It’s winter, which means your morning commute is dusted with snow and so are all your black sweaters, keyboard, and the hair in your brush... No, wait, that’s from your scalp. You might be wondering: how come every January you turn into Allison from The Breakfast Club? The answer isn’t as straightforward as it seems. You might be right to suspect dandruff, but you could also just be dry. (They’re actually different things.) “Both dandruff and dry scalp share main symptoms,” says dermatologist Dr. Michele Green, “but knowing which condition you have makes it easier for you to determine the right treatment.” Show One way to tell the difference is the the flakes themselves. What do yours look like? “Flakes from dandruff are oily, large, and either yellow or white,” says Dr. Green. “In dry scalp you’ll notice smaller, drier flakes.” If you still can’t tell, Dr. Green suggests a little overnight test. “Apply a light moisturizer to your scalp before bed. If the flakes are due to dry scalp, they should disappear once you shower the next day.” Test it on yourself tonight—don’t worry, this story will still be here in the morning. Have you figured it out? Great! Let’s move on to some solutions. Dry ScalpThe cause: “When your skin doesn’t have enough moisture,” explains Dr. Green, “your scalp becomes excessively dry. In return, the skin becomes irritated and flakes start to appear and shed off.” Trichologist (that’s a certified scalp expert) Michelle Blaisure adds that everything from external factors like dry air and a high-pH shampoo, to internal ones like psoriasis, diet, and hormonal imbalances can trigger a dry scalp. “Using too many hair styling products can trigger dry scalp as well,” says Dr. Green. The fix: Just like you would treat your skin in the wintertime, use things that are simple and moisturizing—lay off any extras you can go without, and stick to the basics. “A gentle shampoo followed by a moisturizing conditioner is helpful if you have a dry scalp,” says Dr. Green. Blaisure adds that these products should have a pH under 6.8. (You can buy pH indicator strips for cheap, if you want to be super extra.) The skin on your head is still skin, and it’s naturally slightly acidic—a low pH will keep a happy balance without stripping. Sulfate-free and color safe are always good indicators a shampoo is gentle, too, and you could even try a co-wash. To those with fine hair it might sound crazy, but that extra moisture might be just what your scalp needs. A clarifying treatment every so often (once a week, suggests Blaisure) keeps your scalp from accumulating buildup. And to treat it from the inside out, Blaisure recommends making sure you’re getting enough omega 3 fatty acids in your diet. “Salmon, walnuts, and flax seeds are all good sources of omega 3s,” she says. The cause: If the skin on your face is oily, then there’s a good chance your scalp will be, too. And dandruff is actually caused by an excess of oil—it gets trapped under layers of dead skin, causing it to flake off in patches. “Dandruff is most commonly associated with a scalp condition known as seborrheic dermatitis,” explains Blaisure. Also known as “cradle cap” because it’s common on babies, seborrhea causes oily patches of red, scaly skin. And it doesn’t just affect your scalp! “Seborrheic dermatitis can develop anywhere you have oil glands,” explains Dr. Green, including your armpits and face. Less common causes of dandruff are high amounts of a fungus called Malassezia, which can cause the skin cells to accumulate more rapidly than normal, and not shampooing enough. Bad news for those trying to prolong a blowout. The fix: To treat an oily, flaky scalp, Dr. Green recommends using a shampoo that’s specifically formulated for dandruff. You might want to start with something that contains salicylic acid to gently slough away dead skin that might be causing an oil buildup—Dr. Green recommends Neutrogena T/Gel. If that doesn’t work, your next line of defense are antifungals. Things with pyrithione zinc or selenium sulfide kill the fungus on the scalp to remove flakes,” says Dr. Green, “and tea tree oil is a natural alternative with antifungal properties.” Another route is using Nizoral Shampoo a few times a week as a clarifying treatment. And when all else fails, you can ask your dermatologist for a topical steroid solution. Your dandruff should resolve within a few weeks. Photo via ITG Medically reviewed by Raechele Cochran Gathers, MD — By David Railton — Updated on November 30, 2021 Dandruff and scalp psoriasis can look very similar, as both produce flakes of skin in and underneath the hair. However, there are significant differences between the two conditions that may help a person get a prompt diagnosis and treatment.
Psoriasis is a chronic inflammatory condition that affects multiple systems across the body, including the skin, the immune system, and the musculoskeletal system. It often presents as thick, itchy scales and plaques. Psoriasis often develops on the scalp. Unlike dandruff, the plaques of scalp psoriasis often have a silvery sheen and can look like dry scales on the scalp. Dandruff is a less severe chronic condition that affects the scalp. A dry or greasy scale may present on the scalp, and flakes from the scalp may fall onto a person’s shoulders and clothes. This article explains the difference between dandruff and scalp psoriasis. Although people often find it difficult to distinguish between psoriasis of the scalp and dandruff, these conditions do produce different symptoms. DandruffDandruff is a common scalp condition that causes small pieces of dry skin to flake from the scalp. These flakes can be noticeable and may cause a person to feel embarrassed if they fall onto the person’s shoulders. However, the condition is not contagious or harmful to overall health. Sometimes, what seems to be dandruff might indicate another underlying skin condition, such as seborrheic dermatitis, eczema, psoriasis, or fungal infection. A person should seek medical treatment for dandruff if symptoms are severe or do not resolve with over-the-counter (OTC) shampoos and ointments.
PsoriasisPsoriasis can affect any area of the scalp and will typically appear as thick, inflamed, and reddish patches or silvery-white scaling patches. Scalp psoriasis can cause extreme itching, and the skin might become so dry that it cracks and bleeds. Scalp psoriasis can also spread from the scalp onto the face. Other symptoms of scalp psoriasis include:
People should seek medical attention if they find any cracking or bleeding underneath what they believe to be dandruff.
Other conditionsA flaky scalp might develop as a symptom of several other health conditions, including:
Both psoriasis and dandruff may be due to an inflammatory response in the body, but researchers do not fully understand all the causes. Psoriasis causesAbout half of all people with plaque psoriasis will experience symptoms on their scalp. Scalp psoriasis has the same underlying cause as other forms of psoriasis. When a person has psoriasis, their immune system becomes overactive and instructs the skin cells to grow too quickly. This causes skin cells to build upon the surface of the skin in the form of thick plaques. Stress, extreme temperatures, and infectious illnesses can all trigger flares of scalp psoriasis. In the United States, more than 8 million people are living with psoriasis. Psoriasis frequently begins in individuals aged 15–25 years, although it can develop at any age. Dandruff causesDandruff is a common scalp condition that affects around 1 in 2 adults globally. Contrary to some people’s belief, poor hygiene does not cause dandruff, although infrequent shampooing can make it more obvious. Scientists do not completely understand its root causes. A person with scalp psoriasis may wish to consult a dermatologist. This is a doctor who specializes in skin conditions and can recommend appropriate treatments. Dermatologists also have more experience in differentiating between and diagnosing various skin conditions. Treatments may include the following: Topical treatmentsSevere cases of scalp psoriasis may require topical therapies, such as:
In addition, a person may find success with in-office treatments, such as excimer laser or other light therapies. Excimer lasers allow a dermatologist to treat only the affected areas of the skin. However, it often requires several sessions per week that last about 10 minutes each. MedicationsSystemic medications target specific parts of the immune system to reduce the frequency of flares and the severity of symptoms. For scalp psoriasis, however, doctors do not usually prescribe systemic drugs unless symptoms are severe or do not respond to other medications. Some systemic medications a doctor may prescribe for scalp psoriasis include:
People with more severe scalp psoriasis may need to try and combine several treatments before they find one that works for them. After repeated use, a person’s psoriasis may become less responsive to some medications. If this happens, they should speak with a doctor about their concerns. The doctor can help determine the next steps in treatment. There are many different OTC shampoos for dandruff. Some of these shampoos have slightly different instructions on how long people should lather or leave on the scalp before rinsing the hair. For maximum effect, a person should follow the label instructions closely. People can try using shampoos that have different active ingredients if their first choice is not effective. Active ingredients can include:
It is of note that coal tar may cause discoloration to hair that is not already black and make the scalp more sensitive to sun exposure. If a person’s symptoms improve, then they may be able to use the shampoo less often. However, if they stop using the shampoo altogether, dandruff will likely come back. If symptoms have not improved after a person has tried dandruff shampoos for longer than 1 month, they may wish to seek guidance from a healthcare professional. There are many ways that people who have scalp psoriasis or dandruff can care for their scalp. Certain steps can help manage each condition and provide some relief from symptoms. Scalp care for psoriasisThe following are some self-care tips for dealing with psoriasis:
Scalp care for dandruffAlthough each individual may require different treatment depending on the severity of their symptoms or the specific recommendations from a doctor, some care tips for dandruff may include the following:
A person living with dandruff may not need to consult a doctor. OTC shampoos and conditioners may be enough. If dandruff does not get better, however, a person should speak with a healthcare professional about other options. Individuals living with psoriasis should be monitored by a doctor. If treatment is no longer effective or if scalp involvement occurs, the doctor can help determine the best course of treatment going forward. If a person develops red, itchy patches on their scalp, they should seek medical attention as soon as possible. This could be a sign that psoriasis has developed. Scalp psoriasis and dandruff are different conditions that affect the scalp. Both can cause dryness and flakes to appear. However, psoriasis often presents with more severe symptoms, such as plaques, bleeding, and itchy or burning skin. A person can often treat dandruff with medicated OTC shampoos or conditioners. By contrast, psoriasis typically requires more extensive treatments to prevent flares and reduce the severity of symptoms. In either case, a person should seek guidance from a doctor if their treatment no longer works. The doctor can help determine the next best course of action. Read the article in Spanish. Last medically reviewed on November 30, 2021 |