Common Reasons for an Itchy Scalp During Pregnancy

Itchy skin and an itchy scalp are common during pregnancy, but in most cases, it is nothing to worry about. However, we always recommend checking with your midwife or GP because a liver condition called intrahepatic cholestasis of pregnancy (ICP) can sometimes cause it.

Despite many of the other causes of an itchy scalp during pregnancy being lower priority, it can still be helpful to understand them and how to reduce an itchy scalp.

This article will be a comprehensive guide to the causes of itchy scalps during pregnancy, including easy prevention solutions.

Intrahepatic cholestasis of pregnancy (ICP)

Unlike more common causes of itchiness during pregnancy, ICP requires medical attention. It is a potentially serious liver disorder where your bile acids don’t flow correctly, resulting in high bile acid levels in your body.

It affects around 1 in 140 pregnant women within the UK. You should contact your midwife, GP or healthcare professional if you experience the symptoms below.

Symptoms of ICP

• Feeling itchy is the primary symptom of ICP; you usually won’t experience a rash. For many women and birthing people, the itching is mainly noticeable on hands and feet but can be anywhere on the body, including the scalp. The itching is also worse at night
• Much darker urine
• Pale poo
• Yellowing of the skin and the whites of the eyes (a less common symptom).

ICP symptoms usually occur in the third trimester of pregnancy (around 28 weeks), but you can develop the condition earlier.

It may be worth checking your family history for previous ICP cases, but it can sometimes occur without a history of it in your family.

Additionally, if you had ICP in a previous pregnancy, you have a much higher chance of developing it again in another pregnancy.

Treatment of ICP

If diagnosed with ICP, your doctor/obstetric team will regularly conduct liver blood tests and bile acid measurement tests to monitor the condition. The intervals depend on your symptoms and the results of initial tests.

You can also take certain creams like aqueous cream with menthol to relieve itchiness.

You could also take chlorphenamine if the itchiness keeps you awake at night; chlorphenamine causes drowsiness. Please check with your GP or obstetric team before taking any new medication in pregnancy.

Other causes of an itchy scalp during pregnancy

While ICP is easily the most serious cause of an itchy scalp during pregnancy, it is not the only one. Here are some other causes and some common ways to treat them.

Hormonal changes

• A change in hormone levels – increased pregnancy hormones can increase oestrogen and progesterone levels, affecting skin sensitivity. It can also disrupt natural moisture balance in the skin, making an itchy scalp more likely.
• Increased immune system reactivity – you may be allergic to shampoos and other hair products, which can sometimes cause itching.
• Anxiety and stress – pregnancy-related stress can release cortisol, which disrupts the skin and causes dryness and itching. You can lower stress and anxiety with deep breathing exercises, meditation, scalp massages, or walking.

Scalp disorders and skin conditions

• Dandruff and seborrheic dermatitis – hormonal changes can trigger these, resulting in an itchy and flaky scalp; you can treat these with anti-dandruff shampoos.
• Fungal infections – hormonal changes can shift the skin’s microbiome, making you more prone to fungal infections Antifungal shampoos with ingredients like selenium sulphide and ketoconazole can alleviate this. Please consult your GP before starting any treatment, so a fungal infection can be confirmed.
• Pre-existing skin conditions – scalp eczema and psoriasis can flare up during pregnancy; stress can contribute to this. Use your doctor-approved treatments to manage the symptoms.

External factors

• Increased hair product sensitivity – pregnancy can increase sensitivity to ingredients like sulphates and parabens, so avoid products containing these and look at natural alternatives.
• Increased sweat build-up – the increased body temperature during pregnancy can cause sweating, which can cause an itchy clap by clogging hair follicles. You can combat this with non-greasy hair products and dry the scalp with towels and a scalp-friendly powder.

Nutritional factors

• Dehydration can cause a dry scalp – remember to drink 6-8 200ml glasses of water a day and eat more hydrating foods like water-rich fruit and vegetables (cucumber and oranges, for example) and healthy fats like nuts and avocados (help retain moisture in the skin).
• Iron deficiency – itchiness is a symptom of iron deficiency during pregnancy. To increase skin health during pregnancy, eat more iron-rich foods like lean red meat, lentils, spinach and tofu.

More information on itchy scalp during pregnancy advice

We advise contacting your midwife or GP if you would like further information on reducing an itchy scalp while pregnant.

For other related queries, see the NHS page on itchy skin and learn more about ICB here and here for other complications during pregnancy.