Scaly scalp

What is scaly scalp?

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

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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. About one person in 50 in the UK has psoriasis. This skin condition 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 eczema. This may also be called seborrhoeic dermatitis. In children and adults seborrhoeic eczema 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.

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Can I buy treatments from the chemist?

If you have mild dandruff or seborrhoeic eczema it will usually improve if you use a medicated shampoo once or twice a week. If this is not successful it may respond to a preparation containing salicylic acid and coal tar in coconut oil which will help to remove the scales, so ask your pharmacist about this.
Unfortunately the problem may return if the treatment is stopped so you may need to continue one or more of these treatments for some time.
Some homoeopathic and herbal treatments are claimed to help. Ask your pharmacist for advice about these.

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When should I see my doctor?

If your scalp problem does not clear up you should see your doctor who will ask you about your condition and 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.

What treatments are available from your doctor?

The treatment will obviously depend on the cause of the problem.
For psoriasis your doctor may give you a steroid lotion or mousse, a preparation containing coal tar or salicylic acid or a vitamin D lotion. Your doctor may also refer you to hospital for specialist treatments.
Seborrhoeic eczema may require a steroid or other treatment, such as antibiotic tablets or cream. An antifungal shampoo can also be effective (these are available from the chemist without a prescription).
Cradle cap is usually treated with simple shampoos, but sometimes needs hydrocortisone or antibiotic cream.

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Help yourself

• 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 freq uently - this can dry your skin.
• 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 blond hair avoid shampoos containing tar which may discolour your hair.

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Further information

Patient Factsheet supported by an educational grant from EVANS MEDICAL ~ DERMATOLOGY

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Date of Preparation: March 1998