Scalp Psoriasis Vs. Dandruff: What Are The Differences?

Medically reviewed by Dr. Vindhya L Veerula, MD, FAAD
by Sucharita Mishra
Scalp Psoriasis Vs. Dandruff: What Are The Differences?

Is your scalp flaking and always itching? Well, it might be dandruff or scalp psoriasis. Both conditions are uncomfortable and seem similar, but they are way too different.

Dandruff is not a serious medical condition and is relatively easy to treat. However, psoriasis is a chronic condition that requires medical attention. In this article, we have explored the differences between dandruff and scalp psoriasis in detail and listed their treatment options. Keep reading to know more.

What Is Dandruff?

Dandruff is a non-contagious and common condition marked by a flaking and itchy scalp (1). It is mainly caused due to a dry scalp and can be uncomfortable at times. In some cases, underlying conditions like fungal infections like malassezia, eczema, and seborrheic dermatitis may also cause flaky and itchy patches on your scalp (2).

Dandruff can be easily treated at home (discussed later in the article) and is different from scalp psoriasis.

What Is Scalp Psoriasis?

Scalp psoriasis is a chronic inflammatory condition that causes scaly, red, and itchy patches on the scalp (3). Your skin cells multiply fast in this condition, causing the dead skin cells to buildup in patches on the scalp. These rough patches are often covered with white scales.

The exact cause of scalp psoriasis is unknown. It is thought to be caused by a combination of the immune system, genetics, and environmental factors. It may be aggravated by weather, stress, infections, and injury.

There are a lot of other factors that may trigger dandruff and scalp psoriasis. Let’s take a closer look.

Causes Of Dandruff And Scalp Psoriasis

Dandruff

  • Harsh hair care products like shampoos, dyes, hair sprays, creams, or gels may irritate the scalp and cause flaking, itching, and redness. This is also called contact dermatitis.
  • Irregular scalp cleansing and shampooing may cause oil buildup on the scalp that eventually flakes off skin cells.
  • Excessive dry scalp and skin can cause flakiness. You may also experience flaking on your body skin.
  • Malassezia (a type of fungus) that feeds on the sebum on your scalp also contributes to dandruff (2).
  • Oversecretion of certain male hormones may also cause dandruff. This is why dandruff is more common among men than women.
  • Those who have a weak immune system are also likely to have dandruff.

Scalp Psoriasis

Unlike dandruff, scalp psoriasis is a chronic condition. As stated earlier, the causes of this condition are not clear.

Psoriasis is a chronic inflammatory skin condition in which the antibodies (that are supposed to fight bacterial and viral infections) attack the healthy tissues, causing over-production of skin cells. Under normal circumstances, dead skin flakes off from your skin’s outermost layer in microscopic fragments. However, in psoriasis, the new and healthy skin cells rise to the surface before the older dead skin sheds, causing cell buildup that appears like scaly patches.

Psoriasis shares the mechanism of both autoinflammatory and autoimmune conditions. Currently, this condition is described as a systemic chronic inflammatory condition that has an immunogenetic basis (4).

Let’s take a look at the symptoms of both the conditions to help you distinguish between the two.

How To Know If You Have Dandruff Or Scalp Psoriasis

Dandruff Symptoms

  • Dry patches on your scalp
  • Skin flakes falling off your scalp
  • Itching

Scalp Psoriasis Symptoms

  • Red, dry patches of skin covered in thick, silvery scales on the scalp
  • Cracked skin that may bleed
  • Itching, burning, or soreness
  • May cause swollen and stiff joints

Now that you know the difference between the two conditions, here is how you can treat or manage them.

Treatment For Dandruff And Scalp Psoriasis

Dandruff

Dandruff is not a serious medical condition. It can be treated with over-the-counter products. You can use any gentle anti-dandruff shampoo to clear dandruff from your scalp. If you have excessively dry skin, keeping the scalp moisturized may also help. When buying shampoos for dandruff, look for these ingredients:

  • Coal tar
  • Zinc pyrithione
  • Salicylic acid
  • Ketoconazole
  • Selenium sulfide

If you prefer natural remedies, tea tree oil is an excellent natural treatment for dandruff (5).

Unlike dandruff, psoriasis cannot be cured or treated. However, it can be managed with prescription medication.

Psoriasis

Depending on the severity, the doctor may prescribe topical ointments, biologic medication, or steroid injections. Mild psoriasis can be managed with topical creams. Such creams slow down the skin cell buildup and reduce inflammation, redness, and scaly patches. These include (6), (7):

  • Anthralin (Dritho-Scalp)
  • Calcipotriene (Dovonex)
  • Calcitriol (Vectical)
  • Calcipotriene and betamethasone dipropionate (Taclonex)
  • Tazarotene (Tazorac)

Moderate to severe psoriasis may require more potent medications that could include (6), (7):

  • Methotrexate (Trexall)
  • Acitretin (Soriatane)
  • Cyclosporine (Gengraf, Neoral, SandIMMUNE)
  • Adalimumab (Humira)
  • Certolizumab pegol (Cimzia)
  • Golimumab (Simponi)
  • Etanercept (Enbrel)
  • Infliximab (Remicade)

UV light treatments are also used to control psoriasis patches (8). This treatment can be done at home.

When To See A Doctor

If your dandruff does not reduce even after using anti-dandruff shampoos, you may need prescription-grade products and medications. In the case of psoriasis, consult a dermatologist when you notice the first symptoms. Psoriasis may also be accompanied by stiff pain and inflammation in your joints, indicating psoriatic arthritis (9). In such cases, consulting a rheumatologist is also recommended.

In Summary

If the flaking does not clear up despite trying hair care and over-the-counter products, it is advisable to consult a doctor. Though dandruff and psoriasis may cause distress, remember that both can be treated or managed with a little effort and the right treatment.

Frequently Asked Questions

Is dandruff a genetic disorder?

It is uncertain. There are multiple factors responsible for dandruff, including environmental and genetic influences.

Does psoriasis spread?

Yes, it may spread from one area of your body to other parts. However, it is not contagious.

Is there any cure for psoriasis in homeopathy?

No. Psoriasis cannot be cured but can be managed with homeopathic medications like Hydrocotyle asiatica, Sepia, Arsenic, and Kalium sulph.

What does dandruff look like?

Dandruff looks like white or yellow flakes that are often found in the hair and shoulders of the person who has this condition.

Is psoriasis deadly?

It is rarely life-threatening. However, pustular and erythrodermic psoriasis can be fatal as they reduce the body’s ability to fight infections and control body temperature.

9 sources

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Sucharita Mishra

Sucharita Mishra has a Master’s degree in Biotechnology and specializes in writing on Health and Wellness. She has worked on determining various heavy metals present in green tea for her Master’s dissertation at CSIR- CFTRI, Mysuru. After completing her degree, Sucharita decided to pursue her passion for writing. She is addicted to all things black and aspires to become a bat one day.
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