Suffering from a dry, itchy and flaking scalp? When your head starts to itch it's normal to assume you have dandruff, but you could in fact have a dry scalp. From white flakes to an extremely itchy scalp, dandruff and dry scalp can share the symptoms, but they are two different conditions that require separate treatments. So what's the difference?
If you find yourself scratching or seeing flakes in your hair line, Dr Roger Henderson explains how to tell the difference between dandruff and a dry scalp, and the best course of treatment:
What is dandruff?
Dandruff is a common skin condition that results from dead skin on the scalp clumping together to form grey or white flakes, which are noticeable up close or if they fall on to your shoulders. You constantly produce new skin cells and sheds old cells and dandruff can occur when this cycle of skin renewal is sped up.
Dandruff is perfectly harmless and not contagious, but it may be unsightly if you have white flakes on your clothes and it can be difficult to treat. If your scalp feels dry and itchy it may be because of dandruff. Dirty hair does not cause dandruff but if hair is not washed often enough then oil can build up on it and contribute to flaking. There are several causes of dandruff including:
1. Fungal infections
Fungal infections can cause excess growth of skin cells. One of the most common is called malassezia, which normally lives on the scalp and is harmless but can be present in excess in young people and cause skin cells to multiply too quickly.
2. Seborrheic dermatitis
Seborrheic dermatitis is a skin condition that mainly affects oily areas of the body (i.e. anywhere you have oil glands such as the scalp, groin, along the nose and armpits) and causes the skin to become red and scaly before flaking off as dandruff.
Eczema is a condition that causes skin to become inflamed and itchy.
However, a dry itchy scalp that is not responding to treatment with a dandruff shampoo may be due to loss of natural moisture, so alternative treatments should be considered.
The difference between dandruff and a dry scalp
If you have tried anti-dandruff shampoo with no luck, there is a difference between having a dry scalp and dandruff, so this may be the reason why the shampoo isn't working. With a dry scalp, the skin becomes irritated and inflamed and flakes off whereas with dandruff the cause is too much oil produced on the scalp skin. This causes skin cells to build up and then shed, giving the typical dandruff appearance on the hair and clothing (usually on the shoulders) of people with it.
A dry itchy scalp can result if the natural moisture balance of the scalp is disturbed. A dry scalp can be caused by the following:
Skin conditions such as dermatitis/psoriasis
Hormonal changes, along with getting older in general
External factors such as changes in temperature or seasons
Certain hair treatments where there is a reaction to products such as gels, hairsprays and shampoos. This causes a condition called contact dermatitis.
There are some key ways of telling the difference between dandruff and a dry scalp. With dandruff, there are oily, large skin flakes that are yellow or white, with an itchy scalp and red, oily skin on the scalp. With a dry scalp however, the skin flakes are smaller and dry, along with an itchy scalp and often dry skin on other parts of the body, with the flakes usually disappearing once you have applied a moisturising treatment (unlike dandruff).
So if you do not have white or grey flakes of skin appearing in your hair but your scalp is itchy and dry, then it may be a good idea to try a scalp treatment to help restore the natural moisture balance.
When to see a doctor about dandruff
If you have been using an anti-dandruff shampoo for at least a month with no improvement, if your scalp becomes painful and more red, or if the skin of the scalp becomes increasingly inflamed or the inflammation spreads then seek a medical opinion. This will allow an accurate diagnosis to be made as there may be a different skin condition present that needs to be treated such as eczema or psoriasis.
Dandruff and dry scalp treatment
Although dandruff is not curable and has to be managed over many years, for most people, following some simple tips can greatly help reduce the effect of both dandruff and a dry scalp:
✔️ Avoid oily hair products
Try to avoid using harsh or strong hair products that contain alcohol or bleach as these rapidly dry out the scalp. Always avoid oily hair products too to help prevent a build up of excess oil.
✔️ Use anti-dandruff shampoo daily
If you have dandruff, use an anti-dandruff shampoo every day, making sure you rinse you hair very well afterwards. Most of these shampoos contain medication to kill any fungus and remove flaky skin - look for products containing some of the following:
✔️ Try tea tree oil
If you want to use a natural product for dandruff try shampoos containing tea tree oil. These can cause an allergic reaction in a very small number of people who use them so stop them if you develop any redness or irritation of the scalp.
✔️ Get some sun
There is some evidence that exposure to sunlight is helpful if you have dandruff so try to spend a little time in the sun every day, but also being careful not to get too much sun exposure on your skin.
Anxiety and stress may make things worse in some people so practice relaxation techniques such as deep breathing, yoga and meditation.
Last updated: 18-06-2021
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