Dry Scalp and Dandruff: What's Causing Those Flakes?

If your black shirt is covered in white flakes and it's not snowing outside, your scalp is probably to blame. This symptom, commonly known as dandruff, can be due to a variety of conditions, from a simple dry scalp to a form of eczema or even psoriasis.

Understanding Dandruff

Dandruff flakes are actually dead skin cells that naturally fall off the scalp — more so if you scratch. Many people think that a dry scalp is synonymous with dandruff, but either a dry scalp or an overly oily scalp can cause excess cells to clump and fall off, forming dandruff flakes. A number of skin conditions and other causes can make your scalp flaky.

Some factors that can increase the risk of dandruff include:

  • Heredity
  • Hormonal changes, like puberty
  • Excess alcohol consumption
  • Eating high- sugar, spicy, or high-salt foods
  • Lack of nutrients like fatty acids and vitamin B
  • Weather changes
  • Stress

Common Dandruff Causes — and Treatments That Work

Dry scalp. Dry skin on the scalp can cause scaly flakes. Dandruff due to a dry scalp can be treated with inexpensive, medicated dandruff shampoos sold in drugstores. Look for products that contain pyrithione zinc, salicylic acid, tar, selenium sulfide, or ketoconazole. Use dandruff shampoo a few times a week to keep flakes away.

A gentle scalp massage and a good rinse can also help to prevent dandruff. Remember that your scalp can be sensitive to drying hair products, so take care with your hair and watch what you put on it.

Seborrheic dermatitis. A greasy, oily scalp is a result of increased production of sebum or oil from sebaceous glands around the hair follicles. An oily scalp can lead to other dandruff-producing conditions, notably seborrheic dermatitis, the name for eczema that affects the scalp. This skin problem results from inflammation of the oily areas, causing scaly, yellowish patches to form on the scalp and then flake off. Seborrheic dermatitis can be due to stress, oily skin, and certain medical conditions. Seasonal changes and a family history can also play a role.

To help prevent seborrheic dermatitis outbreaks, keep skin, scalp, and hair clean with frequent shampooing. Medicated dandruff shampoos can help treat the condition. Sulfur, selenium, zinc, or coal tar-based treatments are designed for serious cases.

Scalp psoriasis. This inflammatory skin condition gives the scalp a silvery, powdery appearance. Scalp psoriasis often causes thick scales and large, white flakes, and may cause itching. Psoriasis occurs for unknown reasons, but is thought to be an autoimmune condition. Although you can't prevent or cure psoriasis, various medical treatments, like coal tar, light therapy, and topical corticosteroid use can help manage psoriasis symptoms.

Irritant or allergic contact dermatitis. You can have an allergic or irritant reaction to a shampoo, styling gel, or other hair product. Using a product with an ingredient you’re allergic to or one that simply irritates the scalp can result in inflammation and dry, flaky skin. Discontinuing the product that causes a reaction may be all it takes to stop the reaction and the dandruff flakes.

Get a Dandruff Diagnosis

How do you know for sure what condition is causing your dandruff? Only a dermatologist can uncover the real cause and prescribe the best course of action. This is especially important when a medical condition like eczema or psoriasis is to blame. If drugstore dandruff shampoos and conditioners aren’t helping, get a firm diagnosis and advice on treatment from a specialist — and say goodbye to your flakes.

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