Many people often discover flakes of all different shapes and sizes and resort to the first question on their mind - What are these flakes? Let's break down what type of flake is yours. I have attached textbook example pictures for each diagnosis.
1. Is it just dandruff?
Let's start off the bat with this fact that will help you determine the cause of your flakes. Dandruff is restricted to the scalp. Dandruff is often involves itchy, flaking skin without visible inflammation.
How Do The Flakes Look? The flakes often look light, white to yellow and dispersed on the scalp without any erythema (redness). Can spread to the hairline, retro-auricular area (surrounding the ear) and eyebrows.
Treatment: A medicated anti-dandruff shampoo such as ours, DANDRX, which has not just an anti-fungal agent which is required, Pyrithione Zinc, but with double the strength of 2% while many over the counter shampoos have just 1%.
2. Is it Seborrheic Dermatitis?
Seborrheic Dermatitis can affect the scalp as well as other seborrheic areas such as face, arms, and legs. It also involves itchy and flaking or scaling skin, but also includes inflammation and pruritus.
How Do The Flakes Look? Mild desquamation to honey-colored crusts attached to scalp and hair leading to alopecia. May reach into forehead as scaly erythematous border known as “corona seborrheica”.
Treatment: Similarly, you will need an anti-fungal agent that targets the common fungus that causes this, Malassezia. However, for those with resistant Seb Derm - you will need to see a dermatologist to discuss second and third line treatment options!
3. Is it Psoriasis?
Psoriasis is an immune-mediated, chronic, systemic inflammatory condition affecting the skin and other organ systems. The scalp is the most commonly affected region of the body in psoriasis, involved in about 80% of psoriasis cases
How Do The Flakes Look? Psoriasis lesions on the scalp are usually asymmetrical and sharply demarcated, and exhibit silvery‐white scaling.
Treatment: You will need to see your primary care physician and/or dermatologist to be treated with a combination of steroids vs. biologic agents in addition to further workup in regards to this autoimmune condition.
Medically Reviewed By
Dr. Khanna is a distinguished family medicine physician who brings a wealth of expertise by offering insightful and practical advice on a wide range of health concerns related to hair loss and dandruff. His experience in primary care gives him in-depth knowledge on managing common dermatological issues, including dandruff. Understanding the interplay between skin health, lifestyle factors, and medical conditions allows him to provide effective treatment strategies, from recommending medicated shampoos to addressing underlying causes such as seborrheic dermatitis or fungal infections. He provides a valuable resource for both patients and healthcare professionals, reinforcing the importance of comprehensive, patient-centered care.
