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Flaky scalp (dandruff)
Category: Skin, Hair & Nails · All skin symptoms
What it can feel like
A flaky scalp means visible white or yellowish scales shedding from the scalp, often with itching. At the mild end it is dandruff — an inflammatory reaction to the normal yeasts living on scalp skin (seborrhoeic dermatitis); the same process can affect eyebrows, ears and the centre of the chest.
Possible causes
A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.
Common causes
A flaky scalp can be associated with seborrhoeic dermatitis, dry skin, infrequent washing allowing scale to build, sensitivity to hair products, and psoriasis of the scalp (thicker, well-demarcated plaques that may extend just beyond the hairline).
Other possible causes
A flaky scalp can also be associated with ringworm (tinea) — particularly in children, with patchy hair loss and broken hairs — and occasionally with eczema or, in severe widespread forms, weakened immunity.
Red flags — when to seek help promptly
- A child with scaly patches and patchy hair loss or broken hairs
- A scalp with a swollen, boggy, tender area (possible kerion — prompt treatment)
- Scaling with weeping, crusting or signs of infection
- A flaky scalp that fails to respond to standard anti-dandruff treatment over several weeks
- Scalp scaling joining a rash of similar plaques on elbows, knees or nails (psoriasis pattern)
What a clinician may do
A clinician will examine the scalp, hair and other typical sites, and distinguish seborrhoeic dermatitis from psoriasis and ringworm (a swab or scraping is used when fungal infection is possible). Antifungal shampoos, scalp treatments and topical anti-inflammatories are matched to the diagnosis.
Watch: related videos
Examination and clinical videos from the MedicalVideos.com library relevant to this symptom. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Is dandruff contagious?
Dandruff itself is not — the yeasts involved live on everyone's scalp, and dandruff is your skin's reaction to them, not an infection you catch. Ringworm of the scalp, by contrast, is contagious between children and needs antifungal treatment by mouth.
Why does it keep coming back when I stop the shampoo?
Because the yeast is a permanent resident — treatment suppresses the reaction rather than eradicating the tenant. Maintenance use once or twice weekly after a treatment course is the standard long-term pattern.
Related symptoms — Skin, Hair & Nails
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