Introduction:
A scaly or flaky scalp is found with tiny flakes of skin on the scalp. This occurs if the scalp has lost moisture due to various reasons. The common causes of the scaly scalp are cradle cap, dandruff, seborrheic dermatitis, and psoriasis. However, the condition can be treated if proper measures are taken. The scaly scalp may be severe in a few cases, requiring a dermatologist consultation. This article deals with the various causes of a scaly scalp and its management.
What Are the Causes of the Scaly or Flaky Scalp?
Skin shedding is a natural process that occurs without our notice. But it may be dandruff or seborrheic dermatitis when it sheds more quickly and in considerable amounts, appearing light yellow or white when a person rubs their head. The causes of the scaly scalp are:
-
A flaky scalp may also be inherited.
-
Oily-skinned individuals.
-
Medical conditions like Parkinsonism.
-
Shampooing frequently or rarely.
-
Improper rinsing off the shampoo.
-
Cold climate.
-
Stress.
-
Adverse reactions due to chemicals in hair care products.
-
Skin conditions like eczema and psoriasis.
What Are the Causes and Risk Factors of Dandruff?
Dandruff is called pityriasis capitis in medical terms. It is the most common scalp condition and starts appearing in individuals around 20. Itchy skin flakes on the scalp, hair, eyebrows, mustache or beard, and shoulders characterize it. The symptoms worsen during cold, dry weather, and stress.
The common causes are:
-
Excessive sebum secretions due to the influence of hormones.
-
Irritated skin.
-
Oily skin.
-
Malassezia, a yeast that feeds on oil, can cause dandruff.
-
Allergy to hair care products.
-
Reactive hyperplasia of the epidermis.
The risk factors of dandruff are:
-
Age: Dandruff is a significant problem, especially in the young age group. That does not mean older people do not have dandruff. There are a few cases with lifelong dandruff problems.
-
Gender: Dandruff problems are more common among men than women.
-
Health Issues: Diseases affecting the immune system, such as HIV, and those affecting the nervous system, such as Parkinsonism, can cause dandruff.
How Is Dandruff Treated?
Dandruff can be treated by:
-
Daily shampooing is recommended.
-
Antifungal shampoos containing Tar, Fluocinolone, Ketoconazole, Selenium sulfide, or Zinc pyrithione are effective. If any shampoo loses effectiveness after a period, use an alternative shampoo. When dandruff is under control, stop using medicated shampoo regularly; instead, use it only for maintenance.
-
Cessation of regular use is associated with recolonization of the scalp and a return of the condition. Thus, maintenance therapy is recommended.
-
Hair oil should be avoided because it acts as a food for dandruff.
What Is Seborrheic Dermatitis?
Seborrheic dermatitis and dandruff may be the same, but the disease severity spectrum differs. Seborrheic dermatitis is characterized by the following:
-
Erythematous flaky areas are often associated with greasy, yellowish scales.
-
The hairline and postauricular areas are most often involved, except the eyebrows, nasolabial folds, and sternum area (bony frontal chest area).
-
Psoriasis, especially when it affects the scalp, is common.
-
The scalp may be the common site. However, the posterior hairline and the area above the ears are often the most prominent sites. The presence of typical psoriasis elsewhere on the body or nails in the form of pitting or other psoriatic features.
What Is the Difference Between Dandruff and Dry Scalp?
Both conditions result in itchy and flaky scalp. This can make it difficult to differentiate. Excessive oil production can result in dandruff, while reduced moisture can result in a dry scalp. When there is too much oil production, there will be a buildup of cells, making the scalp appear red, oily, and scaly. These scales flake off, after which dandruff appears.
A dry scalp causes an itchy and flaky scalp, different from dandruff. If there is a dry scalp, then the person will experience dryness throughout the body. The loss of moisture in the scalp may be due to many factors.
How Is Seborrheic Dermatitis Treated?
The treatment of seborrheic dermatitis involves:
-
In mild cases, treatment with a tar-based or keratolytic shampoo is sufficient.
-
More severe cases often respond well to topical treatments, such as Calcipotriol lotion, Betamethasone lotion, Mometasone lotion, or a combination of topical Calcipotriol and Betamethasone valerate.
-
Besides topical creams, oral antihistamines can also be taken to limit the itchiness of the scalp.
-
If the scales are very thick, the scalp should be treated with 15 % Salicylic acid with mineral oil for 30 minutes. The Salicylic acid softens the scales, which can be combed and removed with a fine tooth comb.
-
The treatment should be performed every evening until the scalp is clear, usually for seven to ten days. Once the scalp is clear, maintenance can be achieved by repeating the treatment once weekly or fortnightly.
What Is a Cradle Cap?
A cradle cap is also known as infantile pityriasis or infantile seborrheic dermatitis. This condition is common within the first two to three months of life. The most common causes are overactive sebaceous glands in the scalp under the influence of the mother’s androgen, which is transferred through the placenta. The common sites of the proliferation of Malassezia species other than the scalp are eyebrows, eyelids, and postauricular area, which may also be affected by an orangish-yellow crust or redness.
How Is Cradle Cap Treated?
The treatment of cradle cap includes:
-
Mild cases can be managed by applying mineral oil, like olive oil, on the scalp for ten 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 beneficial.
-
Parents should be reassured that hair loss with scale removal is normal and is not permanent.
-
Shampoo containing Salicylic acid should be avoided due to the risk of salicylism.
How Can a Flaky Scalp Be Prevented?
The recommended tips to prevent a scaly or flaky scalp are:
-
Use a moisturizing shampoo followed by a conditioner.
-
Use an anti-dandruff shampoo at least twice a week and regular shampoo on the remaining days.
-
Use shampoo as per the instructions mentioned in the package.
-
Wash hair often.
-
Avoid scratching the flakes vigorously.
-
Try to control stress.
-
Hydrate oneself.
-
Avoid smoking.
Conclusion:
A scaly or flaky scalp may be of significant discomfort in one’s daily life. However, many people neglect it in their busy schedules and are not ready to fight against it. But the good news is that various remedies are available to treat it, which are nothing but the proper maintenance of hygiene and usage of products. However, if the remedies do not work, consult a specialist and get treated earlier.
