Many people experience scalp issues such as flaking, itching, and discomfort. Two of the most common scalp conditions—scalp psoriasis and dandruff—can appear quite similar but are different in their symptoms and treatments.
Understanding how to differentiate between the two is key to taking care of your hair well. This guide is here to help!
What is Scalp Psoriasis?
Scalp psoriasis is a chronic condition that makes the skin on your scalp inflamed, producing thick, silvery-white or red patches. These patches are often itchy, painful, and prone to cracking and bleeding. Psoriasis is an autoimmune disorder that can develop in various parts of the body, including the scalp, and it tends to occur in cycles, with periods of flare-ups and then remission.
What is Dandruff?
Dandruff is a scalp condition that has the skin shedding small, white flakes. In its severe form, it is known as seborrheic dermatitis. Unlike scalp psoriasis, dandruff does not involve thick patches or plaques. Instead, it manifests as dry or greasy flakes, often accompanied by itchiness and irritation. While dandruff is generally less severe than scalp psoriasis, it can be embarrassing and uncomfortable.
Causes
Scalp Psoriasis
Scalp psoriasis may be caused by genetic and environmental factors. As an autoimmune condition, the immune system mistakenly attacks healthy cells in the body. When this happens, skin cell turnover speeds up dramatically. Instead of shedding every few weeks, skin cells on the scalp renew every few days, leading to the buildup of dead skin cells that form the scaly patches characteristic of psoriasis.
Scalp psoriasis is often triggered by:
- Stress: Emotional or physical stress can cause flare-ups.
- Infections: Bacterial or viral infections can worsen the condition.
- Injury to the skin: Even minor scalp injuries, such as a scratch or sunburn, can trigger a psoriasis outbreak.
- Medications: Certain drugs, including beta-blockers and lithium, are known to worsen psoriasis.
- Weather: Cold, dry weather can trigger psoriasis flare-ups.
Dandruff
On the other hand, dandruff has a more direct link to scalp oil production and the presence of Malassezia. The fungus thrives in oily environments and causes an inflammatory reaction that leads to excessive shedding of skin cells. Several factors contribute to dandruff, including:
- Oily or dry skin: Dandruff tends to occur more frequently in people with oily skin, but it can also affect those with dry skin.
- Irritated skin conditions: Conditions like eczema can cause dandruff-like symptoms.
- Not shampooing enough: An excess buildup of oil and skin cells can contribute to dandruff.
- Yeast overgrowth: The presence of the Malassezia fungus on the scalp is closely linked to dandruff.
- Environmental factors: Cold weather, high humidity, or extreme heat can make dandruff worse.
- Diet and stress: Poor diet and high levels of stress can exacerbate dandruff, though they are not direct causes.
Symptoms
Scalp Psoriasis
The symptoms of scalp psoriasis can vary in severity but typically include:
- Thick, red patches of skin: These patches may be covered with silvery-white scales and can appear anywhere on the scalp, extending to the forehead, neck, or behind the ears.
- Itchiness: Scalp psoriasis can cause intense itching, leading to discomfort and difficulty concentrating.
- Flaking: The scales from psoriasis often flake off, appearing as large, white or silvery flakes, which can be confused with dandruff.
- Bleeding and pain: The thick patches may crack and bleed, causing pain, especially if the scalp is scratched or irritated.
- Temporary hair loss: Although psoriasis itself doesn’t cause permanent hair loss, scratching and harsh treatments can lead to temporary hair thinning or breakage.
Dandruff
Dandruff symptoms are generally less severe than those of scalp psoriasis and may include:
- Flaking: Small, white or yellowish flakes of skin appear on the scalp and hair. They are more noticeable on darker clothing.
- Itchiness: Dandruff can cause mild to moderate itchiness, typically less intense than scalp psoriasis.
- Greasy or dry scalp: Depending on the individual, dandruff can occur alongside oily or dry skin. Oily dandruff often looks greasy, while dry dandruff results in finer flakes.
- No bleeding or thick patches: Unlike scalp psoriasis, dandruff does not cause thick, painful patches or lead to skin cracking or bleeding.
Self-management
If you have symptoms of scalp psoriasis and dandruff, consider these measures to keep them at bay.
Scalp psoriasis
Moisturise regularly
Keep your scalp well-hydrated. Products with ingredients like aloe vera, coconut oil, or jojoba oil can help reduce dryness and soothe irritation.
Use medicated shampoos
Use shampoos containing salicylic acid, coal tar, or ketoconazole, specifically formulated to treat psoriasis.
Take warm baths
Soaking in warm water with added bath oils or Epsom salts can help soften the scales and reduce itching.
Avoid triggers
Stress, cold weather, and certain drugs can trigger psoriasis flare-ups. Managing stress and protecting your scalp from cold weather can help reduce flare-ups.
Dandruff
Use anti-dandruff shampoos
Choose shampoos that contain active ingredients such as zinc pyrithione, selenium sulphide, ketoconazole, or salicylic acid.
Exfoliate the scalp
To clear away dead skin cells, use a scalp scrub or shampoo with natural exfoliants like tea tree oil or papaya enzymes.
Balance oil production
Regulating oil production is critical to managing dandruff. Green tea and witch hazel can be used as natural rinses to help control excess oil and soothe the scalp.
Stay hydrated
Drinking lots of water helps keep your scalp and hair hydrated from the inside out.
Minimise heat styling
Excessive heat from styling tools can dry out your scalp. Avoid using heat-styling tools or keep the temperature low to protect your scalp.
Common Treatment Options
Self-management may not be enough to get rid of dandruff and scalp psoriasis. These conditions can be persistent and often require professional treatment. Effectively managing scalp psoriasis and dandruff requires different treatment strategies because of their different underlying causes. Let’s explore the treatment options for both scalp psoriasis and dandruff.
Scalp Psoriasis
Managing scalp psoriasis often needs a combination of medical treatments and lifestyle changes to keep symptoms under control.
- Topical corticosteroids: These anti-inflammatory creams and lotions help reduce redness, swelling, and itching. They are typically prescribed for flare-ups and should be used under medical guidance to avoid side effects.
- Topical vitamin D analogues: Medications like calcipotriol slow skin cell production and reduce plaque formation.
- Coal tar products: Shampoos and ointments containing coal tar can help reduce scaling and itching. Coal tar slows the reproduction of skin cells and helps manage mild to moderate cases of scalp psoriasis.
- Salicylic acid: This ingredient is found in medicated shampoos and helps soften and remove the thick scales caused by psoriasis.
- Oral medications: In worse cases, oral medications such as methotrexate, cyclosporine, or biologics that target certain parts of the immune system may be prescribed.
Dandruff
Dandruff can often be controlled with over-the-counter treatments and good hair care practices.
- Anti-dandruff shampoos: Shampoos containing ingredients like zinc pyrithione, selenium sulfide, or ketoconazole are designed to reduce Malassezia and control flaking. Regular use is key to managing dandruff.
- Salicylic acid shampoos: These shampoos help exfoliate dead skin cells and prevent flaking.
- Tea tree oil: Being anti-fungal and anti-bacterial, tea tree oil can help control dandruff when added to your regular shampoo.
- Coal tar shampoos: Coal tar reduces skin cell turnover, which can help reduce dandruff symptoms.
- Moisturising treatments: Dandruff caused by dry skin can often be alleviated using moisturising shampoos or scalp treatments.
- Regular shampooing: Keeping the scalp clean can reduce the accumulation of oil and dead skin cells, helping to prevent dandruff.
TrichoLab Recommends
Psoriasis Rescue
Psoriasis Rescue is a treatment specifically crafted to address the symptoms of scalp psoriasis. It offers targeted relief for those dealing with inflammation and irritation. It works by deeply moisturising and soothing the scalp, helping to reduce discomfort and dryness.
The treatment effectively removes the buildup of scales associated with psoriasis, leaving the scalp feeling refreshed and clean. Additionally, it helps minimise discolouration and visible scaling, improving the overall appearance of the scalp. Psoriasis Rescue promotes long-lasting comfort and a healthier scalp environment by relieving persistent itching.
Scalp Exfoliating Treatment
This treatment is ideal for those with mild dandruff symptoms or those looking to maintain a healthy scalp and prevent buildup. It features papaya enzymes to gently exfoliate dandruff, alongside nourishing ingredients like centella asiatica and green tea extracts to balance oil levels. Oat protein extract is included to calm and soothe scalp inflammation.
Scalp Revival Treatment
Perfect for those dealing with more severe dandruff or a dry, flaky scalp, this treatment utilises medical-grade salicylic acid to eliminate dandruff and clear away scalp buildup. Once the scalp is clean, the hydrating nutrients in the nano mist essence can deeply penetrate, leaving your hair feeling fresher, calmer, and cleaner.
If we find that your condition warrants medication or doctor-administered treatment, we may refer you to our sister clinic, SL Aesthetic Clinic for treatment.
Scalp Psoriasis Treatment in Singapore
Though scalp psoriasis and dandruff may appear similar due to the flaking and itchiness they cause, they are fundamentally different conditions. Both require different treatment approaches and knowing which condition you have is the first step toward finding the right solution. If you suspect you have scalp psoriasis or dandruff, consider consulting a hair and scalp specialist.
TrichoLab’s hair and scalp specialists provide specialised treatment plans tailored to your condition. Our approach is based on treating the root cause of your symptoms while relieving itching, flaking, and discomfort.
Book an appointment for dandruff and scalp psoriasis treatment today.
