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Like many things in life, the causes of an itchy scalp and dandruff — and how to get rid of them — are more complicated than I realized.
It’s winter, I thought. The rest of my skin is dry and chapped. It needs better hydration than it would in the summer. Shouldn’t that apply to my scalp as well?
Turns out the answer is no.
“Dry scalp is not akin to dry skin,” said Dr. Julia Tzu, founder and director of Wall Street Dermatology. “It’s a completely different condition. It has nothing to do with how dry the weather is. It’s more to do with the amount of yeast burden in the scalp, and it also has to do with the amount of stress that someone is undergoing.”
Tzu said that when we talk about dry scalp, we often mean dandruff (the medical term is seborrheic dermatitis), which can be brought on by a variety of factors.
Dandruff is yet another way one’s body may respond to stress, and the scalp’s yeast load also tends to be higher for those with oilier skin, people with more abundant hair, and people who wash their hair less frequently.
That last part may seem counterintuitive, since hair seems to get dryer the more you wash it, and dryness causes flakes on other parts of the body.
However, the scalp is a whole different beast, according to Tzu. What happens there is not necessarily reflected in the feel or texture of our hair.
How to get rid of dandruff
Since oil and yeast in the scalp can be dandruff triggers, Tzu recommends washing your hair more frequently if you’re experiencing flaking. You may feel compelled to wash it less if the scalp feels dry or irritated, but a buildup of oil could actually be perpetuating the condition.
Anti-dandruff shampoos are a great over-the-counter option for treating dandruff. You can rotate these into your washing routine as often as your doctor or the instructions recommend. Tzu advises looking for yeast-controlling active ingredients like zinc pyrithione, selenium sulfide, or ketoconazole.
But there are different types of skin conditions that can affect the scalp, and the ingredients you need may depend on your particular skin.
If you have tiny flakes scattered in your hair, that’s most likely the result of seborrheic dermatitis or dandruff. A medicated shampoo with one of those yeast-controlling ingredients is the way to go.
Psoriasis, an immune system–related skin condition that causes itchy, scaly patches on the body, is another possible cause of flakes on the scalp. For scalp psoriasis where there are thick, crusted plaques covering the surface of the scalp, Tzu said, you should consider products with coal tar or potentially something exfoliating to help detach the dead skin.
If your scalp simply feels a bit dry without any flakes or signs of psoriasis, some sort of hydrating scalp serum may be all you need. Tzu described a therapeutic ladder of sorts: The treatment depends on the severity of your symptoms, and it’s always best to consult a dermatologist in case a prescription treatment is your best option.
With any medicated shampoo and general increase in washing to treat the scalp, it’s not uncommon for your hair to feel drier. Tzu’s advice for that is to massage the shampoo directly onto the root of the hair and the scalp and to avoid lathering the ends as much as possible. You can continue to use your regular conditioners or conditioning treatments on the lengths and ends to keep your hair smooth and shiny.
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