in to learning everything scalp care and am here to to spill it all in the hopes of helping my itchy scalp friends and clients what I’ve learned, what I’m in the process of learning, what’s working for me, and what isn’t.
Because I’m quickly learning a chronically itchy scalp is not for the weak. And maybe my experience can help you with yours.
P.S. – This will be a big topic of conversation in Season 3 of Two Wavy Girls On The Internet Podcast. And on an upcoming YouTube video of mine. Be on the lookout.
Lesson one: A flaky scalp can have lots of causes.
And our hygiene isn’t necessarily one of them. Can we get that out of the way first?
I have a number of clients who prefer to wash their hair just once a week, with the happiest scalps you’ve ever seen, and another good handful who wash their hair daily or every other day, whose scalps are just flat out angry. Having a flaky or inflamed scalp does not infer that you (or I!) have poor hygiene or a contagious illness.
In fact, seborrheic dermatitis—aka, seb derm as it’s called all over the internet these days, the condition commonly associated with dandruff—isn’t caused by having an unclean scalp.
Dermatologists believe it’s basically a skin reaction to the yeast that naturally lives on everyone’s skin, along with other factors including sebum. But they’re “not really sure.” Cue my deep sigh.
Translation: The most frustrating part of it all is that an itchy, flaky scalp can have a whole bunch of different causes, diagnoses, or names.
For example. Dandruff. Seborrheic dermatitis. Psoriasis. Eczema. Contact dermatitis. Dry skin. Perimenopausal folliculitis. DHT itch. Nerve damage. And more.
The list is long.
And the causes can overlap.
Some of these, yes, could be related to not cleansing the scalp frequently enough, only because it creates an opportunity for problems. But other causes are related to autoimmunity, hormonal changes, and/or disruption of the skin barrier. Or, in my case, more than likely a combination.
So when someone has a flaky scalp, there isn’t necessarily one obvious answer. Or one product unicorn solution.
Lesson two: Slow down with solutions and minimize your variables
I doubled my HRT at the end of May. I was regularly washing my hair every fourth or fifth day, not near as often as I should have been. During the second week of June, my scalp was suddenly not the same. Constant itchiness, tingling, flaking, crusting like mad. I couldn’t figure out what had happened, but I had a feeling there was an intersection between my scalp’s new irritability and my HRT change.
And, I was miserable.
So initially, I dove into trying all the things I had immediate access to as a hairdresser (who really has always kept scalp health top of mind!).
Then I thought, hey, maybe I just need to exfoliate.
Or maybe I need to moisturize.
Treat yeast?
What if it’s psoriasis?
Probably need an oil.
A couple different medicated shampoos…
Every Innersense, Hairstory, and Cult+King scalp-y product I had in my arsenal. No magic bullet among them. Although, Cult+King Tonik scalp serum was a real standout. More on that in a sec.
So I realized, this is becoming a clinical problem. And I know where my expertise ends.
Time to bring in the pros and get science-y.
Separately, I met with my gynecology P.A. and my dermatology P.A., where I learned that suddenly increased progesterone can convert to higher levels of testosterone. High testosterone converts to DHT (dihydrotestosterone) in the scalp. This then triggers your sebaceous glands to product more sebum (scalp oil) than ever before. And then that excess oil feeds the friendly yeast, called malassezia, currently living on your skin, where they then go nuts and explode in population, thereby becoming less friendly and kind of invasive and disrespectful, leading to a trio of experiences: inflammation, intense itching, and a compromised skin barrier…all of which tracks, and which had I continued to make worse (oops) by doing ALL THE THINGS.
On the derm P.A.’s recommendations, I did consistently use the standard rx Ketoconazole shampoo and rx Clobetasone steroid foam. I hoped these two alone would the the trick and quickly. Two weeks later, I was more miserable than before, with a drier-than-the-Sahara scalp that was still on fire and embarrassingly flaky.
On the gyn P.A.’s recommendation, I added a saw palmetto supplement and a green tea extract to my routine, to suppress the effects of excess testosterone. I expected all of these solutions to work immediately. My scalp had other plans.
I had no idea how much time scalp healing truly takes.
The skin microbiome operates on a delicate balance. This is why I stress to my clients who prefer to cleanse their scalps less frequently to really really keep feelers out for their scalp health.
Any feeling of irritation is a warning sign, and once something is off, I can tell you from personal experience, it’s time-consuming to get back on track.
And nothing was working fast enough for me.
Short of literally throwing spaghetti at the wall, I went in search of more solutions, aka products on products. More shampoos and sprays and tonics and oils This flaking scalp was on month three of absolutely ruining my sanity. I could not control myself.
So I very quickly had approximately 23 products standing around my shower like a dermatological committee. I know, you are not surprised.
You can find some of these helpful potions on Amazon.
The problem wasn’t necessarily that any individual product was ineffective.
The problem was that I was stacking treatments and introducing new variables faster than my scalp could tell me what it needed.
Then I did the last thing I ever think to do, and asked ChatGPT for help.
Its response: Slow down. Get boring. Don’t deviate.
At my wit’s end, I listened.
Lesson three: Give it time
On ChatGPT’s recommendation, I did buy another shampoo and conditioner (I know, I know)—ones I would never have chosen for myself. Vanicream brand, from Target. For the next two weeks, and nothing else.
Boring as can be. Not magic. But fragrance free, essential oil free, not fancy.
So I said FINE. I’LL DO ANYTHING.
As miserable as I was, it was past time to start paying attention and stop with the knee-jerk reactions.
Here’s what I’m doing now, and what seems to be working.
Slower than I’d like, but progress happens in small starts.
Shop here for some of these recommendations.
The Vanicream shampoo and conditioner, every other day. I’m even using the Vanicream conditioner as my leave-in to really minimize products.
Using my prescription shampoo and foam occasionally, as directed.
Cold water to rinse my scalp—both at the end of my shower, and on the in-between days I’m not shampooing. I still condition on those days.
Allegra is an allergy medicine that seems to work better for skin reactions than other histamine blockers, and it actually does help with itchiness. I take it two to three times per week. Thanks for the reminder, Mom.
Cult+King Tonik has the most magical anesthetizing affect on my scalp. A blissful 45 minutes at a time of tingly, cold, then quiet, calm. Use whenever I need.
An actual children’s squishy toy to keep my hands busy, because it turns out skin picking is addictive.
I also elected to reduce my HRT back to my original dosage.
Because I honestly do believe that hormone fluctuations are at the root cause of my personal scalp issues. I’m not cutting it out entirely, as I was doing well on my previous dosage. Getting back to a hormonal baseline, I hope, will help resolve the issue, however many more weeks or months it takes to rebuild my scalp’s skin barrier.
I’m taking it one day at a time.
The most uncomfortable part of this for me is that
I am literally a hairstylist. Like, a really good one (if my reviews mean anything).
I spend my days examining people’s hair and scalp.
I counsel each client on the best ways to care for their scalp and hair.
I know entirely too much about hair products.
I have opinions about surfactants.
I read ingredient lists for fun.
And yet, when my own scalp started behaving a fool, I did what I suspect many of you would do:
I reacted over and over again.
The biggest mistake I made
I was treating the flakes instead of paying attention to the skin underneath them.
The symptom vs. the part of me that was screaming for help.
Those aren’t the same problem.
When you feel something foreign on your scalp like scale, the human instinct is to:
GET IT OFF.
Scrub it.
Pick it.
Exfoliate it.
Use a stronger shampoo. Buy another one.
Use a scalp brush.
Loosen it.
Get every last piece off.
But if the underlying skin is inflamed, mechanical irritation can actually make things worse. Guilty as charged.
My lovely friend and dermatology P.A., Alyssa Spiegel specifically recommended being gentle with my scalp and to avoiding scratching, scraping and aggressive brushing because trauma can aggravate inflammation. I tried to listen. But do you know how hard that is? Jeez Louise.
So the new question I’m on the lookout for an answer to is:
What does healing look like?
I’m trying to give my scalp enough time—with my simplified routine—to tell me what happens when I stop constantly intervening.
I’m paying attention to the things that matter:
Is the itching decreasing?
Is the redness decreasing?
Is the crusting decreasing?
Does my scalp feel less reactive?
Are the flakes getting finer and easier to release?
Does my scalp generally look better?
Those are much more useful measurements than:
“How many flakes did I see in the sink today?”
And here’s the part I wish someone had told me sooner
Healing skin doesn’t always look healed.
We’re working with three issues: Inflammation, skin barrier, and scale/flakes.
Sometimes the inflammation settles before all of the scale disappears.
Sometimes the skin barrier takes longer to recover.
Sometimes a product that felt wonderful when your scalp was inflamed isn’t a product you need to keep using once things start calming down.
And sometimes the answer isn’t another treatment.
Sometimes the answer is:
Stop messing with it.
Which, for someone like me who wants to try every product and solve the problem immediately, may be the hardest lesson of all.
So where am I now?
Recovering, but still figuring some things out.
Sometimes I have a good, calm-scalp day, and then a flare up the next.
I’m giving it time.
Trying to be patient.
I don’t have a dramatic before-and-after photo. YET.
I don’t have a miracle product. Although Tonik and Allegra do come close.
What I do have is a much better understanding of my scalp than I had 12+ weeks ago.
And maybe that’s actually the most useful part.
Because if you, too, have stood in your bathroom surrounded by shampoos, oils, scalp scrubs, serums, acids, and “miracle” treatments, wondering why your scalp is still angry…
I get it.
Friend, you may not need another product.
You may need fewer products. Carefully selected for simplicity and effectiveness, of course.
And you likely need someone qualified to help figure out what’s actually happening underneath all those flakes. In and under that skin that’s begging for help.
That’s where I am.
Still learning.
Still experimenting.
Learning how to help myself, and others.
And trying to leave my scalp alone long enough to heal.
My mantra these days: Boring can be pretty useful.
But you’d better believe I’ll be in touch as soon as I’m brave enough to play with all the exciting things once again.
Until next time,
Alyson