Pharmaceutical and natural remedies for flaky, itchy scalp.
DERMATOLOGY Part 1. Sometimes scalp itch goes beyond typical dandruff. There may be burning and severe flaking that is not relieved by over-the-counter (OTC) medicated shampoos. If you have gone through Head & Shoulders, T-Gel, Selsun Blue, Denorex and Nizoral and still can't find relief beyond a day or two, you may decide to contact your dermatologist. Some powerful remedies lurk behind a doctor's prescription pad.
Historically, inflammation may have been combatted with cortisone. Adverse affects associated with topical corticosteroids (i.e. liver damage) have shifted focus to:
- Anti-fungal remedies: zinc pyrithione, selenium sulfide, propylene glycol, lithium succinate
- Hydroxypyridones: ciclopirox
- Azoles: bifonazole, fluconazole, itraconazole, ketoconazole, miconazole, metronidazole
- Allylamines: terbinafine
Many of these are listed as active ingredients in the over-the-counter shampoos listed earlier. For stubborn cases of scalp psoriasis, your doctor may prescribe oral medications, such as methotrexate (Trexall®) or cyclosporine, or combine stronger medications with medicated creams and ointments.  Ciclopriox (Loprox®) is currently available only with a prescription. Severe cases of scalp psoriasis may also be treated with phototherapy using the Excimer Laser or a UV light.
Why Does My Scalp Itch So Much?
Psoriasis, clinically called atopic or seborrheic dermatitis, is a lifelong condition that causes thickened, red patches of skin and silvery-white scales affecting approximately 2.2 percent of the population. Rapid skin cell proliferation forms patches on top of one another — forcing prematurely discarded skin cells to the surface. These psoriatic patches can be itchy, sore, and even burn. The condition can be either mild, moderate or severe. Though it can't be cured, it can be controlled. Symptoms and appearance may resemble eczema and are therefore treated similarly. [2,3] For distinction, eczema has been called by some dermatologists the itch that becomes a rash; skin manifestations are usually secondary to scratching. Whereas psoriasis is a manifested skin condition that also itches.
A dietary deficiency in essential fatty acids (EFAs) like omega-3 and omega-6 is common among psoriasis patients and vegetarians or vegans. Psoriasis, seborrheic dermatitis, and eczema have been linked to allergies, stress, and genetics. A study of 319,000 13-14 year olds from 107 centers in 51 countries and more than 181,000 six to seven year olds from 64 centers in 31 countries links fast-food consumption to eczema and asthma. The authors suggest plausible explanations for the findings: fast food contains high levels of saturated and trans fatty acids, which are known to affect immunity, while fruit is rich in antioxidants and other beneficial compounds. 
What is The Cure for Scalp Psoriasis?
Ciclopriox clinical study: If OTC shampoos cannot keep flaking under control for more than three or four days, ciclopirox offers some promising results. One hundred and two patients were randomly selected to apply either ciclopirox olamine 1% shampoo or the vehicle shampoo to the scalp for 5 minutes, twice per week for 4 weeks. By the end of the study, erythema (reddening), scaling, and pruritus (itching) had significantly improved or cleared in 93% of the ciclopirox shampoo-treated patients compared to 41% in the placebo group (P<0.00001). 
That's the good news. But what if you discovered that a 120 mL bottle is comparable to the cost of a brand new smartphone? Suppose you had to purchase two bottles per year. Hopefully you have a good insurance plan that reduces your co-payment. But what if you already have (or could purchase for under $20) a remedy in your kitchen cabinet? Perhaps you prefer natural approaches, are waiting for a prescription refill in the mail or need something more than a watered down shampoo when your prescription is running low. You likely wish to decrease the incidence of flare ups. There are some options.
Natural Remedies for Itchy Scalp
Flaxseed oil: You may drink flaxseed oil from a tablespoon, in capsules in juice or in protein shakes. The oil doesn't retain its properties more than about six months even when refrigerated. This might make it difficult to consume a large bottle before it goes bad. Rich in omega-3 essential fatty acids, flaxseed oil, applied topically, soothes dry skin and may provide the EFAs necessary to inhibit the compounds in the body that cause inflammation. [6,7] Flaxseed oil (an acquired taste) taken orally and topically may reduce the symptoms or eczema and psoriasis for some people.
Apple Cider Vinegar: While there is no clinical support for the efficacy of vinegar in treating psoriasis, anecdotal evidence suggests many chronic sufferers have found relief from their symptoms through the use of apple cider vinegar. Some of the things that can be found in apple cider vinegar are detoxifying elements. Apart from the ones that are good for detoxification and cleansing, there are other elements that are quite good in a fight against bacteria that cause skin ailments. 
Some people have had success drinking the vinegar to attack psoriasis from within. You may consume a tablespoon of apple cider vinegar diluted with water 3:1 to reduce acidity twice a day. [9,10] Twenty minutes afterwards, drink a full glass of water and one hour later, as with all citrus juices, it is advisable to brush teeth to minimize tooth enamel erosion. (Brushing immediately after drinking citric acid has reverse effect.)
You may decide, depending upon the severity of your condition, to apply the diluted vinegar topically once or twice per week until the condition is under control (or until your prescription arrives). Soak a cotton ball or cotton swab with vinegar and blot it on the affected areas, or soak a compress in a mixture of vinegar and water and apply it directly to the skin. Leave it in for about 30 minutes before exfoliating with a fingernail brush, soft-bristle toothbrush (no longer used orally) or facecloth while rinsing or washing out with cool water.
If the residual vinegar smell is too strong, use a mild shampoo like Johnson's No More Tears or Neutrogena Anti-Residue shampoo. Washed skin requires moisturization to halt inflammation. You can try using a tea tree oil conditioner to nourish hair and scalp but rinse throughly with cool water to prevent irritation. In place of a conditioner, you might pat dry and massage a teaspoon of flaxseed oil or aloe vera into the scalp. Some with eczema on other parts of their body, add flaxseed oil to bathwater.
Caution: Oil and vinegar are not cures for chronic skin conditions. Either might provide days or weeks of temporary relief. But everyone's skin reacts differently. Some people may not tolerate citric acid. Flaxseed oil may be too oily for other people. Some adapt well to topical application while others can only take either component orally. When using natural topical remedies, monitoring efficacy is necessary.
Ease into topical use by treating a small non-facial area first — perhaps an inconspicuous spot behind an ear or on a temple. If there are no flare ups, you may decide to treat your whole scalp. The nice thing about using a single-ingredient remedy is that you learn fairly quickly if it doesn't agree with you.
Psoriasis is a complex disorder with hereditary, dietary, emotional and dermatological triggers. Consider any suggestions offered as an adjunct to professional care. Consult your primary doctor or dermatologist if your condition worsens or you do not see improvement within two weeks.  Looking to join an online support group? Visit patientslikeme.com.
Did you learn anything that will help you be A Bit More Healthy? If so, please mention it in the comment section.
- Difference between scalp psoriasis and seborrheic dermatitis. mayoclinic.com msn.com
- Symptoms And Treatment of Scalp Psoriasis. urbsocietymagazine.com
- Psoriasis, Eczema, Dermatitis: What's the Difference? msn.com
- Fast Food Diet Linked to Asthma and Eczema Severity in Kids. sciencedaily.com
- Ciclopirox Shampoo for Treating Seborrheic Dermatitis. medscape.com
- The Benefits of Topically Applying Flaxseed Oil to Skin. livestrong.com
- How to Treat Eczema with Flaxseed Oil. ehow.com
- Health Benefits of Apple Cider Vinegar (ACV). eatingbirdfood.com
- Psoriasis Treatment Using Vinegar. ehow.com
- Eczema cure - Apple cider vinegar. steadyhealth.com
- Let doctors know if you’re using alternative medicine. kevinmd.com
- Flaxseed oil for scalp eczema - Mallory, Asheville, USA. talkeczema.com
- Image by Fotografie NRW licensed from iStock Photo.