What’s the difference between dandruff and psoriasis on the scalp?

Everyone has heard about dandruff, but you could be forgiven if you haven’t heard of scalp psoriasis. These two skin conditions share commonalities and affect many people across the world, with the predominant symptoms seen on the scalp. But how do you differentiate between scalp psoriasis vs dandruff?

What is dandruff and psoriasis?

Before we get into the differences, let’s have a look at these skin ailments and understand the cause of dandruff or psoriasis.

  • Dandruff – This is a widespread scalp problem, which affects almost 1 in 2 people globally. It is caused by excessive oil build-up on your scalp and a naturally occurring fungus known as Malassezia Globosa. If the sebaceous glands on your scalp end up secreting excess amounts of sebum and you can’t maintain a balance, the fungus gets to work. It breaks down the sebum into fatty acids that your body might react to. It triggers flaking of dead skin cells, redness and severe scalp itching.
  • Scalp Psoriasis – This is a chronic inflammatory condition that is classified as an autoimmune disease. Your immune system goes into overdrive and starts attacking healthy skin cells, considering them to be harmful foreign irritants. This leads to a shorter life cycle of your skin cells and a faster build-up, along with intense itching. This is why scalp psoriasis is usually associated with scaling on the skin and flaking of psoriasis dandruff.

It takes on the shape of red patches with silvery scales for lighter skin, and dark brown or purple patches with grey scales for darker skin. This condition can be triggered by tobacco, alcohol, stress, infections, extreme temperatures and even obesity. It is usually genetic in nature and passed down within the family.

Scalp Psoriasis vs Dandruff – How to tell the difference?

Certain symptoms are common to both these ailments, such as itching and flaking, albeit with some diverging characteristics. Identifying the difference between dandruff and psoriasis might help you pinpoint the treatment you require. Some of these are:

  • Oiliness – Dandruff is usually associated with an oily scalp, while scalp psoriasis comes with a dry scalp.
  • Location – Dandruff will affect your scalp and possibly your face – areas with the highest number of sebaceous glands. Scalp psoriasis is usually on the scalp, but can also affect the forehead, behind the ears, elbows, knees, groin and even the palms.
  • Scaling – You will find redness when suffering from dandruff and rarely see any scaling. Scalp psoriasis is characterised by the silver or grey scaling over raised skin. The psoriasis dandruff flakes would also vary accordingly.
  • Burning – Stinging, burning and soreness sensations are common with scalp psoriasis. This is not generally seen with dandruff.
  • Genetics – Dandruff may or may not be passed down, but you can inherit the sensitivity to fatty acids and an excessive oily scalp. Scalp psoriasis has a larger tendency to be passed down generations.
  • Itching and bleeding – Dandruff is characterised by itching of the scalp, but the intensity might vary. Scalp psoriasis comes with severe and intense itching, which can often lead to bleeding on the scaly skin.
  • Hair loss – Scalp psoriasis can also lead to temporary hair loss, something that is exacerbated by scratching. Dandruff will not usually result in hair loss.
  • Treatment – Dandruff can be solved with shampoos and good hair care, but for scalp psoriasis you would require medicated products.

Treatments for dandruff vs psoriasis 

Scalp psoriasis affects about 3% of the world, which is minimal when compared to 50% for dandruff. However, both these conditions can be troublesome for those who suffer from it. It’s important to get the right diagnosis and treatment so that you can move forward with life.

  • Dandruff – You can create your own hair mask with ingredients like aloe vera, neem, apple cider vinegar, lemon, or tea tree oil. Be careful with the quantities and always conduct a patch test first. You also get shampoos that are specifically designed for dandruff, like the Head and Shoulders Neem which can protect you from dandruff, germs and bacteria.
  • Scalp psoriasis – The first step towards solving your scalp psoriasis is to reduce the triggers – tobacco, alcohol, stress, etc. Your doctor might also prescribe oral medications or injections that contain blockers or inhibitors to counter scalp psoriasis. There are also medicated shampoos, gels, creams and sprays which contain ingredients like corticosteroids, salicylates, retinoids, and coal tar extracts. Never self-medicate and always get expert advice. People have also tried UV light therapy, which has shown to calm down inflammation and reduce symptoms.

These few differences between dandruff vs psoriasis should help you understand a bit more about how to spot the ailments. But always visit a dermatologist if you’re unsure and need an expert opinion.

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