It’s one of the most common myths I hear in clinic: “I shaved my head—so why do I still have dandruff?”

The truth? You don’t need hair to have dandruff. In fact, many bald or closely shaved individuals continue to experience flaking, itching, and irritation on their scalps. As a physician, I see this all the time—and there are good biological reasons behind it.

Let’s break it down.

First: What Is Dandruff, Really?

Dandruff isn’t about hair—it’s about skin.

Specifically, it’s a reaction in the scalp’s skin barrier, often involving:

• • Malassezia yeast overgrowth – A fungus that thrives in oily areas.

  • Seborrheic dermatitis – Chronic inflammation that causes redness and flaking.

  • Dry skin – Often worsened by overwashing or harsh cleansers.

  • Product irritation – Especially after shaving or using aftershave balms.

  • Underlying conditions – Like psoriasis or eczema, which can affect the scalp with or without hair.

Hair can sometimes hide dandruff flakes, but it doesn’t cause them. When the scalp’s microbiome or oil balance is disrupted, flaking can occur regardless of how much hair you have.

Why Bald Scalps Are Still Vulnerable

Even without hair, the scalp remains one of the most sebaceous (oil-producing) areas on your body. Malassezia yeast feeds on these oils and releases irritants that cause flaking and inflammation.

Shaving or waxing can also introduce microtrauma to the skin, disrupt the barrier, and make it easier for inflammation to take hold—especially if the skin is dry, irritated, or exposed to harsh products.

In other words: no hair = less coverage, not less activity.

What Dandruff Looks Like on a Bald Scalp

• • Fine white or yellowish flakes, especially around the crown or temples

  • Redness or mild irritation

  • Greasy sheen in some areas, dry patches in others

  • Itching, tightness, or burning after sun or shaving

  • Small pink plaques in the case of sebopsoriasis

It’s often mistaken for sunburn, dry skin, or razor irritation—but the underlying process is frequently the same one causing classic dandruff.

Treatment: What Actually Works

1. Antifungal Shampoos: Yes, even bald people should use them. Lather and leave on for 2–5 minutes before rinsing.These target Malassezia directly and reduce inflammation.

• • Ketoconazole 2%
  • Selenium sulfide 2.5%
  • Zinc pyrithione such as DandRX

2. Moisturizers With Barrier Support: Choose light, non-comedogenic moisturizers. Avoid alcohol-based aftershaves and fragrances. Look for:

• • Ceramides

  • Aloe vera

  • Urea (for gentle exfoliation)

3. Exfoliate—Gently: Once or twice a week, use a mild chemical exfoliant (like salicylic acid) or a soft scalp brush to help remove buildup.

4. Sun Protection: A bald scalp is exposed—and UV damage can trigger inflammation. Use a non-greasy SPF or wear a hat when outdoors.

5. Treat Underlying Conditions: If flaking persists despite treatment, you may be dealing with seborrheic dermatitis, psoriasis, or eczema. A dermatologist can help confirm and tailor treatment.

Final Word

Yes, you can be bald and still have dandruff. And no, it doesn’t mean you’re doing anything wrong.

The scalp is still skin—active, complex, and prone to the same issues as anywhere else on your body. The good news? With the right routine, even the shiniest scalp can stay smooth, clear, and flake-free.