Scalp psoriasis and dandruff often get mistaken for one another. While both scalp afflictions are fairly similar, there are some major differences between the two. We want to ensure you don’t confuse psoriasis with dandruff and vice versa. That’s why we reached out to The Scalp Therapist herself, Bridgette Hill, to get her expert breakdown on scalp psoriasis vs dandruff. The certified trichologist and founder of Root Cause Scalp Analysis weighed in on what each of these scalp issues is, what they look like, their major differences, and how to treat them. Read more below!
What Is Dandruff? What Does It Look Like?
Before we get into the differences of these scalp issues, it’s important to know what they respectively look like. Having this foundation will help you better differentiate between the two when figuring out which one you’re dealing with.
As far as dandruff goes, Bridgette shares it “is medically known as pityriasis capitis” and happens when “skin cells of the scalp shed at a faster rate than normal, creating a buildup.” Those with a healthy scalp have what Bridgette notes as layers of “tightly coherent cells.” Whereas those with dandruff don’t have these types of coherently formed layers. This “results in the development of what we call ‘flakes.'”
Dandruff is not a one-size-fits-all issue, as there are two types of dandruff: dry and greasy. However, Bridgette shares they are “caused by an overproduction of yeast, Malassezia. It is a monophyletic genus of fungi found on the skin and associated with a variety of conditions, including dandruff, atopic eczema (AE)/dermatitis, pityriasis versicolor, seborrheic dermatitis, and folliculitis.”
But what exactly does dandruff look like? Dry dandruff “is an accumulation of white, yellowish, or grey small scales that accumulate on the scalp that shed and produce a ‘snowfall of skin,” Bridgette shares. “With greasy or wet dandruff, the rapidly shedding skin cells bind together with scalp oil and produce mounds of dandruff that bind together. The color is often beige to yellow.”
What Is Scalp Psoriasis? And What Does It Look Like?
Now, onto scalp psoriasis. Bridgette notes “psoriasis is a condition that is genetically determined. It is believed that the initial onset of psoriasis can begin as a topical bacterial infection or brought on by stress.” It will appear “bright pink on lighter skin tones. On darker skin tones, the coloring can come across as more of a dark rose, like a healing scab with slight exposure of pink underneath.”
Similar to dandruff, it can appear as scaling, though it will have a much more defined pattern. “Patches on the scalp are often itchy and covered with silver, flaky scaly skin that is pink or red in color. The skin is raised and thick,” Bridgette points out.
There are also five different types of psoriasis, which Bridgette breaks down:
- Plaque: “This is the most common type and appears mainly on the scalp. It will manifest as patchy skin and flaky silvery white scales.”
- Erythrodermic: “This will apper as intense red skin that covers a vast area on the body.”
- Guttate: You’ll notice “small pink-red spots on the skin” with this type of psoriasis.
- Inverse: This is most often “skin irritation and redness that occurs in the armpits, groin, and in between overlapping skin on the body.”
- Pustular: “White blisters surrounded by red irritated skin” is what this type of psoriasis looks like.
What Are the Biggest Differences Between Scalp Psoriasis vs Dandruff?
There are quite a few differences between psoriasis and dandruff. There are three that Bridgette points to as the most notable ones.
1. Active ingredients won’t work on psoriasis.
“All types of dandruff will visibly diminish after an active ingredient shampoo is used to remove the scaling almost immediately,” Bridgette shares. “Active ingredient shampooing does not immediately diminish psoriasis. Shampooing psoriasis sometimes removes the outer scabs and leaves the patches exposed to raw skin cells.”
2. Their skin fall is distinctive.
While both produce flakes, their skin fall is not similar. Bridgette shares that “dandruff skin fall will more than likely always look more like dry salt flakes, where psoriasis resembles more of dry onion flakes.” Yum!
3. Only one can cause your scalp to bleed.
This is a fairly major difference between the two that many don’t know how to interpret. “Psoriasis is often accompanied by scalp bleeding and soreness,” Bridgette says. “Dandruff rarely is associated with bleeding.” So if your scalp is bleeding, it’s more than likely psoriasis, not dandruff.
How Do You Treat Dandruff?
The way you treat your dandruff will depend on the type you have. Bridgette does recommend you “look for products with ingredients such as selenium sulfide, salicylic acid, sulfur, coal tar, zinc, and alpha-hydroxy acids” no matter what type of dandruff you have. “In general, zinc and coal tar-based products applied to the scalp (scalp masks, scalp tonics) with anti-microbial properties will prevent unhealthy bacteria and fungus that can be developed on the scalp as a result of dry flakes on the scalp.”
Amino acids are a beneficial scalp care ingredient that can work for greasy and dry dandruff. “Sulfur amino acids, such as cysteine and methionine, help with managing dandruff by reducing skin cell buildup as well as offer antimicrobial properties,” Bridgette notes. “Selenium sulfide is for use on the scalp only and not to be used on the hair fiber. Also use selenium sulfide only on the specific area(s) where there is dandruff, bacterial or fungal infections, and extreme oiliness. Selenium sulfide is an agent that treats dandruff, and fungal infections on the scalp and skin. This agent also controls and reduces inflammation, itchiness, and redness of the scalp.”
Now, let’s dive into how to treat the two different types of dandruff.
How to Treat Dry Dandruff
Bridgett recommends you use “a shampoo that has active ingredients such as selenium sulfide, salicylic acid, sulfur, or zinc.” When it comes to using the shampoo, she shares you can “shampoo as often as needed yet alternate between dandruff fighting active ingredients and gentle daily shampoos to maintain the balance of the scalp’s microbiome. It is important to slow down the cellular turnover of the scalp when managing dandruff. It is the overactivity of the scalp’s cells that create the embarrassing flakiness.” Even though you may feel the urge to shampoo often, don’t. Doing so will only make things worse.
As far as a conditioner is concerned, Bridgette suggests using one “based on hair type and texture.” When you use the right products for your hair type, your strands will be better-taken care of. And who doesn’t want that?
How to Treat Greasy Dandruff
For greasy dandruff, Bridgette recommends you “have two types of shampoos in your arsenal: one that has the ingredients suggested for dry dandruff, as well as a shampoo for oily hair.” She prefers “clay-based shampoos for oily scalp,” because “the healing properties of clay slow down the overproduction of sebum, which is a culprit to greasy dandruff.”
Similar to dry dandruff, this type of dandruff can shampoo as often as needed, though you should alternate between using products with dandruff-fighting ingredients and ones that are more gentle. Again, you’ll also want to use a conditioner that is specific to your hair type and texture.
How Do You Treat Scalp Psoriasis?
When it comes to psoriasis, Bridgette notes it “can be treated with topical medications that are tar-based, have salicylic acid or lactic acids, and can be managed by dandruff fighting shampoos and oatmeal-based shampoos and conditioners as well.” A visit to your dermatologist couldn’t hurt either. They’re better equipped to arm you with products more tailored to your specific scalp needs.
An easy way to manage your psoriasis? Look at what you eat. Certain foods can trigger both psoriasis and dandruff. Bridgette suggests avoiding “yeast, high-sugar fruits, grains that contain gluten, deli meats, farm-raised fish, refined oils and fats, sugar, high-fructose corn syrup, artificial trans fats, vegetable and seed oils, refined carbohydrates, excessive alcohol, and processed meat.” Removing these from your diet could help minimize your scalp concerns more than you know.