If an itchy scalp and white flakes peppering your shoulders seem to be the embarrassing norm, read on to learn how to get them under control.
Dandruff vs. Flaky Scalp
“There are many causes of a flaky scalp,” says Amy Kassouf, M.D., a dermatologist at the Cleveland Clinic, “the main reason being seborrheic dermatitis [also known as] dandruff.” Dandruff doesn’t come from the scalp being dry, as most people commonly think. Instead, it comes from an overreaction to yeast commonly found on the skin, which leads to an overproduction of oils. This causes irritation, and the creation of oily, waxy flakes. Doctors aren’t sure why it happens to some people, but not to others.
Other causes of dandruff include illness and dermatological conditions. “People with psoriasis and eczema and other skin conditions can get flaky scalps as well,” says Dr. Kassouf.
Some factors don’t cause flaky scalp, but make flaking worse, including everyday stress, your diet, and hair products. “Protein-enhanced or enriched drug store shampoos and conditioners are loaded down with things like silicone and I’ve seen many scalps having trouble with them,” says hairstylist and cosmetology educator Stephanie Johnson, creator of HairFacePhoto.com.
Another factor that makes flaking worse: Age. As we get older our skin naturally loses moisture and dries out more easily. But points out, Dr. Kassouf, “Age is only one factor. Even things as simple as season changes can result in improvement or worsening of these scalp changes. Medications can contribute as well.”
How to Get Rid of Flakes
If you notice flakes, make an appointment with your dermatologist, who can tell you exactly what is going on with your scalp. He or she will likely recommend one of several of these remedies:
Dandruff shampoos ― “Dandruff shampoos come with many different ingredients,” says Dr. Kassouf. Your best bet is to read shampoo labels to find out the active ingredients. “Shampoos with salicylic acid help exfoliate the scales, selenium sulfide or zinc pyrithione decrease inflammation and certain types of bacteria and yeast, and ketoconazole is mainly to decrease yeast in the scalp,” says Dr. Kassouf.
Topical steroids ― Your dermatologist can prescribe topical steroid solutions such as hydrocortisone, which can be helpful in decreasing scalp inflammation.
Tea Tree Oil -- This natural essential oil found in health food and vitamin stores, is commonly used as an astringent on the skin to help unclog pores. You can rub a few drops into your scalp to help reduce itchiness and oil.
White or Apple Cider Vinegar ― “Sometimes something simple like rinsing with a diluted solution of vinegar can change the pH of the skin and rebalance the flora and diminish the irritation,” says Dr. Kassouf.
You might think that you should shampoo less often when you have dandruff, but that would be a mistake. Shampooing normal hair every day can strip oil from your scalp, leaving hair dry. When you have dandruff, there is an overproduction of oil, so shampooing daily to clear the oil is important. Dr. Kassouf suggests shampooing daily for a week or two until remedies kick in and sympotms get better. Also take time to brush your hair a few times a day. “Doing this, especially before bed, helps distribute the natural oils,” says Johnson.
A Word About Skin Cancer
While flaky scalp is most often benign, it can sometimes be a warning sign of skin cancer. “Skin cancers and general sun damage can result in flaky scalp as we get older, especially if there is hair thinning that lets sun get to the skin of the scalp,” says Dr. Kassouf. “if a scaly area never heals or begins to get sore or bleed or if a pigmented area changes, then it should be evaluated by a dermatologist.”
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