Itchy scalp in menopause and perimenopause: why your head itches and what helps

It might be along your parting, at the crown, or just behind your ears. You catch yourself scratching while you read, or lying in bed with your fingers in your hair. Sometimes there are flakes on your shoulders. Sometimes there's nothing to see at all.

So can menopause cause an itchy scalp? It's possible. The NHS lists "dry and itchy skin" among the symptoms of perimenopause and menopause, and your scalp is skin. But very little research has looked at the scalp itself, so the link is a sensible guess rather than a proven fact.

What we can say for sure is that an itchy head has lots of common causes. Most are easy to sort out. A few need a doctor, so read the box below first.

Can menopause cause an itchy scalp?

It can be part of the picture. Here's what we know:

• The NHS lists dry, itchy skin as a symptom of perimenopause and menopause.
• A 2022 review of menopause and skin problems says itching is common after menopause, and often comes with dry skin.
• Women's Health Concern, the patient arm of the British Menopause Society, says the volume and condition of hair very often seems to get worse in the months or years around menopause.

And here's what we don't know. We couldn't find good research looking directly at itchy scalps in menopause. So when you read that falling oestrogen "dries out your scalp", that's an educated guess, based on what happens to skin elsewhere. It may well be right. It just hasn't been properly tested.

Why does menopause make your scalp itch?

Drier skin

Oestrogen seems to help your skin hold on to water. The 2022 skin review explains that oestrogen put on the skin has been shown to cut the amount of water lost through it. The authors suggest that lower oestrogen may mean more water loss, and so drier, more easily irritated skin. Dry skin itches.

The review also found that eczema-type rashes were the skin problem most often reported by women around menopause, in one large study.

Stress and tired nights

Perimenopause often brings poor sleep and mood changes (NHS). That matters for your scalp. The British Association of Dermatologists says tiredness, stress and cold, dry weather can all make seborrhoeic dermatitis flare up. The NHS says stress and cold weather can make dandruff worse too.

So even if menopause isn't the direct cause, it can stack the odds.

Perimenopause itchy scalp: other common causes

Before putting it down to menopause, it's worth ruling out the usual suspects. Most are easy to treat.

Dandruff. The NHS describes dandruff as white flakes of skin on the scalp and in the hair. Your scalp may feel dry and itchy. It's common, it isn't harmful, and it's not caused by poor hygiene. A yeast that normally lives on the skin may play a part.

Seborrhoeic dermatitis. This is a more inflamed version of the same problem. The British Association of Dermatologists says it can make the scalp itchy, sore and sensitive, with yellowish flakes. The skin may look red, or lighter or darker than usual. It can also affect oily areas such as the face, chest and back, and it can't be cured, but it can be kept under control.

Other skin conditions. The NHS lists psoriasis and eczema among the long-term skin conditions that cause itching.

Head lice. The NHS lists them among the causes of itchy skin. If your head itches and you're not sure why, it's worth a check, especially if there are children in your life.

Fungal infections, such as ringworm. These are on the NHS list too. Scaly patches on the scalp are one reason to see your GP rather than treat it yourself.

Hair dye. If you colour your hair, this one is worth thinking about. The NHS explains that many permanent and some semi-permanent dyes contain a chemical called PPD, which can irritate the skin or cause an allergy. Reactions include stinging, burning, an itchy rash, dryness and soreness, and can take up to 72 hours to appear. So a reaction might not show until a couple of days after your colour.

Frontal fibrosing alopecia (FFA). The British Association of Dermatologists says this type of hair loss mostly affects women who have been through menopause. Some people feel nothing. Others notice an itchy, painful or burning band across the front hairline, sometimes with redness and flaky skin around single hairs. The hairline slowly moves back. That's why a new itch along your hairline deserves a look.

How to soothe an itchy scalp: things to try tonight

These tips come from the NHS, the NHS dandruff page and the British Association of Dermatologists.

When the itch strikes

• Pat or tap your scalp instead of scratching it.
• Notice when you scratch most. Is it at night, when you're tired, or when you're stressed? Knowing your pattern helps.

In the shower

• Don't stay in the bath or shower for a long time.
• If your skin is generally dry, an unperfumed moisturiser or emollient on the rest of your body is a good habit.

If you have flakes

• Try an anti-dandruff shampoo. The NHS says to look for one with at least one of these: ketoconazole, coal tar or salicylic acid. A pharmacist can help you choose and show you how to use it.
• The British Association of Dermatologists suggests massaging the shampoo into your scalp and leaving it for 5 to 10 minutes before rinsing. It also lists zinc pyrithione and selenium sulphide as options.
• Give it time. The NHS says to keep going for up to 4 weeks to see if it helps. If one type doesn't suit you, try another.
• Once things settle, the British Association of Dermatologists suggests using an antifungal shampoo once or twice a week to help keep flakes away.

If you colour your hair

• The NHS suggests testing a new dye on a strand of hair at least 48 hours before you use it.
• Wear gloves when you apply it.
• If your scalp reacts, wash your hair and scalp straight away with a mild shampoo, and don't use that dye again.

Look after yourself too

• Tiredness and stress are known triggers for seborrhoeic dermatitis. A wind-down routine before bed, and a bit more rest where you can find it, are kind to your whole body, scalp included.

What a pharmacist or GP can offer

A pharmacist can help you pick the right shampoo and explain how to use it. For general itching, the NHS says a pharmacist may suggest things like antihistamines or menthol creams. For a mild reaction to hair dye, they can suggest emollients or antihistamines (NHS).

Your GP may:

• look at your scalp and ask about your symptoms
• suggest a stronger scalp treatment, such as a steroid scalp treatment for a flare of seborrhoeic dermatitis, or a product to loosen thick scale (British Association of Dermatologists)
• refer you to a skin specialist (dermatologist) if the cause isn't clear. For FFA, a small skin sample (biopsy) may be taken to confirm it (British Association of Dermatologists)

If you have other menopause symptoms too, it's worth talking about them all together. The NHS says to see a GP if you think you have symptoms of menopause or perimenopause and want to know your options. No one has studied whether HRT helps an itchy scalp in particular, so think of that as a question for your GP, not a promise.

When to see a GP about an itchy scalp

The NHS says to see a GP if:

• an anti-dandruff shampoo hasn't helped after at least 4 weeks
• your dandruff is severe, or your scalp is very itchy
• your scalp is red or swollen
• you get flaky, itchy patches on your face or elsewhere on your body

The NHS also says to see a GP if itching is affecting your daily life, or keeps coming back.

And use the box at the top of this page for patches, hair loss or anything around your hairline. It can help to take a list of all your symptoms, even the odd ones. Our symptoms checklist lets you tick them off and print a list for your GP.

Related

An itchy scalp often comes with itchy skin elsewhere, hair loss in menopause and itchy ears, and you can see them all in our list of perimenopause symptoms.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.

See all perimenopause symptoms