Scaly Scalp

What is scaly scalp?

Scaly scalp is a common problem and usually causes flaking and itching.

What causes scaly scalp?

A number of different conditions can cause scaly scalp:

Dandruff - Skin cells are lost from everyone's scalp each day, but if more cells than usual are lost they clump together to form white or grey flakes of dandruff. Dandruff affects men and women equally and can cause irritation and itching.

Psoriasis - This condition is very common and while people of any age can be affected, it usually begins between the ages of 15 and 35. Psoriasis often affects the scalp, where red areas covered in thick silvery scales appear under the hair. Scalp psoriasis can be stubborn and difficult to treat and may look unsightly, but it is not infectious.

Seborrhoeic dermatitis - This may also be called seborrhoeic eczema. In children and adults seborrhoeic dermatitis causes itchy, scaly patches on the scalp. It can also affect the eyebrows, face, ears and the upper parts of the body.

"Cradle cap" - In babies this condition causes greasy, yellow scales to appear on the scalp, giving a crusty appearance. This can spread to the face and body.

How is scaly scalp treated?

The treatment for scaly scalp will depend on the cause of the problem.

If you have mild dandruff or seborrhoeic dermatitis it will usually improve if you use a medicated shampoo once or twice a week for at least a month. Medicated shampoos are available from pharmacies without a prescription. In seborrhoeic dermatitis use of a preparation containing salicylic acid or coal tar may help to remove the scales - ask your pharmacist about this. Shampoos containing ketoconazole (an antifungal) or selenium sulphide may also be used. Unfortunately the problem may return if treatment is stopped so you may need to continue one or more of these treatments for some time.

In some cases seborrheic dermatitis may require treatment with a topical steroid preparation.

For psoriasis affecting the scalp, your doctor may give you a steroid lotion or shampoo or a preparation containing coal tar. If you are unable to use steroids on your scalp your doctor may prescribe a preparation containing a vitamin D analogue to be applied directly to the scalp. Your doctor may also refer you to a hospital for specialist treatments.

Cradle cap (which you may also hear referred to as infantile seborrhoeic dermatitis) does not usually require treatment and will clear up on its own within a few months. However, there are a few simple measures that may help, such as washing the scalp regularly with baby shampoo then brushing gently with a soft baby brush to loosen the scales. Massaging olive oil or baby oil into the scalp may also help to loosen the scales. Shampoos to help loosen cradle cap are also available to buy from pharmacies. If the cradle cap does not clear up after using these simple measures your doctor may prescribe an antifungal cream.

When should I see my doctor?

If your scalp problem does not clear up you should see your doctor who will examine your scalp. If you have eczema your doctor will check that it is not infected. If you do have an infection your GP may prescribe antibiotics.

Self-help measures

  • Do not use more than the recommended amount of prescribed cream or lotion or mousse - this will reduce the risk of side effects
  • Do not wash your scalp too frequently as this can dry your skin and encourage scaling and flakiness
  • Be careful when using hair styling products as they can irritate your scalp and make your condition worse
  • If your scalp is itchy, rub it gently. Your skin is delicate and can be damaged or become infected if you scratch it
  • Tar-based products can stain, so use old sheets and pillow cases
  • If you have blonde hair avoid shampoos containing tar which may discolour your hair

Further information available from:

National Eczema Society
Hill House
Highgate Hill
N19 5NA
Tel: 020 7281 3553
Helpline: 0800 089 1122 (8am-8pm, Monday to Friday) /

Psoriasis Association
Dick Coles House
2 Queensbridge
Tel: 08456 760076 / 01604 251620

Fact sheet provided by MIMS

Date last reviewed: May 2014

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