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Dandruff vs. dry scalp causes | Prevalence | Symptoms | Diagnosis | Treatments | Risk factors | Prevention | When to see a doctor | FAQs | Resources
Do you ever see flakes in your hair and around your scalp? What about an itchy scalp? What causes these symptoms? While some people use the terms dandruff and dry scalp interchangeably, they are actually two different conditions. Although they may have similar symptoms, dandruff is caused by excess oil on the scalp, while dry scalp is caused by lack of moisture. The good news is that there are treatments and lifestyle changes that can help your condition. Continue reading to learn more about dandruff and dry scalp.
Causes
Dandruff
Seborrheic dermatitis is a type of skin condition that is called dandruff (also known as pityriasis capitis) when it’s found on the scalp. Too much oil on the scalp causes dead skin cells to build up, shed, and flake off—leading to those pesky dandruff flakes. Even babies get dandruff—the condition is known as cradle cap in babies. Although experts are not sure of the exact cause of seborrheic dermatitis, they think there may be different causes of dandruff, including:
- An overgrowth of a type of yeast called Malassezia
- Increased levels of hormones called androgens
- Increased levels of skin lipids (natural fats)
- Inflammation
- Family history
Seborrheic dermatitis may also be triggered or worsened by things like stress, a cold/dry climate, oily skin, alcohol-based skin products, and a history of other skin conditions such as rosacea, acne, or psoriasis.
Dry scalp
A dry scalp problem can be caused by several reasons. For example, hair care products may strip the hair of its natural oils and cause a reaction called contact dermatitis, leading to an irritated, dry scalp. Weather can also play a role—low humidity and cold climates can cause dry scalp. Also, as you get older, your skin (including the scalp) starts to dry out.
More serious causes of dry scalp may include medical conditions such as psoriasis, scalp ringworm (a contagious fungal infection of the skin on the scalp also known as tinea capitis), or actinic keratosis (also known as solar keratosis), a type of precancerous sun damage.
Dandruff vs. dry scalp causes |
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| Dandruff | Dry scalp |
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Prevalence
Dandruff
Studies estimate that about 50 million people in the US experience dandruff, spending almost $300 million on treatments every year. Worldwide studies estimate dandruff may affect about 50% of the population.
Dandruff prevalence |
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| Dandruff | |
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Symptoms
Dandruff
The main dandruff symptom is the appearance of itchy, white flakes of skin on the scalp. When you scratch, the flakes loosen, mix in with the hair, or fall onto your shoulders.
Dry scalp
Symptoms of dry scalp may vary, based on the condition causing it. You may have itchy, flaky skin on the scalp, similar to dandruff symptoms.
People with psoriasis may see patches called plaques, scales (flakes of skin with a silvery color), temporary hair loss, and a dry, itchy, and/or burning scalp.
Individuals with scalp ringworm may notice scaly patches, patches of hair loss or broken hair, pink skin, and itchiness.
Those with actinic keratosis may experience skin-colored or pink dry, rough, scaly bumps or patches which may feel crusty or like sandpaper.
Dandruff vs. dry scalp symptoms |
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| Symptoms of dandruff | Symptoms of dry scalp |
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Diagnosis
Dandruff
Dandruff can usually be identified by its appearance on the scalp, without the need for testing. You can always consult a healthcare provider for a diagnosis, because sometimes dandruff can be a sign of another condition like seborrheic dermatitis, eczema, psoriasis, or a fungal infection.
Dry scalp
A dry scalp can often be identified by its appearance, without the need for testing. However, a dry scalp may be associated with a serious medical condition, so if lifestyle changes do not work, you should see a healthcare provider for a diagnosis and to check for medical conditions.
Dandruff vs. dry scalp diagnosis |
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| Dandruff | Dry scalp |
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Treatments
Treatments may be over the counter or prescription. You can always use a free SingleCare card or coupon to save up to 80% on the cost of your medications. (For OTC items, you’ll need a prescription from a healthcare provider in order to apply the SingleCare discount.)
Dandruff
When you have dandruff, it is important to wash your hair with a regular shampoo on a frequent basis, to remove the scales as quickly as they appear. If regular washing is not effective, you can purchase an over-the-counter dandruff shampoo. You can alternate regular shampoo with a dandruff shampoo. Nizoral 1% (ketoconazole) is an OTC antifungal shampoo that is considered very effective. Shampoos that contain active ingredients like selenium sulfide, salicylic acid, zinc pyrithione, or coal tar are also available. At first, you may need to use dandruff shampoo frequently, but, as symptoms improve, you may be able to use it less often. When treating dandruff with a special shampoo, lather the hair twice, and on the second lather, let the shampoo remain on the hair for five minutes before rinsing. Gently massage (do not scrub) the scalp.
People with recurrent dandruff or more severe cases may need a prescription shampoo, which can be prescribed by a healthcare provider such as a board-certified dermatologist. Some examples of prescription dandruff shampoos include the antifungal Nizoral 2% (ketoconazole) shampoo, or steroids such as topical Clobex (clobetasol) shampoo.
Because dandruff often recurs, your healthcare provider may recommend using prescription or OTC dandruff shampoos on a regular basis to help prevent dandruff from returning.
Dry scalp
Treatment for dry scalp depends on the underlying cause (what’s causing the condition). If hair care products are the culprit, you may need to try different products (such as a gentle shampoo or dry scalp shampoo) and/or take extra care to completely rinse out your shampoo—shampoo that’s not completely rinsed out can irritate the scalp.
If your dry scalp is caused by a serious health condition, consult your healthcare provider. A dermatologist can take a closer look and diagnose your condition and suggest a dry scalp treatment plan, depending on the cause.
If you have psoriasis, you may be prescribed a steroid ointment or cream to apply to the scalp and/or a medicated shampoo. They may also recommend light therapy and oral medication.
If you have scalp ringworm, you may be prescribed oral antifungal medicine like Lamisil (terbinafine), a medicated shampoo, and topical antifungal creams or steroids.
People with actinic keratosis may require topical medications like Aldara (imiquimod)—or other types of treatment like cryotherapy surgery (the dermatologist freezes precancerous cells on the scalp), or photodynamic therapy (the dermatologist applies special lights that activate drugs to destroy precancerous cells).
Dandruff vs. dry scalp treatments |
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| Dandruff | Dry scalp |
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Risk factors
Dandruff
Risk factors for dandruff include oily skin, overgrowth of Malassezia fungus, changes in skin barrier function, poor nutrition, stress, an inflammatory response, and immunosuppression.
Dry scalp
Certain hair care products, increasing age, dry and cold weather, and other medical conditions like psoriasis, scalp ringworm, and actinic keratosis, can increase the risk for dry scalp.
Dandruff vs. dry scalp risk factors |
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| Dandruff | Dry scalp |
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Prevention
Dandruff
There is no surefire way to prevent dandruff, but using anti-dandruff shampoo on a regular basis may help keep dandruff under control. If you see a healthcare provider for your condition, follow their recommendation for product usage. Also, avoid excess heat on the scalp, such as frequently blow drying. Because certain factors can increase the risk of dandruff, you can also try to get enough rest, minimize stress, and get a few minutes of sunshine daily (avoid the midday sun).
Dry scalp
If your dry scalp is due to a medical condition, ask your healthcare provider how best to manage and prevent dry scalp. General tips for preventing dry scalp include using a gentle, moisturizing shampoo, minimizing stress, drinking plenty of water, washing your hair less often, stopping smoking, and using a humidifier at home.
How to prevent dandruff vs. dry scalp |
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| Dandruff | Dry scalp |
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When to see a doctor for dandruff or dry scalp
It may be difficult to differentiate dandruff from dry scalp. And, in some cases, the symptoms of these conditions may be related to other medical conditions. A dermatologist can determine if you have dandruff or dry scalp—and also if you have a more serious skin condition. Also, if you try over-the-counter remedies and/or lifestyle changes and do not see an improvement, check in with a dermatologist. If your condition worsens or if you have redness, constant itching, irritation, or swelling, see a dermatologist.
Frequently asked questions about dandruff and dry scalp
How do you know if it’s dry scalp or dandruff?
It may be difficult to tell. Both conditions can result in similar symptoms of itchy and flaky skin on the scalp. People with dandruff have excess oil production, and may have an oily scalp with large pieces of dry skin. On the other hand, people with dry scalp may have dryness on other parts of the body. Dry scalp can also be caused by other conditions such as psoriasis, scalp ringworm, and actinic keratosis.
What does a dry scalp look like?
In general, dry skin on the scalp may be itchy and flaky. However, dry skin due to other medical conditions can vary in appearance, based on the cause.
How often should you wash your hair if you have a dry scalp?
It depends on various factors, such as age and ethnic background. If your hair is dry and prone to breakage, you may be washing your hair too often.
How do you hydrate your scalp?
You can hydrate the scalp by using a gentle, moisturizing shampoo. Wash your hair two or three times weekly. Limit heat as well as hair products that dry the scalp. Ask your dermatologist if there is anything else you can do to keep your scalp hydrated.
Do conditioners help with dry scalp?
Using a gentle, moisturizing shampoo along with a similar gentle, moisturizing conditioner, and washing your hair two or three times a week (along with avoiding heat and harsh treatments) can help with dry scalp.
Resources:
- Dandruff, Harvard Medical School
- Dandruff, University of Michigan University Health Service
- Dandruff, cradle cap, and other scalp conditions, National Institutes of Health Medline Plus
- Dandruff: what it is and what to do about it, Cedars Sinai
- How to treat dandruff, American Academy of Dermatology Association
- Seborrheic Dermatitis, Cleveland Clinic
- Dry Scalp, Cleveland Clinic
- Is your dry scalp something more serious?, American Academy of Dermatology Association
