By: Ava Alderman: I hear from a good amount of people who are not only shedding hair, but who are also having scalp issues. Many of them notice a tight, itchy scalp and they do not understand why. Some of them have never had dandruff or any itching before. So they can correlate the scalp problem as occurring shortly after the hair shedding started. They know that the two must be connected, but they don’t know why.
Someone might say: “ever since my hair started shedding badly, my scalp has itched. I don’t notice any flaking, so I don’t think that it is dandruff. But it’s really bad. It’s hard not to notice it all of the time. Scratching really doesn’t make it any better. I try not to be obvious with the scratching, but last night my husband asked me if I had fleas. He was only joking, but this means that the scratching is obviously noticeable. Why is this happening? I’ve read that your scalp can itch with hair loss from DHT. Is that what is it is? My doctor thinks that I have telogen effluvium.”
In cases of telogen effluvium, the most common cause for the itch (at least in my experience and observation) is inflammation and irritation. Except for when you’re experiencing telogen effluvium or a severe summer shed, it’s just not normal for so many of your hair follicles to go into shedding mode all at once. Normally, you may have less than ten percent of hair in this mode. So when the hair sheds out during a normal cycle, you don’t notice it much or feel any discomfort in your scalp. But when this is magnified by five times or more (as is the case with TE,) than you most definitely do notice it and you can sometimes see evidence of it on your scalp, which can become irritated and inflamed.
Another reason for the itching is regrowth. Since you probably have many more follicles growing hair than normal, this can create some tightness, tingling, or itching as the hair begins to fill in.
The inflammation and tightness can often be helped with a little tea tree oil or the commercially available product scalpacin (at least it gave relief in my experience.) And frankly, even if dandruff is not a problem and never has been, many people with TE get some relief using dandruff shampoo simply because it kicks back inflammation.
As far as DHT goes, if you truly have TE, DHT really should not be the cause of your itching. However, there is another type of hair loss (androgenetic alopecia) where DHT is most definitely an issue. The scalp becomes overly sensitive to this androgen and the follicles shrink as a result – causing hair loss, and eventually, miniaturization. This process can cause itching and discomfort also.
But people with TE typically don’t have hair loss caused by androgen sensitivity. Their hair loss and shedding is caused by stress or change to the body or illness. It’s important to understand the difference between the two and to differentiate which type you have. AGA and miniaturization can be addressed if treated early. But since TE doesn’t permanently affect the follicles and doesn’t include the DHT sensitivity, it’s more likely that the itching isn’t from DHT if you are dealing with telogen effluvium. It’s most likely from inflammation, irritation, or regrowth. Sometimes, you can have all three going at once, which can be a challenge. It took me a while to get a handle on my inflammation, but I had CTE (chronic telogen effluvium.) I often wonder if I would not have developed the chronic variety if I had gotten the inflammation under control earlier. But I did not know then what I know now. You can read more on my blog at http://stop-hair-loss-in-women.com/