Scalp itching associated with seborrheic hair loss can arise from two possible scenarios. One is that the itching is due to seborrheic dermatitis accompanying the hair loss. The other possibility is that the scalp, being greasy, provides a conducive environment for the proliferation of microbes, leading to a fungal infection of the scalp, which then results in itching and increased dandruff. In cases of seborrheic dermatitis, the affected area may show erythema and papules with oily scales or crusts, and there may even be exudation, crusting, and erosion, resembling eczema. The local treatment should primarily focus on degreasing, anti-inflammation, and itch relief. When fungal infection is also present, antifungal treatment becomes the priority. Ketoconazole shampoo can be used in such cases, applied three times a week for a period of 6-8 weeks.