In short
- Atopic scalp eczema often coexists with hand or face eczema.
- Triggers: hard water, fragrance, stress, wool hats, dry heat.
- Emollient shampoo + short steroid course breaks acute flares.
- Long-term: barrier repair — not just anti-itch.
Scalp eczema (atopic dermatitis of the scalp) is under-diagnosed in adults. It gets called 'dry scalp' or 'sensitive scalp' for years before someone names it correctly.
How to know it's eczema, not SD
- No greasy yellow scale — dry, cracked, sometimes weeping
- Coexisting eczema elsewhere on body
- Worse with stress, better with sun/humidity
- Family history of atopy (asthma, hay fever, eczema)
London flare triggers
London's hard water (240 ppm+ in most zones) strips the acid mantle. Central heating in winter dehydrates. Fragranced shampoos and dry shampoos concentrate irritants. Woollen hats trap heat and friction. Chronic sleep debt raises inflammatory tone.
The protocol
- Fragrance-free emollient shampoo (Eucerin, La Roche-Posay)
- Short course topical steroid (clobetasone 0.05%) for acute flare
- Weekly leave-in oil treatment (jojoba or squalane)
- Shower filter for hard water
- Silk pillowcase — friction reduction
Frequently asked
Common questions
Can I use hydrocortisone long-term?+
No — steroid-induced atrophy is a real risk. Rotate with non-steroid options (tacrolimus 0.1%) if flares are frequent.
Does diet matter?+
For some — food-triggered atopy is worth exploring with a dermatologist if flares seem cyclic.
Will it cause hair loss?+
Not directly, but chronic scratching can cause breakage and low-grade traction.
Keep reading
Related, trichologist-reviewed
Scalp
Dry scalp: London causes, real fixes, and what not to do
A dry scalp isn't thirsty — it's leaking. Rebuild the barrier and the itch stops.
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Scalp
Itchy scalp: the London differential and treatment paths
Itching is a symptom, not a diagnosis. The wrong product on the wrong cause makes everything worse.
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Scalp health
London hard water and your hair: what it actually does, and the fixes that work
London water is genuinely hard, and it is measurably harder on your hair than the water in most of the UK. Here is what it does — and what actually helps.
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