What is the difference?
| Feature | Dandruff | Seborrheic dermatitis |
|---|---|---|
| What the name describes | Flakes shed from the scalp | A condition involving skin inflammation |
| Where it appears | The scalp; beard dandruff is also recognised | The scalp, face, ears and upper chest |
| What you can notice | Flaking and itching, sometimes with an oily, scaly scalp | Red, flaky, itchy skin that can be dry or greasy |
| How the terms overlap | Often caused by seborrheic dermatitis | Often called dandruff when it affects the scalp |
What causes the flakes?
Seborrheic dermatitis involves an inflammatory response to an overgrowth of yeast that normally lives on the skin. It tends to affect oily areas, and stress can contribute. The condition is not contagious and does not mean your skin is unclean. Dandruff commonly comes and goes, so returning flakes do not necessarily mean you have developed a new problem.126
How should you treat a flaky scalp?
- 1Consider the pattern first. An oily, scaly scalp fits dandruff; dryness elsewhere on your body can point towards dry scalp. These are clues, not a diagnosis.
- 2For dandruff associated with seborrheic dermatitis, try a medicated shampoo containing selenium sulfide, zinc pyrithione or ketoconazole. These ingredients help manage the condition.
- 3For ketoconazole shampoo, usual treatment is twice a week. Some people then use it every 1 to 2 weeks to help prevent dandruff returning. Irritated skin is its most common side effect.
- 4If moisture loss or product irritation seems more likely, switch to a gentle, nonmedicated shampoo and rinse thoroughly. Stop using a product that is causing irritation.
- 5If pharmacy treatments do not help, see a dermatologist. Prescription shampoos and medicated creams, foams or ointments can address yeast overgrowth, inflammation and itching.
Which hair care habits help?
Hair gels and sprays are optional styling products, not compulsory members of a bathroom committee. Reduce them if your scalp is irritated, then reintroduce products individually to identify a trigger. Keep your hairdryer on a low or warm setting rather than hot. Fragranced products, including essential oils, can irritate scalp eczema.3
Conditioner is designed to keep hair smooth and shiny, a fairly modest job for a bottle with so much label space. Because conditioner is designed to remain on hair, it can also irritate scalp eczema.3
What if the flakes are in your beard?
Beard dandruff can involve flakes, an itchy rash and greasy patches beneath the hair. Gently brush before washing to lift scale, without scrubbing. A dandruff shampoo containing 2% zinc pyrithione, 1% ketoconazole or 1% selenium sulfide can be used on the beard and scalp at least once a week. Persistent rash, pain, broken skin or acne like breakouts need a dermatologist's assessment.5
When should you see a doctor?
Get assessed if itching persists, treatment is not helping, or you have hair loss, a rash, swelling, warmth or pain. Thick scales with clearly defined edges can suggest psoriasis rather than dandruff. Psoriasis and seborrheic dermatitis can also overlap, called sebopsoriasis. Treating every flaky patch as dandruff can miss a condition that needs different treatment.1267
Where this answer comes from
- 1Dry Scalp: Causes, Treatment & Preventionmy.clevelandclinic.org
- 2Dermatitis: Types, Treatments, Causes & Symptomsmy.clevelandclinic.org
- 3Hair care for eczema of the scalpgloshospitals.nhs.uk
- 4About ketoconazolenhs.uk
- 5DIY treatment for 5 common beard problemsaad.org
- 6Why Is My Scalp So Itchy? 8 Common Causeshealth.clevelandclinic.org
- 7Psoriasis: On the road to discoverymagazine.medlineplus.gov
