No dandruff, but experiencing scalp itching and hair loss—what could be the cause and how to manage it?

Scalp itching and hair loss without dandruff may be caused by physiological factors or pathological conditions such as neurodermatitis and seborrheic dermatitis. Treatment should be selected according to the specific cause. The detailed analysis is as follows:

1. Physiological Factors

Inadequate scalp hygiene, such as infrequent shampooing, can lead to sebum buildup and clogged hair follicles, resulting in scalp itching and hair loss. This is generally a normal phenomenon that does not require medical treatment—maintaining proper personal hygiene is sufficient.

2. Pathological Factors

1) Neurodermatitis

Excessive psychological stress or prolonged mental tension may trigger neurodermatitis, causing noticeable itching and hair loss in the affected area, although dandruff is usually absent. Under a doctor's guidance, patients may use topical medications such as triamcinolone acetonide/econazole cream, mometasone furoate cream, or compound fluocinonide tincture for treatment.

2) Seborrheic Dermatitis

Overproduction of scalp oil may lead to hair loss accompanied by scalp itching, even without visible dandruff. Patients should follow medical advice and apply medications such as hydrocortisone butyrate cream, halometasone cream, or compound fluticasone ointment.

In addition, conditions such as tinea capitis (scalp ringworm), psoriasis, or folliculitis could also be responsible. It is recommended to seek timely evaluation at a reputable medical facility for accurate diagnosis and prompt treatment.