A dry, flaking scalp is most often suspected to be dandruff. But it could also be a sign of psoriasis or simply dry scalp.
Dry scalp is not classified as a medical term but is a more descriptive term for dry skin on top of the head.
Dandruff is commonly called a cosmetic condition as it’s neither life threatening nor contagious. Almost 50 percent of the world’s population will suffer from dandruff at some time in their lives.
Psoriasis is thought to affect least 100 million people worldwide and can be found on many other parts of the body too. Flaking or scaling of the scalp occurs in approximately 62 percent of psoriasis patients.
The Difference Between Dry Scalp, Dandruff and Psoriasis
Finding those first few natural snowflakes on your collar can often be quite distressing or embarrassing if in company. Despite the stigma of dandruff, it’s very rarely caused by poor hygiene and isn’t dirty as such. Dead skin cells may not be too appealing, but they’re certainly not catching.
If the problem is severe or doesn’t respond to a medicated shampoo, a visit to your healthcare specialist or a dermatologist will help diagnose what’s causing the flakiness. Dandruff is sometimes mistaken for dry scalp, a much easier complaint to treat. If left untreated, a dry scalp may result in dandruff. Dry scalp is probably the easiest problem to solve.
Dandruff can be annoying, but is pretty harmless. Scalp psoriasis on the other hand, is a completely different issue. Psoriasis is a chronic autoimmune disease which left untreated will have serious consequences for your health. Psoriasis is the most intense of the three conditions, with no cure you can only control or manage psoriasis.
A doctor should be able to diagnose which condition you have and start you on the right treatment. Although they all display similar symptoms, the treatment of dandruff, dry scalp or psoriasis are very different to each other. We’ll take a look at what makes each condition so different to enable you to effectively control the itching and flakiness of your condition more efficiently.
What Is Dry Scalp and What Are Its Characteristics?
A dry scalp occurs when your skin has too little moisture and can often be triggered by cold, dry air, diet, a reaction to hair care products causing contact dermatitis or as the body gets older. Skin on the scalp becomes irritated and flakes off due to dryness. If you have a dry scalp, you may find other parts of your body like your arms or legs have dry patches too.
Dryness and an itchiness are the primary symptoms of dry scalp accompanied by a shedding of white/off-white small flakes that people often mistake for dandruff. Flakes of dandruff tend to be larger, more greasy and a yellow or greyish color.
How to Treat Dry Scalp
Dry scalp is most commonly treated by changing your hair routine. Some shampoos can contain harsh chemicals, including sulfates and astringents, that can strip natural oils and moisture from the scalp. A clarifying shampoo can help remove product buildup that can be drying out the skin while there are many shampoos and conditioners that can moisturize or nourish both the hair and scalp. In more extreme cases formulas, or scalp-moisturizing masks are available to penetrate the skin and moisturize and protect the scalp.
As we said earlier, dry scalp isn’t really a medical disorder by itself, but can be indicative of other conditions that may be causing it. If moisturizing products, changing your diet or protecting your scalp from the environment show no improvement in the dryness of your scalp, it’s beneficial to seek a doctor’s advice who may be able to pinpoint other potential causes.
What Is Dandruff and Its Causes
Dandruff is the most prevalent hair or scalp complaint in the world today with your local supermarket or online retailer usually carrying a wide range of anti dandruff shampoos. Dandruff that’s normally caused by seborrheic dermatitis can usually be treated quite easily and rarely leads to further complications. Dandruff normally manifests itself as flakes in the hair but may also be found on your clothing and sometimes carrying a distinctive smell.
Unlike flakes caused by dry scalp, the main cause of dandruff is excess oils caused by seborrheic dermatitis; a condition that turns the skin oily, red and scaly. Yellowish or grey scales flake off forming dandruff. Seborrheic dermatitis happens anywhere on the body where there are oil producing glands including the eyebrows, armpits, groin area and down the sides of your nose. Sometimes babies can suffer seborrheic dermatitis called cradle cap.
A fungus is naturally found on the scalp called Malassezia that triggers the dandruff. When you have an excess of this yeast, or fungus, the skin cells multiply quicker than usual which causes flaking. Stress, hormones and age are major factors which cause Malassezia to multiply. This is why dandruff can be prevalent in puberty as our bodies go through hormonal changes which cause the body’s oil production to run wild and the stress associated with these changes.
How to Treat Dandruff
Again most dandruff treatment can be carried out at home by using one of the many specialized hair products that fight dandruff. Simply moisturizing the scalp won’t work for dandruff and may even contribute to excess oils that cause the dandruff. Active ingredients, either chemical or botanical are used which can absorb excess oils and slow down the growth of yeasts and fungi like Malassezia.
Active ingredients including pyrithione zinc (found in most Head and Shoulders products), selenium sulfide and ketoconazole are antifungal drugs that kill the flake-causing fungus on your scalp. Other treatments may include salicylic acid or coal tar which remove extra scale from your scalp and slow the growth and shedding of skin cells. Botanical ingredients like tea tree oil, cinnamon, thyme or peppermint oils are also used in many formulas to fight the fungus if you prefer a less chemical route.
If after using an over the counter treatment for a month you don’t see any significant decrease in the flakes, they’re getting worse or your scalp looks redder or more swollen, a doctor may be able to assess whether you have a more chronic condition like eczema or psoriasis. Although dandruff can never fully be cured, the Malassezia yeast occurs naturally on the scalp, it should be controllable with the right treatment and present no further health complications.
Psoriasis—an Autoimmune Disease
Although both dry scalp and dandruff can be annoying, psoriasis is a chronic condition. An autoimmune disease which can affect all parts of the body caused by white blood cells that are meant to be fighting off infection attacking your skin cells instead. Scalp psoriasis is more scaly than flaky with milder psoriasis cases looking like silver colored scaly patches on the scalp that shed in tiny pieces. More severe cases can be red and painful and may extend past the scalp down the back of your neck or to the skin surrounding your ears. This short Youtube Video takes a microscopic look at the difference between dandruff and psoriasis:
How to Treat Psoriasis
Psoriasis is medically treated with topical medications or lotions that can sometimes be steroid based. They won’t cure psoriasis but can make the symptoms milder. Topical creams can include anthralin, calcipotriene or tazarotene which slow the psoriasis skin build up and reduce red scaly patches on the scalp.
A doctor can also inject strong anti-inflammatory steroids into patches on your scalp in milder cases but more severe psoriasis may need much stronger drug treatment. Drugs that can affect how cells grow or slow down your immune system can be prescribed or botanics that are targeted for specific areas of the immune system. Ultraviolet or UV light treatment is sometimes used to control psoriasis patches, with special lamps or a handheld UV comb that shines the light directly on the scalp.
Symptoms can also be eased by many over the counter products too. Salicylic acid and coal tar based shampoos are effective at peeling away scaly areas of skin and there are many formulas available that are specially formulated scalps with psoriasis. Essential oils like argan oil can be an alternative route if your skin suffers from bad reactions to certain chemicals or you simply want a more gentle, natural remedy.
Dandruff, Psoriasis or Dry Scalp: Getting the Right Diagnosis and Treatment
Although all three scalp problems can share the same symptoms of flaking of skin and irritation to the scalp, following the wrong treatment may aggravate the condition you actually have. If over the counter methods don’t seem to work, or the symptoms are persistent, a visit to your health care provider or a dermatologist who can analyze your scalp and identify which condition is causing your irritation is advised.
Using a dandruff shampoo can actually further dry out the scalp and make the symptoms of dry scalp much worse. Using a moisturizing solution on seborrheic dermatitis dandruff can add to the sebum already present on the scalp and clog pores or follicles which will cause more dandruff. Psoriasis if not treated can cause further medical complications including psoriatic arthritis which causes joint damage and can be debilitating, eye conditions, obesity, cardiovascular disease and other autoimmune diseases.
One of the easiest ways to determine what’s causing your flakiness or itchy scalp is to look at the flakes themselves. Small dry white flakes tend to be caused by a dry scalp, larger yellowish or grey greasier flakes are more commonly dandruff and silver scaly patches, of dry and cracked skin may be psoriasis. Seek medical advice if in doubt, and whatever you do resist the urge to scratch (often easier said than done) and cause more infection or bleeding.