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Scaly or Flaky Scalp

Written by
Dr. Suvash Sahu
and medically reviewed by iCliniq medical review team.

Published on Dec 15, 2016 and last reviewed on Jul 08, 2019   -  2 min read



Dry, itchy, or flaky scalp can be a sign of dandruff or fungal infection. Dandruff is also the leading cause of hair fall. Learn about ways to get rid of it.

Scaly or Flaky Scalp

Scaly scalp or flaky scalp is raised, tiny flakes of skin in the scalp. The common causes of scaly scalp are cradle cap, dandruff, seborrheic dermatitis and psoriasis.

Cradle Cap

Cradle cap is also known as infantile pityriasis or Infantile seborrheic dermatitis. This condition is common within the first 2 to 3 months of life.


  • The common sites of proliferation of Malassezia species other than the scalp are eyebrows, eyelids and postauricular area, which may also be affected with an orangish-yellow crust or redness.


  • Mild cases can be managed by applying a mineral oil like olive oil over the scalp for 10 minutes before bathing.
  • After massaging the oil, a mild steroid and antifungal combination (1% Hydrocortisone with either 1% Clotrimazole or 2% Miconazole) should be used as it is very helpful.
  • Parents should be reassured that hair loss with the scale removal is normal and is not a permanent issue.
  • Shampoo containing Salicylic acid should be avoided due to the risk of salicylism.


Scaling due to dandruff (Pityriasis capitis) in the scalp is the most common at about 20 years of age.


  • Excessive sebum secretions due to influence of hormones.
  • Malassezia yeast, which is a lipid-dependent and free fatty acids.
  • Reactive hyperplasia of the epidermis.


  • Cessation of regular use is associated with recolonization of the scalp and a return of the condition. Thus, maintenance therapy is recommended.
  • The use of hair oil should be avoided because it acts as a food for dandruff.

Seborrheic Dermatitis

Seborrheic dermatitis and dandruff may be considered as the same condition, but it differs in the disease severity spectrum.

Seborrheic dermatitis is characterized by,

  • Erythematous flaky areas that are often associated with greasy yellowish scales.
  • The hair line and postauricular areas are most often involved except the eyebrows, nasolabial folds and sternum area (bony frontal chest area).


Psoriasis of scalp is common.

Site of Involvement:

  • The scalp may be the common site. The posterior hair line and the area above the ears are often the most obvious sites.
  • The presence of typical psoriasis elsewhere on the body or nails in the form of pitting or other psoriatic features.


  • In mild cases, treatment with a tar based or keratolytic shampoo is sufficient.
  • In more severe cases, they often respond well to topical treatments such as Calcipotriol lotion, Betamethasone lotion, Mometasone lotion or a combination of topical Calcipotriol and Betamethasone valerate.
  • If the scales are very thick, then the scalp should be treated with 15% Salicylic acid in mineral oil for 30 minutes. The Salicylic acid softens the scales, which can then be combed out with a fine tooth comb.
  • The treatment should be performed every evening until the scalp is clear, usually for a period of 7 to 10 days. Once the scalp is clear, then the maintenance can be achieved by repeating the treatment either once weekly or once fortnightly.

For further knowledge regarding scaly scalp consult a dermatologist online -->


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Last reviewed at:
08 Jul 2019  -  2 min read


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