They both cause itching and flakes, after all.
When you first notice the telltale signs of scalp psoriasis, you might think you actually have dandruff. After all, scalp psoriasis may cause itching and white flakes, just like dandruff. Despite the similarities, there are some major differences between the two skin issues, and once you know, it will be easy to tell the two apart.
What Is Dandruff?
Dandruff is linked to an oily and itchy scalp. It’s notorious for causing visible white flakes of dead skin in the hair and on the shoulders. It can get worse when sebum oil (produced by the sebaceous glands in the skin) increases, such as during puberty or from cold winter air.
Dandruff is technically a mild form of seborrheic dermatitis, which is an inflammatory skin condition. It affects the sebaceous glands, and in more severe cases, it causes yellow and greasy scales on the scalp or face, as well as reddened skin in some cases.
Mild dandruff is treated at home with over-the-counter anti-dandruff shampoos. These special shampoos contain one of four different active ingredients, such as zinc pyrithione, to help combat dandruff. If one doesn’t work, you might find success with an alternative anti-dandruff shampoo that uses a different active ingredient.
If you’re using anti-dandruff shampoo as instructed on the bottle and you’re not seeing improvement in dandruff after a month or so, the itching and flakes may be caused by something else, such as scalp psoriasis or a more severe case of seborrheic dermatitis.
What Is Scalp Psoriasis?
Although scalp psoriasis can also cause a scalp that itches and causes flakes, it often also comes with other symptoms that distinguish it from your standard dandruff. Like seborrheic dermatitis, scalp psoriasis is an inflammatory skin condition. It speeds up skin cell turnover, resulting in a pile-up of skin called in patches called plaques.
You might have scalp psoriasis if your flakes are accompanied by:
Bright red patches (plaques) of skin with a silvery sheen
An itching sensation that feels burning and tingling
It’s important to recognize if your dandruff is actually being caused by scalp psoriasis. That’s because psoriasis is a sign that your immune system is overactive, and even though it manifests on the skin, it’s actually a sign of systemic inflammation that can cause complications throughout the body, if it goes untreated. Learn more about the complications of psoriasis here.
Talk to a dermatologist if your dandruff shampoo doesn’t help your scalp. An accurate diagnosis can help you find the treatment that works—for your scalp and for your entire body.
Dandruff. Jacksonville, FL: Nemours Foundation. (Accessed on March 26, 2020 at https://kidshealth.org/en/teens/dandruff.html.)
Dandruff. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on March 26, 2020 at https://medlineplus.gov/dandruffcradlecapandotherscalpconditions.html.)
How to treat dandruff. Schaumburg, IL: American Academy of Dermatology. (Accessed on March 26, 2020 at https://www.aad.org/public/everyday-care/hair-scalp-care/scalp/treat-dandruff.)
Managing itch. Portland, OR: National Psoriasis Foundation. (Accessed on March 26, 2020 at https://www.psoriasis.org/life-with-psoriasis/managing-itch.)
Nazik H, Nazik S, Gul FC. Body image, self-esteem, and quality of life in patients with psoriasis. Indian Dermatol Online J. 2017 Sep-Oct;8(5):343-6.
Over-the-counter (OTC) topicals. Portland, OR: National Psoriasis Foundation. (Accessed on March 26, 2020 at https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-hair-loss.)
Scalp psoriasis. Portland, OR: National Psoriasis Foundation. (Accessed on March 26, 2020 at https://www.psoriasis.org/about-psoriasis/specific-locations/scalp.)
Scalp psoriasis: shampoos, scale softeners, and other treatments. Schaumburg, IL: American Academy of Dermatology. (Accessed on March 26, 2020 at https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-shampoo.)
Seborrheic dermatitis. National Eczema Association. (Accessed on March 26, 2020 at https://nationaleczema.org/eczema/types-of-eczema/seborrheic-dermatitis/.)
Seborrheic dermatitis. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on March 26, 2020 at https://medlineplus.gov/ency/article/000963.htm.)