Dandruff vs. Scalp Psoriasis: Symptoms, Images, Differences

How to tell the difference between these scalp conditions

Medically reviewed by Casey Gallagher, MD

Dandruff and scalp psoriasis are two similar conditions that share many of the same symptoms.

Dandruff is a mild form of seborrheic dermatitis and causes white or yellow skin flakes.

Scalp psoriasis is a chronic inflammatory condition characterized by silver or white scales.

This article will discuss dandruff and scalp psoriasis, their causes, and treatments for both conditions. It will also cover how to get an accurate diagnosis.

Scalp Psoriasis vs. Dandruff

Scalp psoriasis and dandruff are often confused and misunderstood conditions. They share some of the same symptoms, but these conditions differ. The following explains the specifics of each condition.

What Is Psoriasis?

Psoriasis is a chronic inflammatory condition that affects 1–2% of people in North America. The condition causes skin rashes with well-defined edges that are red with thick white or silver scales.

Psoriasis has no cure and goes through periods of remission and exacerbation. It can be a painful, irritating condition that interferes with daily activities.

What Is Dandruff?

Dandruff (pityriasis sicca) is a non-inflammatory skin condition that causes skin flaking. It is a common symptom of the mildest form of seborrheic dermatitis, a condition that causes skin irritation and redness. Research estimates that dandruff affects half of the adult population at some point in their lifetime.

Can Dandruff Lead to Psoriasis?

Dandruff does not lead to psoriasis. These two conditions have similar symptoms but are not the same.

Psoriasis causes thick white skin scales that can flake. This can make the two conditions seem similar.

Scalp Psoriasis

• Autoimmune condition

• Chronic
  

• Prescription treatment

• Causes dryness, flaking, skin scales, redness, and itching
  

Dandruff

• Non-inflammatory condition

• Acute or chronic

• Over-the-counter treatment

• Causes dryness, itching, and flaking

Scalp Psoriasis vs. Dandruff: Comparing Symptoms

Scalp psoriasis and dandruff are similar but have many symptoms that make them unique. Below is a list of symptoms of scalp psoriasis and dandruff.

Symptoms of Psoriasis on the Scalp

Scalp psoriasis can be found in the hair area or extend outside of skin covered with hair. The symptoms can include:

• Red patches on the scalp

• Silver, white skin scales

• Flaking

• Itching

• Dry scalp

• Burning sensation

• Temporary hair loss

• Bleeding

Psoriasis is a chronic condition, and these symptoms can come and go. Not every person will experience these symptoms.

Dandruff Symptoms

Skin flakes are one of the most common dandruff symptoms. Many people realize they have dandruff for the first time when they see skin flakes on their shoulders or in their hair.

The other symptoms of dandruff include:

• Flaky skin

• Scalp rash

• Itching

• Burning

Scalp Psoriasis vs. Dandruff: Understanding the Causes

Scalp psoriasis and dandruff have very different causes. This section will explain the causes of these two conditions.

What Causes Psoriasis on the Scalp?

An autoimmune condition causes scalp psoriasis. It occurs when someone's immune system does not work properly and tells the skin cells to grow too quickly. The new skin cells develop in days instead of weeks.

When this happens, psoriasis patches appear because the body does not get rid of the extra skin cells and the skin cells accumulate on the skin.

Why Does Dandruff Occur?

A mild form of seborrheic dermatitis causes dandruff. The cause of this condition is not entirely known, but it is thought to be a combination of yeast found on the skin (Malassezia) and excess oil (sebum) in the oil glands and hair follicles.

Dandruff begins around puberty when hormone levels increase, and the body produces more oil. Cold, dry weather and certain hair products can worsen dandruff.

Treating Psoriasis on the Scalp

Scalp psoriasis treatment can come in many forms.

A healthcare provider will examine the rash and determine the best therapy route. In some cases, it may take multiple treatments to effectively treat psoriasis. The treatment options include:

• Shampoos: A salicylic acid shampoo breaks down the outer layers of skin and can help medications like corticosteroids reach the scalp. A clobetasol propionate shampoo is also effective in treating scalp psoriasis.

• Topical treatments: There are many topical treatments available for scalp psoriasis. Some of the most common are Compound W (salicylic acid), Ala-Cort (corticosteroid), Anthra-Derm (dithranol), and Daivonex (calcipotriol).

• Oral treatments: These treatments can also improve scalp psoriasis. They include Otzela (apremilast), TNF inhibitors, and IL-12/IL-23 inhibitors.

Dandruff Treatment

Over-the-counter medicated shampoo is the typical treatment for dandruff. There are many types to choose from, but you should look for shampoos that contain one of the following active ingredients:

• Zinc pyrithione

• Selenium sulfide 1%

• Tar-based shampoo

• Ketoconazole

If dandruff does not improve after four to six weeks, try a shampoo with a different active ingredient.

Differences Between Psoriasis and Dandruff

The primary difference between scalp psoriasis and dandruff is their cause:

• Psoriasis is an autoimmune condition that does not have a cure. Treatment can improve psoriasis symptoms.

• Dandruff is flaking skin from a condition called seborrheic dermatitis.

Getting an Accurate Diagnosis

A healthcare provider can diagnose both scalp psoriasis and dandruff by looking at the scalp. They may ask questions about itching and flaking.

To diagnose scalp psoriasis, a healthcare provider may need to take a small piece of skin to send to a lab.

Summary

Scalp psoriasis and dandruff are two different conditions with a few overlapping symptoms. They both cause skin flaking, itching, and sometimes a rash.

Read the original article on Verywell Health.