Flaky skin on the face and scalp: causes and what to do

What causes dry, flaky skin and scalp?

Facial dryness can follow cold, dry weather, sun exposure, aging or drying products. Some medicines and health conditions also contribute. Scalp flakes do not automatically mean the scalp needs more moisture: dandruff usually relates to seborrheic dermatitis, which can cause redness and irritation as well as flaking.12

Seborrheic dermatitis affects oily areas, including the scalp and face. Yeast normally living on the skin contributes to an inflammatory response that produces itching and flakes. Products offer another possible connection: shampoo, conditioner and hair dye touch the scalp and can also cause a rash on other skin they contact.345

What causes flaky skin on the forehead and scalp?

Flaking on the forehead alongside scalp flakes can fit a condition affecting both the face and scalp, such as seborrheic dermatitis. The facial rash can look oily or dry and scaly. Forehead flakes alone cannot identify the cause: contact dermatitis, eczema and psoriasis can also affect facial skin.6

Seborrhoea means excessive oil production, not simply dry skin. Overactive oil glands commonly affect the face and scalp. When redness and greasy, scaly patches develop, the condition is called seborrheic dermatitis. For excess facial oil, washing twice daily with water and a mild soap or soapless cleanser helps remove oil. Antifungal creams reduce yeast on the skin, while hydrocortisone can reduce inflammation. Facial treatment needs care: using hydrocortisone longer than directed can itself cause a skin reaction.67

What causes flaky skin on the scalp?

How to care for dry, flaky facial skin

1. 1Wash with cooler water rather than hot water. Avoid rubbing or scrubbing, and pat the face dry.
2. 2Apply moisturizer within five minutes of washing. Moisturize multiple times daily if needed. Ceramides support the protective skin barrier, while hyaluronic acid helps add moisture.
3. 3Choose fragrance free products made for the face. Unscented products can still contain irritating fragrance chemicals.
4. 4For severe dry spots, gently dab on a petroleum jelly based product before bed. Limit or stop its use if pimples develop.
5. 5Protect facial skin from sunlight, wind and cold, dry air. Wear sunscreen daily.

Skip exfoliation while facial skin is dry and sensitive: removing flakes can also damage the skin beneath them. Review retinol, astringent toners, makeup and shampoo as possible contributors. A useful facial moisturizer can come from the drugstore, without a name that sounds like a research facility.1

Which scalp treatment fits the problem?

For dandruff associated with seborrheic dermatitis, shampoos containing selenium sulfide or zinc pyrithione can help. Ketoconazole shampoo targets the fungus involved in dandruff. Salicylic acid shampoos help lift scale, and coal tar products can help manage scalp psoriasis. These ingredients serve different purposes; a scale lifting shampoo and an antifungal shampoo are not interchangeable treatments.34

For a dry scalp, fragrance free moisturizing shampoo is an option. Tar shampoos can discolor light hair and increase scalp sensitivity to sunlight. Selenium sulfide shampoos can discolor hair and scalp. If ordinary shampoos irritate scalp eczema, an emollient lotion, a moisturizing preparation, can be used for washing instead, although it can leave hair greasy.4

What should you change in your hair routine?

Rinse shampoo thoroughly because residue can irritate the scalp. For scalp eczema, avoid fragranced products, including essential oils, and shampoos containing sodium lauryl sulphate. Reduce styling products, then reintroduce them individually to help identify a trigger. Keep the hairdryer on a low or warm setting rather than hot.45

Conditioner is designed to keep hair smooth and shiny, which is a job description rather than a scalp treatment. Because conditioner remains on hair after rinsing, it is more likely to irritate scalp eczema. Hair dye and bleach can also irritate an affected scalp.4

What should you expect from treatment?

Dandruff shampoo often controls dandruff, but facial seborrheic dermatitis usually needs treatment to clear. A clinician can combine shampoo with medicine applied to the skin for a short time. A product reaction tends to clear after exposure stops, even when the culprit is something you have used for years. Eczema and psoriasis need condition specific care rather than repeated attempts to remove the visible flakes.6

If a dandruff shampoo does not help, contact a healthcare professional. Stronger prescription shampoos or medicated creams, foams and ointments can treat the underlying inflammation. Scalp ringworm typically needs an oral antifungal medicine, so shampoo alone is not the treatment. Home remedies can make scalp problems worse.23

What if the flakes are on a baby's scalp?

Babies can develop cradle cap, a form of seborrheic dermatitis that usually lasts a few months and goes away on its own. Wash the baby's hair daily with mild shampoo and gently rub the scalp with your fingers or a soft brush. Severe cases need a clinician's advice about prescription shampoo or cream.2

When should you see a doctor?

• Arrange an assessment for scalp symptoms that persist, keep returning or come with hair loss, rash or pain.
• See a dermatologist if facial redness lasts more than two weeks.
• Get facial dryness checked if it looks wet and red, stays pink, does not improve or causes itching that interferes with daily life.
• Seek medical assessment for an intensely itchy scalp with pus filled bumps or hair loss; scalp ringworm requires prescription treatment.