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Scalp Psoriasis vs. Dandruff: What’s the Difference?

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by James Roland

Published 01/27/2025

If you’re experiencing a flaking, itching scalp, you may do a quick self-diagnosis of dandruff. But that flaking and itching could instead be a sign of scalp psoriasis, a more serious condition that can require a doctor’s care and prescription medications. 

While both are common scalp conditions affecting women and men, dandruff vs. scalp psoriasis differ in some important ways. Knowing which one you have is key to finding the right treatment.

This article breaks down the difference between dandruff and psoriasis and covers what treatments may be appropriate depending on whether you have scalp psoriasis or dandruff.

Dandruff, a form of seborrheic dermatitis that occurs on the scalp, is an inflammatory condition in which the scalp sheds excess dead skin. It’s not contagious, and it doesn’t lead to more serious complications beyond dry skin, itchiness and those annoying white flakes.

Some people are more likely than others to experience dandruff, and the reasons why a person develops dandruff aren’t always clear. It appears that combination of your scalp flora — all of the tiny microorganisms living on your scalp — and environmental and behavioral factors can conspire to cause dandruff

People with naturally dry skin are more likely to have dandruff. Spending time in cold, dry weather can also contribute to a dandruff problem. Of course, having oily skin is also a risk factor for dandruff — further proof that it’s always something.

Certain hair care products that irritate the scalp or create buildup may cause dandruff, too. The same is true for some styling methods, such as hair straightening, or even blow drying your hair too much, as the heat can increase the dryness of your scalp.

These environmental and behavioral factors won’t always cause dandruff or other skin conditions, but it’s good to be mindful of them. Carefully following the instructions on all hair care products is essential.

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Psoriasis is an autoimmune disorder, in which the body’s immune system causes the body to produce new skin cells at an accelerated rate — days instead of weeks. A chronic condition, psoriasis can affect any part of the body, including the scalp. Like dandruff, it is not contagious.

The National Psoriasis Foundation reports that about 45% to 56% of people with psoriasis on some part of their body also have scalp psoriasis. Scientists don't know exactly why some people develop psoriasis, though it does tend to run in families. There may also be some environmental factors that contribute to psoriasis risk.

Scalp psoriasis usually causes patches of white scales and flaky skin to form on the scalp, often behind the ears. Flare-ups of psoriasis symptoms can be unpredictable, though there are some common triggers to many people with psoriasis, including:

  • Alcohol consumption

  • Cold, dry weather

  • Infection, including skin infections and others, such as strep throat

  • Skin injury, including sunburn

  • Stress

  • Tobacco, either smoking or secondhand smoke exposure

Being proactive about flare-up prevention and scalp psoriasis treatment is important, and not just to find relief from the itchiness, flakes, and discomfort. Sometimes hair loss follows scalp psoriasis flare-ups.

Mild cases of scalp psoriasis can look and feel very much like dandruff. However, with scalp psoriasis, you may notice more than just skin flakes. If you feel thickened patches of skin that may be red or scaly, it’s likely you have scalp psoriasis. Dandruff doesn’t cause redness, scabs, or scaly patches of skin.

A psoriasis flareup can linger for weeks or months and occur your whole life. Dandruff flare-ups can also last for weeks at a time, but they can often be halted quickly with an effective dandruff shampoo. Also, dandruff is more common in adolescence and young adulthood, and it tends to occur less frequently as you get older.

Another key difference between dandruff and psoriasis is that dandruff is a problem isolated to the scalp. If you see patches of scaly skin on other parts of the body, then you’re probably dealing with psoriasis or possibly different conditions, such as eczema or lichen planus. 

In either case — dry scalp vs. psoriasis — getting a proper diagnosis from a dermatologist or other healthcare professional is in order.

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The first-line treatment for dandruff is an over-the-counter (OTC) dandruff shampoo that can tame some of the bacteria and fungi on the scalp, as well as reduce inflammation and exfoliate your skin. Most dandruff shampoos contain some combination of salicylic acid, pyrithione zinc, and selenium sulfide, while some include other ingredients like coal tar and tea tree oil. Prescription-strength medicated shampoos are also available if your OTC product isn’t working.

The American Academy of Dermatology recommends choosing a dandruff shampoo and treatment regimen based on your hair type. For example, fine or oily hair should be washed daily, though you may need to use your dandruff shampoo twice a week to control dandruff. Coarse or naturally curly hair should be washed less frequently, with a dandruff shampoo used once weekly.

In addition to careful hair care, certain lifestyle adjustments may help ease dandruff symptoms. Eating a balanced diet, including foods rich in B vitamins and zinc, may help keep your scalp health, as conditions like zinc deficiency are associated with a higher risk of dandruff.

Effectively treating scalp psoriasis is usually more involved than treating dandruff. 

One of the main goals with scalp psoriasis is to reduce the inflammation causing your symptoms. This often requires applying corticosteroids, in the form of creams, ointments, lotions, or foams to the affected area or areas. If topical treatment options aren’t working, your dermatologist may recommend using an injectable corticosteroid, wherein the steroid is injected directly into the psoriasis lesion on the scalp.

Particularly for severe cases of psoriasis, another widely used treatment is light therapy, also known as phototherapy. Light therapy can be done several ways, and the location and severity of your scalp psoriasis will determine what system is used. 

Generally, light therapy is done at a hospital or other medical facility. You either step into a special light box or have a light source passed over the affected area. Light therapy has been shown to be particularly helpful for difficult-to-treat areas like the scalp and as a complement to other treatments, such as topical lotions and other products.

How you care for your scalp on a daily basis can also make a difference in the severity and duration of a flare-up of scalp psoriasis. For example, the American Academy of Dermatology recommends using a soft brush and gently brushing away scaly skin on the scalp, rather than picking at the scales.

Dandruff can usually be treated effectively with an OTC dandruff shampoo. You may need to use it regularly or just occasionally if you notice a dandruff flare-up. But if your over-the-counter dandruff shampoo isn’t getting you the results you want, there are prescription dandruff shampoos and other topical treatments available.

Because psoriasis is a more serious skin condition, you should work with a dermatologist to treat flare-ups and develop a treatment plan to reduce the frequency and intensity of future flare-ups.

Of course, different conditions can trigger dry skin and a flaky scalp. And in some cases, complications, such as minoxidil side effects, can cause those same symptoms. Talking with a dermatologist about any scalp or skin troubles can be helpful. You may benefit by switching to a different treatment or receiving other good scalp care advice.

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Proper scalp care is important — not just for the health and appearance of your hair but also to help manage or reduce the impacts of scalp psoriasis, dandruff, and other skin conditions.

While dandruff can usually be managed without a dermatologist or other medical professional, scalp psoriasis will require working closely with your healthcare provider and following their advice about treatment and everyday scalp and hair care. These two skin conditions can produce some of the same symptoms, but their treatments and potential complications can be quite different.

8 Sources

  1. Tucker, D., et al. (2024). Sebhorreic dermatitis. https://www.ncbi.nlm.nih.gov/books/NBK551707/
  2. American Academy of Dermatology. (2024). How to treat dandruff. https://www.aad.org/public/everyday-care/hair-scalp-care/scalp/treat-dandruff
  3. Dall'oglio, F., et al. (2022). An Overview of the Diagnosis and Management of Seborrheic Dermatitis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365318/
  4. Borda, L., et al. (2015). Seborrheic Dermatitis and Dandruff: A Comprehensive Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852869/
  5. National Psoriasis Foundation. (2024). Scalp psoriasis. https://www.psoriasis.org/scalp/
  6. American Academy of Dermatology. (2024). Psoriasis causes. https://www.aad.org/public/diseases/psoriasis/what/causes
  7. Nakamura, M., et al. (2016). Recent advances in phototherapy for psoriasis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946393/
  8. American Academy of Dermatology. (2024). Scalp Psoriasis: 10 Ways to Reduce Hair Loss. https://www.aad.org/public/diseases/psoriasis/treatment/genitals/scalp-hair-loss
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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  • Dermatology Residency. San Antonio Uniformed Services Health Education Consortium

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