Asked And Answered: What Is Dry Scalp And How Can I Get Relief?

Flakes in your hair and uncomfortable itching can make anyone miserable, so it’s time to find out what’s causing your dry scalp, and how you can get some relief.

February 16, 2018
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It’s winter time, and many parts of the country have been experiencing record-breaking cold. The frigid, dry air can take a toll on your body. If you’re like most people, you’ve probably had to stock up on chapstick, body lotion, and facial moisturizer to keep your skin hydrated and healthy this winter. But the cold might be having an unexpected impact somewhere else: your scalp.

If you’ve been noticing white flakes on your shoulders or in your hair, or have found yourself reaching up to scratch more often, you might be experiencing dry scalp. This condition begins with an itchy, irritated feeling, and can lead to white flakes or red, irritated skin. Since it generally gets worse if left untreated, it’s important to get ahead of your dry scalp before it gets worse.

In order to know how to treat dry scalp, it’s important to recognize what it is and how it’s different from dandruff. Read on for two doctors’ insights on scalp health and answers to all your questions about dry scalp and scalp care.

What is dry scalp?

Dry scalp is, on a basic level, just what it sounds like: dry skin on your scalp, the area on your head beneath your hair. Dry scalp isn’t as common as dry skin because the scalp is typically a fairly moist area of the body.

“With such a high concentration of oil glands on the scalp, it is rare for the scalp to actually be dry,” says Asma Ahmed, DO, a double board-certified dermatologist specializing in medical, cosmetic, and surgical dermatology.

Dry scalp is usually caused by some sort of irritation (more on that in a minute!), but can also have environmental and health-related causes.  

What are the symptoms of dry scalp?

The first sign of dry scalp is usually increased itchiness or a feeling of irritation at the base of your hair. Next, you might notice small white flakes coming from your scalp. This is a sign that your dry scalp is becoming worse, says Shari Hicks-Graham, MD, a dermatologist who practices general, cosmetic, and surgical dermatology in Columbus, Ohio.

“Flaking occurs when skin dryness is more intense and the skin cells become detached from the skin,” she says.

If the condition isn’t treated, it can continue to get worse.

“Over time, if dry scalp is left untreated, flaking can lead to persistent scaling that is thicker and more pronounced,” Hicks-Graham says. “The scalp itself can also look more red in color, indicating that there may be some type of inflammation resulting from the dryness and irritation.”

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Eventually, severe and untreated dry scalp can even lead to hair loss.

“If the individual scratches the scalp repeatedly as a result of the itching, scalp rashes become worse, the skin may thicken, and hair loss may ensue,” Hicks-Graham warns.

Although dry scalp might not sound like the most serious condition, it can be both uncomfortable and frustrating, so it’s important to begin treating it as soon as you notice symptoms.

“The problem can be very annoying and can negatively impact the quality of life,” Hicks-Graham says. “Most cases of dry scalp can be treated very well, so do consider scheduling a visit with your healthcare provider for direct assistance.”

What causes dry scalp?

The underlying cause of dry scalp is decreased moisture on the scalp. However, there are a number of different environmental, lifestyle, and health-related factors that can cause that to happen.

“Some people have dry scalp chronically, but most only experience it from time to time due to environmental factors. Typically, dry scalp arises during the winter months when the air is drier and colder,” Hicks-Graham says.

Although environmental factors are the most common reason for dry scalp, there are other causes as well. For example, if you use a lot of hair products to protect your tresses, you could actually be doing more damage than good.

“Some haircare styling products or chemical processes such as coloring may cause irritation to the scalp which can lead to dryness,” Ahmed says. “Luckily, dryness because of this generally improves once you stop the insult-causing irritation.”

If you notice that you’re developing dry scalp, try backing off the products or switching to a product that is designed to moisturize the scalp (more on those later!). If you notice an improvement, it’s probably best to change up your haircare routine permanently.

People with other skin conditions including psoriasis or eczema might experience dry scalp more frequently, Ahmed says. That’s because these conditions decrease the skin’s ability to stay moisturized.

Isn’t that called dandruff?

Nope!

When most people see white flakes in their hair, they immediately think they have dandruff. Dandruff is a relatively common and well-known condition, and its symptoms can mirror those of dry scalp. However the causes, and therefore the treatments, of these conditions are distinct, so it’s important to understand the difference between dry scalp and dandruff.

Dry scalp is caused by a lack of moisture. Dandruff, however, is associated with excess oil and moisture on the scalp, Ahmed explains.

Dandruff, which is also known as seborrheic dermatitis, is usually caused by too much growth of Malassezia, a type of yeast that is naturally found on our skin. Like most yeast, Malassezia grows best in moist environments, including in moisture given off by the oil glands on the scalp.  

“The yeast flourishes in oil, thus someone who may have increased oil production or infrequently shampoos will be providing an environment ideal for the yeast to grow in,” Ahmed says. “The skin cell sheds more frequently with overproduction of the yeast, creating the visible flakes.”

Since both dry scalp and dandruff are characterized by the flakes on the scalp, it can be hard to tell them apart. However, if you’re willing to look closely you can spot the difference.

“Dandruff presents with greasy, yellowish or greyish flakes, and an itchy scalp,” Ahmed says. “The clumps may seem larger than what is seen in dry scalp. Typically the hair near the scalp may appear oily.”

The type of hair you have can also affect the symptoms you see.

“Straighter hair types may look and feel more oily with thick greasy, yellow scale on the scalp,” Hicks-Graham says. “Curlier, coarse hair types may demonstrate thick scaly plaques that are tougher to resolve with normal shampoos.”

Usually the treatment for true dandruff is an antifungal or a keratolytic—a treatment designed to address excess skin. Meeting with a dermatologist can help you identify whether you’re dealing with dry scalp or dandruff. A doctor will then be able to recommend the most effective form of treatment after giving a proper diagnosis.

“Scalp conditions fall along a spectrum and may partially overlap but the primary difference between dry scalp and dandruff is that dry scalp tends to be more transient and easier to manage, while dandruff (seborrheic dermatitis) typically requires a targeted regimen of products with active ingredients and routine maintenance,” Hicks-Graham says. “There is no cure for dandruff but it can be well managed.”

Ahmed agrees about the importance of consulting a doctor to know whether you’re dealing with dry scalp or dandruff.

“Since numerous scalp conditions may mimic each other, I highly recommend seeking out an expert dermatologist’s opinion to avoid misdiagnosis and wrong treatment,” she says.

What are the treatments for dry scalp?

If you’re dealing with dry scalp (not dandruff) you want to make sure that your scalp is getting more moisture. One way to do this is by using moisturizing or clarifying shampoos and hair oils like argan oil.

“Consider sleeping in (hair oil) overnight after massaging it gently into the scalp, and washing it out in the morning,” Ahmed says.

You can also use a boar-bristle brush to help redistribute your naturally-occurring oils, she says.  

Since dry scalp occurs most often during the dry winter months, you will want to incorporate increased scalp-care measures once the temperatures drop.

If you’re still experiencing symptoms of dry scalp, Hicks-Graham says you can try using an over-the-counter dandruff shampoo such as Head & Shoulders, Selsun Blue, or Neutrogena T-Sal. These are marketed as dandruff shampoos and have ingredients aimed at keeping yeast growth under control, but they also contain ingredients that will moisturize your scalp and reduce inflammation, so they can work on dry scalp, too.

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If you use a specialized shampoo for a month or two but are still experiencing flakes or itching, Hicks-Graham recommends visiting a dermatologist. The doctor can help you develop a proper haircare and scalp-care routine and may even provide a topical prescription steroid that can help reduce inflammation and alleviate symptoms.

Ahmed notes that many patients ask about natural remedies, but there isn’t yet evidence that these work. “Oftentimes patients ask me about tea tree oil or apple cider vinegar and whether they are useful in treating dandruff,” she says. “I have not seen any valid scientific studies proving either of these two are successful [scalp treatments].”

If you are experiencing dry scalp, it’s important to remember to be gentle with your treatment of choice.

“Try not to be aggressive with scratching the scalp to remove the flakes because harsh rubbing of the skin can cause damage that is difficult to manage over time,” Hicks-Graham says.

How can I prevent dry scalp?

One way to prevent dry scalp before it starts is to establish a haircare and scalp-care routine that works for you. This means finding products that work for your specific hair and skin types, and avoiding any products that are too harsh.

Hicks-Graham says it’s “critical to use shampoos to remove dirt and oil, yet avoid over-cleansing, which may irritate the skin barrier and cause additional discomfort.”

She recommends a new product line, LivSo, which includes a hydrating shampoo.

“It employs a unique formula of ingredients that help remove yeast and [prevent] flaking while being supremely moisturizing, which is particularly beneficial for curly or textured hair,” she says.

Eating well and staying hydrated can also help keep dry scalp at bay.

“Drinking water and eating foods high in healthy omega-3 fats may be helpful in preventing dry scalp as well,” Hicks-Graham says.

Why does my baby have such a dry scalp?

If you have a new baby, you might notice dry skin or flakes when you bend down to kiss the top of their adorable head. This is a common condition known as cradle cap.

Cradle cap, which is relatively common in infants and toddlers, is more closely linked to dandruff than dry scalp. This means it’s likely caused by overproduction of oil. To treat cradle cap, try shampooing your baby’s hair with a gentle formula once a day. You can also gently rub the flakes with a washcloth to remove loose skin.

Cradle cap will usually resolve on its own. However, if you’re concerned or the case is particularly severe, it’s best to talk to your pediatrician, who may recommend using a medicated shampoo or refer you and your little one to a dermatologist.

Dealing with dry scalp can be frustrating and embarrassing. No one likes to have white flakes on their shoulders, or to have to scratch an itch in the middle of an important conversation. Keeping your scalp well-moisturized, eating a healthy diet, and drinking plenty of water can all help keep dry scalp at bay.

If you continue to find yourself dealing with symptoms, don’t hesitate to get help. Although dandruff and dry scalp may be relatively common medical conditions, they can be treated and well-controlled, so don’t put up with unsightly or uncomfortable symptoms for longer than you have to!

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