3 Hair Conditions that are Mistaken for Dandruff

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By Audrey Sivasothy, author of The Science of Black Hair: A Comprehensive Guide to Textured Hair Care

Everyone has had to deal with dandruff at one point or another.  And let’s face it, those flakes are just never welcome!  For most of us, a quick washing with Head and ShouldersNizoral, Selsun Blue, or some tea-tree inspired something is enough to clear up most flake flare ups— but sometimes dandruff can be, well . . . not really dandruff.  If you’ve used every dandruff treatment in the book and still can’t seem to beat the flakes, it might be that you are really fighting something other than dandruff.

How do you know if your dandruff is just dandruff, a false alarm, or a real symptom of something else entirely?

Before we talk about the dandruff false alarms— let’s talk about real dandruff.  Sometimes dandruff really is dandruff.  Real dandruff is believed to be caused by excessive growth of a fungus calledmalasezzia.  Malesezzia is naturally found on the scalp in non-dandruff sufferers, but the fungal population is out of control in those who are plagued with dandruff.  Experts are not quite sure why malassezia multiplies on the scalp, but many attribute its growth to having excessive amounts of oil on the scalp from infrequent cleansing, having a compromised immune system, poor diet, or simple hormonal changes in the body. In most cases, a standard shampoo regimen will clear up dandruff in a few weeks.  Common shampoo active ingredients include zinc pyrithione, ketoconazole, selenium sulfide, coal tar, tea tree and other tingly active ingredients.  For stubborn cases, the active ingredient in the shampoo may need to be rotated for best results (for example, using zinc pyrithione shampoo during weeks 1 and 2, and a selenium sulfide-based shampoo in weeks 3 and 4).

The False Alarms:
1. Dry Scalp

One commonly mistaken dandruff lookalike is plain old dry scalp.  Some products have a knack for drying out the scalp— shampoos are a common culprit.  Regularly using a soap or shampoo formula that is too harsh (usually sulfate-based) will lead to scalp dryness over time.  Other dry scalp instigators include weather changes, using water with a high mineral content or pH, and using water that is too hot.  Those who chemically treat their hair with relaxers, texturizers, or hair coloring products and those who overdry their hair when blowdrying may also run into this kind of problem as those treatments/techniques tend to dehydrate the scalp.  If you aren’t hydrating your body from within by drinking water, you’ll also tend to have dry skin— not just on the scalp— but all over.   Proper diet is also key to maintaining the skin— and essential fatty acid and Vitamin C deficiencies are common triggers of dry, itchy scalp  You can add more fish, citrus fruit, nuts and leafy green veggies to your diet to work around this, but know that it can take three months of good nutrition or more before the results improve.

2. Product Buildup

Product buildup and less than thorough rinsing can also lead to dandruffy looking conditions!  Conditioner is the number one culprit here, and in kinky-curly hair (or relaxed hair with considerable new growth) conditioner can become “trapped” near the roots upon rinsing.  If efforts aren’t taken to gently agitate or free conditioner that has settled close to the scalp, you will be in for an itchy, flaky mess once the hair dries.  In my experience, this type of buildup is also oilier and gummier— like a gross, icky blanket on the scalp.  Gels, serums and oils can also create sticky films that combine with sebum and regular debris to produce what looks like flaky, dandruffy scalp conditions.

3. Psoriasis and Seborrheic Dermatitis

Sometimes real dandruff can be a symptom of some other scalp condition— and making a distinction between plain dandruff, psoriasis and seborrheic dermatitis can be tricky.  What really helps distinguish the conditions from one another is the degree and kind of flaking you tend to get.  In psoriasis and seborrhea, dandruff is usually the main symptom among other symptoms like redness and crusting, for example.  Psoriasis tends to produce thicker, drier looking scales of skin than seborrhea does— and it also tends to appear on other parts of the body (knees/elbows).   Seborrhea tends to produce an oilier kind of flake.  Fortunately, treatments specifically targeted for basic fungal dandruff can help clear up outbreaks of psoriasis and seborrheic dermatitis. A quick visit to the dermatologist will help you figure out if your dandruff is just dandruff, a false alarm, or if you’ve got a dandruff as a symptom of something else.

Ladies, have you ever mistaken one of these conditions for dandruff?

Audrey Sivasothy is a Houston-based freelance writer, health scientist and author of The Science of Black Hair: A Comprehensive Guide to Textured Hair Care (available on Amazon.com & Barnes&Noble.com).

For more insight from The Science of Black Hair— relaxed, natural or in between, visit us on the web atwww.blackhairscience.com and on facebook & twitter.

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Black Girl With Long Hair

Black Girl With Long Hair

Leila, founding editor of Black Girl with Long Hair (April 2008), social media and black beauty enthusiast. When I'm not here, I'm moderating a Facebook group for black mothers called Black Moms Connect.

 

34 thoughts on “3 Hair Conditions that are Mistaken for Dandruff

  1. Good article! Yes I have mistaken the first two for dandruff. Number two is why I gave up co-washing. The build up was crazy. Hats off to whom co washing works for cause its a great concept. I have fine hair build up can happen over night. This especially sucks when you just washed your hair. One thing not mentioned up there is keeping your scalp covered too much without a breather. I notice that I get flaky scalp when I wear hats or scarves too long. Anybody else experience this?

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    • yeah co-washing only works if I don’t have much product in my hair and my hand is ‘heavy’ so co-washing is a no-no for me now. I get flaky scalp when wear hats too often too but I always thought it was material from the hat/cap!!!

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  2. I always was told by my hair stylist that I had really bad “dry scalp”. I assumed that she just meant that I had dandruff. Eventually, the flakes were all over my scalp & larger than just the fine dust that dandruff looks like. After talking to my mum & a dermatologist, I discovered that I have Seborrheic Dermatitis. I haven’t found anything to completely get it under control though.

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    • I have had seborrhea dermatitis all my life. The only thing that really made a difference after I went natural was washing with a shampoo with tea tree oil (I use Trader Joe’s Tea Tree Tingle), and putting tea tree oil on my scalp every day.

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      • I have the same scalp condition. I have dreads though. Seriously thinking about cutting them off. How often do you wash your hair?

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        • I have dreads too. And like you I’m tempted to cut mine off because of my scalp condition. I just can’t seem to find a good treatment and my scalp flares up so bad sometimes I’m embarassed and self-conscious when I leave my house.

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        • Oh no don’t cut your beautiful locs!! Reading all this, I just had to post on here just cause I’ve suffered from SD for 7 years — you need to cleanse from the inside out. ALL BEAUTIES READING THIS PLEASE do yourself a favour and do an internal cleanse! Nothing topical will cure it in the long run and it will always return as long as the yeast in your body lives. Also look into candida cleanses as well. Or see a naturopath. Drink a tablespoon of Apple Cider Vinegar everyday; it’s the little things that start to keep it down. Coconut oil in the hair, cooking with it, apple cider vinegar as a hair rinse will save the embarrassment as well. And I shampoo with Dr Bronner’s Tea Tree Oil Soap. Don’t know what I’d do with out it. I wash 2x a week. I even fell off my cleanse but I gotta get back on. It becomes a lifestyle but it’s worth it.

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    • I have seborrheic dermatitis on my scalp and on my face (nose and eyebrows). I have tried EVERYTHING to control it. I had ketaconzol shampoo prescribed and creams for my face. Going natural helped my scalp a little, but still a NIGHTMARE. My miracle came from two sources: Coconut Oil and Cortizone (over the counter cream). My boss told me to toss the prescription creams and use cortizone and it worked on my face. Then I read another article about a little girl in New Zealand whose hair wouldn’t grow b/c of dermatitis. the mom started using coconut oil on her scalp. I just started this recently on my scalp and face and I’m happy to say I don’t look scaly anymore. I rub a little on my face in the problem areas each night. I hope it helps.

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      • All of you guys should check out the book the coconut oil miracle. Get it from the library. Has a good section about dermatitis and other skin conditions. Very interesting read as it gives some science behind why coconut oil is superior. If cortizone is a steriod be careful with that stuff.

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        • i don’t use the cortizone on my scalp, just on my face in the really scaly parts. but if i’m diligent with the coconut oil, i usually don’t have to pull it out. :)

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    • I have seborrheic dermatitis, i find not putting oil on my scalp helped alot, which makes sense because the condition is your skin producing too much oil which clogs and irritates your pores, i also wash my scalp regularly, oo and also try taking a zinc supplement i found once i did that, I might get a minor itch but my scalp isnt caked with dandruff like it use to be. I also found when i my body was under stress, be it mentally or my immune system was down (e.g. winter cold) my scalp is at its worse, so i would say use it as an indicator that u should be paying attention to your health. saying that everybody is different good luck x

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  3. So…nothing about eczema?

    I have eczema on my scalp, and it makes its way down my forehead. My doctor said it is not just dry scalp (I drink plenty of water), build up or psoriasis. I do have eczema in other areas of my body, but this one is the worst. We know its eczema because it is “the itch that rashes”. I do lots of things to ‘cover up’ the dry, scaly looking areas, but only a liver flush really makes it go away. Coconut oil works well, as does a peppermint/tea tree oil mix (for me). It also causes flakes, which are quite embarrassing…

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  4. Good topic. Managing scalp psoriasis has been a struggle with my 4a/4b natural hair. I’ve often been curious about how other naturals deal with the condition. My longest strands are about 12″. Unfortunately, my hair has gradually thinned due to breakage from (1) over-washing my hair to keep the scaling/plaques under control and (2) excessive tangles (even when my hair is wet with conditioner) when trying to remove scales that get caught in my coils (I know… it’s kinda gross, but I’m simply explaining in order to get a bit of feedback).

    Wash-and-goes… notorious for causing tangles and knots… have been my go-to style for some time. I’ve found that the tangling is exaggerated when dealing with psoriasis. As a result, I’ve finally started to experiment with more twist-outs and protective styling. The psoriasis has been a bit more manageable with these styles.

    Also, I use a number of natural remedies on a regular basis which have been somewhat effective: massaging my scalp with aloe vera, adding tea tree to my hair oils and taking cod liver oil pills. Jason Naturals makes a gentle cream cleanser for the scalp, which I like; it treats dandruff and mild psoriasis.
    I use a cortisone cream on the temple area of my scalp, where I can see some visible thinning due to the psoriasis. It’s too early to say if this is working, but I’ve heard that it is helpful.

    I hope that I am on the right track to regaining the volume and length that my natural hair used to have. Would love your comments and suggestions!

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    • I had serious flakes in my head, I could remove them all and they would be back 12 hours later like they never left. Flakes was ruining my life. I couldn’t function. Then I tried the Shea Moisture Purification Masque(black label). I can finally go a whole week without washing my hair due to flakes. That stuff has changed my life. I rub it generously on my scalp, put a plastic bag on my head and let it sit for a few hours, then rinse it out. I also try not to have my hair tied up all the time and wear less hats.

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    • I SO feel you about your flakes being so big, they are scales that need to be removed…I actually have to slide them down the hair shaft to keep from damaging my strands. Does your scalp itch as well? Just curious…

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      • Yes, sliding the scales down my hair shaft is exactly what I have to do as well. It is quite tedious… and the scales that I miss seem to cause the problem with tangles and breakage when I cleanse.

        I do have problems with itching, but treating my scalp with aloe vera has worked wonders. I literally get immediate relief from itching once I apply aloe vera to the affected area. I use pure aloe vera from the leaf (I basically puree the inner gel, strain it, then add a bit of vitamin c powder to the extract to help preserve it… it lasts for at least a month in my fridge. To apply, I use a bottle that has an applicator tip so it goes directly to my scalp without wetting my hair much). Similar results can likely be achieved with aloe vera gel from a drug store.

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        • Thank God for this article! I too have to slide scales down the shaft of the hair- only problem is I have locs! And now this problem, which started about2 years ago and was only a minor nuisance until last year, has caused so much trouble. First: it’s unsightly and gross. I work in a professional environment, and I don’t want anybody being able to say anything about my hair! The dead skin tends to look like build up on my scalp and in my locs, which means I wash and twist more often than I should to try and keep it nice. And because the flakes don’t dissolve or melt away with shampoo (I’m sorry, I know how TMI this is) I end up picking the flakes out and inevitably breaking strands of my hair. So now my locs are thinning, my crown looks unkempt and I’m still none the better! I’m so at a loss here. Going to see my GP/dermatologist first thing next week but does anybody have a suggestion? I know how old this post is but I don’t want to lose my hair :(

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          • You and I are exactly the same. Locs, huge flakes, professional working environment, breakage and unkemptness from picking at flakes constantly. I’m really considering trying to wash more often. It’s just that I take a whole day to retwist when I wash and retwisting too often isn’t good in the first place. And I’m not a fan of the chemical stuff dermatologists gives you. My last derma gave me a mixture that seemed to work sometimes and when I called to get some more, apparently the supplier died and didn’t leave a successor. SMH. I’m really tempted to just cut my locs off and I’ve had them for almost 8 years now.

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  5. I have dry scalp and product build-up but the reason I still use soap over shampoo is that I’ve found that what works best on my eczema-prone skin also works best with my scalp. Therefore, Pears/Yardley/Jergens works best with my skin so I wash my hair with them too; mixing mineral oil with coconut, castor, & tea tree oils help with my skin (especially during an allergic reaction to grass/insect bites) and I’ve also found this works great on my scalp too; adding some of the same oil combination to a low-scented lotion or cream works great on my skin and doing the same to the butter and water I apply to my hair works out as well. I still have to revert to cortisone on my skin sometimes but that only happens when I’m lazy I don’t check the label on something I want to try out (I’m also really allergic to walnuts, so not in my stomach or on my skin and definitely nowhere near my scalp). I will try to wear hats less now, didn’t know that could make the dry scalp worse!

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  6. I definitely have a dry scalp. I never thought that my diet is what needs to change. My hair is weird. Oils just sit on my scalp and in my hair. That also causes build up. It doesnt penretrate at all. Ive tried all kinds of oils for my scalp and everything just sits there. It makes my hair feel gross and greasy. This wad very helpful. Thank you.

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  7. Wow. i always thought I had like severe dandruff. I need to read the labels on my shampoo and conditionier. i’ve been using the same stuff for about 5 years and I dont think it’s really helping, unless my hair-washing habits are bad.
    I live in Las Vegas and i admit i do not drink enough water or use enough oils in my hair. I never cared enough b/c my hair was growing in-between relaxers. I will have to invest in good products before the summer hits or i wont have any good hair. it’s currently breaking off and very un-even. will be going to see a co-woker’s wife about it in 2 weeks.

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  8. I alternate between ketoconazole and ciclopirox (both prescription anti fungals) shampoos about every 2 weeks. I wash my scalp every 4-7 days depending on how much I sweat during my 6 day a week workouts and whether I’ve been swimming. During really bad flare ups I use ciclopirox olamine cream on affected areas. Be wary of the “oil your dry scalp” or “massage ‘insert name here’ oil/butter into your scalp” suggestions. Aside from certain essential oils like tea tree, lavender, and others, most oils touted by naturals just feed the malassezia furfur and exacerbate symptoms. Malassezia furfur is the opportunistic yeast that feeds off of the excess sebum on your scalp. Grapeseed, olive, castor, and coconut oils along with shea butter and many others are high in oleic and fatty acids. Oleic and fatty acids are not “bad” for you per se, but sebum is also high in oleic and fatty acids which means these oils mimic your natural sebum. Seborrhea just means there’s an overproduction of sebum in the affected area. So adding more “food” doesn’t fix the issue; it makes it SO much worse. If you are going to use oils at all, put them only on your strands NOT your scalp. Naturals without skin conditions may be able get away with using oils liberally, but I urge those individuals with SD to avoid greasing/buttering/oiling their affected scalp and skin entirely. Seborrheic dermatitis is a chronic (life long) condition. It doesn’t go away, you just manage syptoms by reducing/controlling/ceasing flare ups. Be wary, too, of Clobetasol propionate (Clobex) and desonide as these are topical corticosteriods which may reduce symptoms for a while but their long term use has been known to do some pretty awful damage to skin and the lose their effectiveness over time. Also, I found that no-pooing and co-washing do not get my scalp anywhere near clean enough to treat SD and the flakes will take over my whole face if I don’t treat them. I was diagnosed with SD in 2004 at age 18 after spending my whole life believing my scalp was either a parched desert or perpetually filthy. About a year ago, I found a great dermatologist and together we worked out a regimen that works for me. I haven’t seen a SINGLE FLAKE in 7 months. Different stuff works for different people but I’ve found that applying medicated shampoos and creams to a sqeaky clean scalp and avoiding oils and product build up has worked best for me. Work with your dermatologist and if he/she sucks find a new one until you figure out what works best for you. It may take a while. Best of luck to all of you!!!

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  9. I have ingrown hairs on my scalp. Went to the doctor and got something to treat it that also can cause ingrown hairs. I have been natural for a few years and have had to keep my hair cut very, very short. Are there any natural products out there that will really help me?

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  10. Most people will develop some kind of skin condition at some time in their life. Whether you suffer with a rash, itchy skin, skin fungus or infection, skin bumps, or skin tags, talk to your doctor because there’s treatment available. If you have oily or dry skin it makes sense to learn the best methods to clean, treat, and protect your skin type.`..””

    Our own web page <http://www.healthwellnessbook.com

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  11. Pingback: scalp build up | Afro Frenzy

  12. Wow it is really refreshing to see this topic and so many that relate! I’ve had SD all my life and actually managing it has been an adventure. Back in my relaxed days my hair would break at a certain point due to flare ups and management and sliding the scales down the shaft of my hair thus weakening the hair and so on and so forth. I went natural my first time over 15 years ago for the experience, for learning how to care for my own hair and for the discovery of how beautiful it was and what I could do with it. At a point I got bored relaxed it for a year and quickly went thru the same old routine of breakage.back to natural I went and am still here Honestly the ONLY treatment for my scalp(and trust me I have tried EVERYTHING, is ketoconazole and ciclopirox (both prescription anti fungals) shampoo and conditioners but geez they cost so much! The last time I purchased them it was $127.00 per bottle. I am not a PJ so I don’t spend like this for product and as fast I would go through the bootles of shampoo and conditioner I just felt it wasn’t worth it. I’m thinking about going back though because it really does flare up up horribly. I want to also look at what kind of foods cause flare ups as well. I know stress and fatigue causes flareups. Just looking for a way to get it under control.

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  13. Hey! I live in France, I have SD diagnosticated since last year but had dandruff all my life. I managed to calm it down by switching shampoo each time i need to wash (3wash/week). My dermatologist told me that this condition tend to accustom with one kind of shampoo: so i have 5bottle of shampoo (3dermatological, 1moisturizing, 1anti-dandruff) which I switch, and it helps! It is not a miracle, I still have dandruff but on a manageable scale. But for sure, when I deal with stress, my scalp does like a dry desert… I continue my mosturizing routine on my hair but try to not put anything on the root and scalp of my hair. It work for me, my hair doesn’t suffer anyhow and still continue to grow. :) (3B hairtype, armpit length)
    Hope that help
    and excuse my poor english…

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