SCALP PSORIASIS VS DANDRUFF: HOW TO TELL THE DIFFERENCE

If you have an itchy, scaly scalp, your first thought might be that it's just dandruff. However, it's not always the case. There could be another skin condition at play, such as scalp psoriasis.

It's crucial to understand the distinction between these two conditions. This article will delve into both symptoms, provide helpful tips to differentiate between them and discuss prevention, treatment, and the diagnostic process.

Moreover, we will guide you on when to consult a doctor regarding your itchy and flaky scalp.

Psoriasis Vs Dandruff

Psoriasis is a condition characterized by inflammation and an autoimmune response in which the immune system mistakenly attacks the skin, perceiving it as a threat.

As a result, the skin undergoes a rapid repair process, with new skin cells forming before the old ones can shed properly. This leads to the formation of scaly, itchy patches called plaques.

On the other hand, dandruff is a condition where the skin on the scalp flakes off. Unlike psoriasis, dandruff is not caused by an immune issue. It occurs when the body reacts excessively to a common type of yeast that naturally resides on the skin's surface. This reaction causes excessive production of skin cells, resulting in more flaking.

It's worth noting that individuals with dandruff may also experience dry skin in other parts of the body.

Symptoms

Although the symptoms of psoriasis and dandruff may appear similar to someone unfamiliar with these conditions, they have distinct characteristics. Being able to differentiate between them is essential for proper scalp care and to prevent unnecessary complications.

Understanding the dissimilarities will enable you to effectively manage your scalp health and minimize potential side effects.

Psoriasis

Psoriasis is a condition that can affect various parts of the body, including the scalp. When it affects the scalp, it can manifest anywhere on the scalp, the back of the neck, behind or around the ears, or even on the forehead.

The affected skin may appear thicker and display red, white, or silver colouration. Common symptoms of scalp psoriasis include:

• Presence of scaly patches that cause itching.
  
  
• Flaking of the scalp.
  
  
• Burning or tingling sensations on the scalp or in areas where plaques form.
  
  
• Temporary hair loss in regions with the thickest patches.

If you notice cracks or bleeding around the psoriasis patches, it is crucial to seek medical care promptly. Sometimes, psoriasis patches can become infected due to excessive scratching, necessitating separate and urgent medical attention to prevent further complications.

Dandruff

Dandruff is a common condition that affects the scalp, accumulating dry skin flakes that resemble "snow-like" particles. These flakes may fall on or around the shoulders. It's important to note that dandruff is not caused by poor hygiene and is not contagious, although it can be embarrassing for some individuals.

The main symptom of dandruff is the presence of flaky and dry skin flakes. However, suppose you experience itching, burning, or other unusual symptoms. In that case, it is recommended to consult a medical professional as it could indicate a different condition rather than just dandruff.

Other Conditions

You must see a medical professional for an accurate diagnosis if you notice any new flaky skin patches or rashes. Several conditions can have symptoms similar to dandruff or psoriasis. Here are some examples:

1. Seborrheic dermatitis: Sometimes, what appears to be dandruff is seborrheic dermatitis, a form of scalp eczema. Instead of dry skin flakes, this condition typically presents as patchy and flaky skin with red or yellow oily patches that appear stuck to the scalp. It may be more common in individuals who have eczema elsewhere in their body.
   
   
2. Eczema (atopic dermatitis): Although seborrheic dermatitis can affect the scalp, other forms of reddish eczema rashes may appear on the face, behind the ears, at the back of the neck, or even on the scalp. People may mistake it for psoriasis since it can manifest in other areas. Eczema is not an autoimmune disorder but has genetic, immune dysfunction, and skin barrier factors. Individuals with eczema may be more likely to develop autoimmune disorders or food allergies.
   
   
3. Fungal infection: Various types of fungal infections can impact the scalp. Tinea capitis, also known as ringworm, can cause itching and flaking. It appears as a red ring and does not relate to worms or poor hygiene. Unlike psoriasis, dandruff, or eczema, ringworm is highly contagious.

Prevention

You can avoid dandruff by understanding the differences between psoriasis and dandruff.

Psoriasis

Psoriasis, an autoimmune disease, cannot be prevented or cured. However, there may be periods of remission when flare-ups and symptoms are absent. Although psoriasis typically develops in older adolescents or adults up to age 35, it can occur in individuals of any age.

Dandruff

Dandruff is a condition that can be prevented, although some individuals may be more susceptible to it than others. Regular use of a dandruff shampoo can help prevent the buildup of flakes.

If you have eczema or psoriasis instead of dandruff, using a dandruff shampoo may irritate your scalp. If you are prone to dandruff, washing your hair at least 2-3 times per week is advisable. However, you may need to wash more frequently if you have an excessively oily scalp or thick hair.

Treatment

For both types of scalp conditions, there are treatment options. The treatment options differ so that one won't work for the other.

For the right kind of treatment, you need an accurate diagnosis.

Psoriasis

Psoriasis treatment depends on its severity.

Pain can be relieved, and symptoms can be minimized, but no cure exists.

Treatment options include:

• Biologic drugs
  
  
• Topical steroids
  
  
• Aloe vera
  
  
• Systemic drugs
  
  
• Topical creams
  
  
• Injectable steroids
  
  
• Phototherapy

The best results may be achieved when multiple treatments are used simultaneously or alternated.

Dandruff

Special medicated shampoos are primarily used to treat dandruff. Some active ingredients may work better for some people than others, and many options are available.

Active ingredients in over-the-counter dandruff shampoo include:

• Salicylic acid
  
  
• Climbazole
  
  
• Ketoconazole
  
  
• Coal tar
  
  
• Zinc pyrithione

It is essential to carefully follow the instructions provided for each shampoo or active ingredient you use.

Different products have their specific guidelines, and it is crucial to adhere to them closely.

Using too much of a particular product or ingredient can lead to scalp irritation or reduce effectiveness. Therefore, using the recommended amount and frequency as instructed is essential.

Diagnosis

In most cases, it is possible to determine if you have dandruff without seeking medical advice. However, if you observe anything beyond a few white flakes on your shoulders, you should get evaluated by a doctor or dermatologist for confirmation.

The diagnosis of psoriasis usually involves a physical examination by a healthcare professional. They will assess the characteristic symptoms and signs associated with psoriasis.

In certain instances, when psoriasis is more severe, or there is uncertainty about the diagnosis, a doctor may perform a small skin biopsy. This procedure helps ensure an accurate diagnosis and rules out any potential infections causing the symptoms.

When To See A Medical Professional

If you experience a new rash on your scalp, persistent itching, or worsening dandruff despite using shampoo, it is advisable to seek medical attention.

In the case of dandruff, a dermatologist may prescribe a stronger shampoo that requires a prescription. However, if the underlying cause is psoriasis, you might need a different treatment, such as steroids or other medications.

Psoriasis has the potential to spread to other parts of the body, leading to increased inflammation and additional symptoms.

If psoriasis is left untreated or unmanaged, it can exacerbate other health conditions and potentially result in complications in the future.

When psoriasis progresses to psoriatic arthritis or other related conditions, you may be referred to a specialist like a rheumatologist specialising in treating inflammatory immune disorders.

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