The Independent Pharmacy

Dry Scalp

Living with dry skin on your scalp can really impact your daily life. Not only can the itching and flaking drive you mad, but it can also be embarrassing and inconvenient. You might notice redness and an uncomfortable, tight feeling as well. Conditions like eczema, dermatitis, psoriasis and dandruff are all common causes of dry scalp and finding the best treatment will depend on the specific issue. But if you need something fast our team can recommend a cream, ointment or medicated shampoo to soothe your scalp and give you some much-needed relief.

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Advice for Dry Scalp

What is Dry Scalp & what causes it?

Dry scalp refers to a condition characterized by dryness, flaking, and itching of the skin on the scalp. It is a common problem that can affect people of all ages and can be temporary or chronic. While it may share some similarities with dandruff, a dry scalp is primarily caused by the loss of moisture from the scalp rather than an underlying fungal or inflammatory condition.

Several factors can contribute to dry scalp:

  1. Environmental factors: Cold, dry weather or low humidity can strip the scalp of its natural oils, leading to dryness and flaking. Excessive exposure to heat, such as from central heating systems or hair styling tools, can also contribute to dryness.
  2. Overwashing or improper hair care: Frequent washing with harsh shampoos, using hot water, or excessive use of hair products can strip the scalp of its natural oils, causing dryness. Similarly, not rinsing the hair and scalp properly can leave behind residues that contribute to dryness and flaking.
  3. Age: As people age, the sebaceous glands produce fewer natural oils, resulting in drier skin, including the scalp.
  4. Skin conditions: Certain skin conditions like eczema or psoriasis can affect the scalp and lead to dryness, itchiness, and flaking.
  5. Health conditions: Dry scalp can also be a symptom of underlying health conditions such as hormonal imbalances, malnutrition, or autoimmune disorders.
  6. Incorrect diet: A diet lacking essential nutrients, particularly those important for skin health, can contribute to dryness and other scalp issues.
  7. Stress and emotional factors: High-stress levels or emotional disturbances can sometimes trigger or exacerbate dry scalp conditions.

It is worth noting that dry scalp and dandruff can have overlapping symptoms. Dandruff is often associated with an overgrowth of a fungus called Malassezia on the scalp, leading to increased cell turnover and flaking. If you are uncertain about your condition, it is advisable to consult a dermatologist for an accurate diagnosis and appropriate treatment.

What are the symptoms of Dry Scalp?

Scalp Psoriasis

Symptoms of scalp psoriasis can range from mild to severe. Milder symptoms may only present as a fine, slight scaling on the skin of the scalp. Moderate to severe symptoms may include:

  • Dry scalp
  • Red, bumpy, scaly patches
  • White/silvery scales
  • Burning, itching or soreness
  • Hair loss*

* Psoriasis itself doesn’t cause hair loss. However, the associated harsh treatments, scratching and picking can, unfortunately, result in a temporary loss of hair.

Eczema of the scalp

Eczema of the scalp is usually characterised by patches of skin that can be either:

  • Flaky
  • Extremely itchy
  • Red and scaly
  • Greasy or waxy
  • Weeping lesions
  • Blistering
  • Causing a change in skin colour after healing
  • Causing a discharge from the ear, should the condition have spread from the scalp into the ear canal

Other skin/scalp conditions may produce symptoms similar to scalp eczema. These conditions include; psoriasis, allergic contact dermatitis and atopic eczema.

Dandruff

Dandruff will present as white/grey flakes of dead skin, appearing on the scalp and (or) hair. These flakes are often noticed if they fall from the scalp onto the shoulders. Associated symptoms of dandruff also include a dry, itchy scalp. The magnitude of these symptoms can range from mild to severe.

How is Dry Scalp diagnosed?

If presenting with any of the symptoms of psoriasis or eczema of the scalp, it is recommended to visit your GP or dermatologist. Usually, a visual inspection of the affected area is enough for a diagnosis. However, in some cases, a sample of the affected skin (usually a couple of loose flakes), may be taken for analysis. This will usually be to help identify the cause, which will aid in choosing the appropriate treatment.

How do I treat Dry Scalp?

Scalp Psoriasis

Psoriasis of the scalp is typically harder to treat than its eczema equivalent. Normally, a topical corticosteroid is used, which will help reduce the inflammation as well as slowing the growth of the offending skin cells. Examples of topical corticosteroids include;

Betnovate Scalp Application and Betacap Scalp Application.

Additional steps that can help manage flare-ups of scalp psoriasis include:

  • Applying heavy creams or ointments that lock in water.
  • Use lukewarm water when bathing to help the scalp retain its moisture.
  • Avoid hair care products that contain alcohol or fragrance.
  • Omega-3 has been linked to a reduction of inflammation, so a balanced diet that includes Omega-3 can help decrease the associated inflammation.
  • Ensure you use your treatments as directed.
  • Keeping the scalp moisturised is an important factor when managing scalp psoriasis. Ensuring the skin is lubricated will help prevent or reduce the dry, itchy skin experienced during a flare-up.

Eczema of the scalp

Treatments for eczema of the scalp can vary depending on the severity of the condition. Different people respond differently to medication, which means it may take a few attempts to find the right solution. In many cases, over-the-counter treatments for dandruff can be enough to improve flaking and soothe the itching. However, should these treatments prove ineffective, stronger prescription treatments are also available. These are usually in the form of a topical corticosteroid application, such as Betnovate Scalp.

For babies it is recommended to use mild baby shampoo, massaging it into the scalp using a very soft brush. It is important to be very gentle when using this technique, as breaking the skin can lead to infection. If this proves ineffective, or you have concerns about your baby’s scalp, it is advised to consult with your GP or dermatologist.

Dandruff

Mild cases of dandruff are easily treated using a range of over-the-counter products as well as self- care techniques. These include:

  • Washing your hair daily, using a mild shampoo. Shampoos that contain tea tree oil are known to be particularly effective.
  • Avoid scratching the scalp when applying shampoo. Instead, use a gentle massaging motion.
  • Try not to use hair products, such as sprays or gels until after dandruff has cleared.

For cases where the dandruff is more severe, an anti-dandruff shampoo may be required. These treatments are available without prescription from most pharmacies and supermarkets. The most widely used formulations include:

  • Zinc pyrithione – which works by killing the fungus that is thought to be partially responsible for causing dandruff.
  • Selenium sulphide – which works to slow down the production of skin cells whilst also killing the fungi.
  • Ketoconazole – which has a powerful antifungal action.
  • Salicylic acid – works to soften and shed the dead skin cells on the scalp.
  • Coal tar – like Selenium, coal tar helps to slow down the production of skin cells. The most popular coal tar shampoo is Alphosyl 2 in 1. Coal tar is combined with Salicylic acid and coconut oil in the popular treatment, Capasal Therapeutic Shampoo.
  • Combination treatments: Cocois ointment contains coal tar, salicylic acid and sulfur for added effects.

Not every dandruff shampoo is suitable for everyone. For example, people with blonde or chemically treated hair should avoid using Selenium, as it can discolour the hair. Pregnancy and breastfeeding may also be a factor when choosing an anti-dandruff treatment, as certain types are not recommended as a precaution. If in doubt, speak to your pharmacist or GP for advice.

How can I prevent Dry Scalp?

Sadly, conditions like Psoriasis, eczema and dandruff tend to be lifelong conditions that cannot be prevented outright. However, these conditions can be successfully managed through following the advice from your doctor. There are various self-help techniques that will help both control and minimise further flare-ups. These techniques are listed below:

  • Avoid cold, dry weather – the climate can have a significant effect on psoriasis and eczema. For many, the cold, dry weather can exacerbate their symptoms. Warmer weather tends to make it better, though this is not always the case.
  • Use a humidifier – using a humidifier when the weather is dry will help keep the skin moist.
  • Avoid using medicines that are known to cause flare-ups – certain medications can cause psoriasis symptoms to worsen. These medicines include; Lithium, Propranolol and Quinidine.
  • Avoid trauma to the scalp – cuts, scrapes and bumps to the scalp can trigger a flare-up, potentially leading to an infection.
  • Get the right amount of sun – the ultraviolet rays in sunlight will slow down skin cell growth, so moderate sun exposure can be beneficial. Keep your exposure brief (about 20 minutes at a time), as sunburn will exacerbate dry scalp conditions.
  • Avoid stress – although still unproven, many dry scalp sufferers link flare-ups with feelings of stress or anxiety.
  • Use a mild shampoo every day – regular shampooing will help avoid a build-up of skin cells and hair products. If this isn’t enough to control the symptoms, try switching to an over-the-counter dandruff shampoo. It is important not to shampoo too oft en as this can make dry scalp conditions worse. It is recommended not to wash your hair more often than once a day.
  • Limit the number of haircare products you use – exposure to excessive amounts of ingredients and chemicals can contribute to scalp irritation, which can cause more itching and flaking.
  • Eat a healthy diet – there are some indications that B-vitamins and Zinc may help with dry scalp conditions, so a healthy diet rich in vitamins and minerals can help relieve symptoms.

For eczema of the scalp, avoid any potential irritants and known triggers, such as high and low temperatures, excessive perspiration and allergens.

Alternatives

There are non-prescription treatments available for dry scalp such as:

  • Nizoral shampoo
  • Alphosyl 2in1 Shampoo
  • Neutrogena T-Gel
  • Selsun Shampoo

Dry Scalp FAQs

  • Dry scalp is a condition that can cause dandruff, itching, redness, irritation, and scaly patches to occur on the scalp. In more severe cases, blistering and weeping lesions can also present. Dry scalp conditions can also leave your hair appearing dry and dull. The severity of these symptoms will vary from person to person, with some sufferers experiencing mild intermittent bouts, while others experience more sustained, chronic episodes.
  • Dry scalp can be caused by a number of things, including:
    • Eczema of the scalp – the most common form being seborrheic dermatitis
    • Psoriasis of the scalp
    • Cold/dry weather
    • Overuse of shampoo
    • Haircare products (especially those that contain alcohol)
    • Dietary deficiencies
  • The symptoms relating to your dry scalp can vary depending on the cause. The universal symptoms that apply to most dry scalp conditions include:
    • Itching
    • Flaking (dandruff)
    • Dry skin on the scalp
    Other symptoms that are more specific to the condition that’s causing the dry scalp, include:
    Eczema of the scalp
    • Red/scaly scalp
    • Greasy or waxy scalp
    • Blistering
    • Weeping lesions
    Scalp psoriasis
    • Bumpy, red scaly patches
    • Silvery white scales
    • Burning/soreness
    • Hair loss
  • Dry scalp conditions themselves rarely cause hair loss. However, the associated scratching and picking at the scalp, due to itching and irritation, can cause hair to break and fall out. In most cases, this form of hair loss tends to only be temporary.
  • It doesn’t matter whether your hair is coloured at home, or by a professional in a salon. The chemicals used to dye hair can potentially irritate the scalp, causing it to become dry and itchy. This is because the chemicals found in hair dyes are designed to penetrate the root of the hair, which is found under the skin. This, coupled with additional styling products, can block the pores on the scalp, which will prevent the scalp’s natural moisturiser (sebum) from being excreted.
  • In most cases, dry scalp conditions are harmless and only causes mild to moderate irritation.
    If you suspect your dry scalp is being caused by eczema or psoriasis, it would be recommended to visit your GP for an informed diagnosis. Your doctor will then be able to prescribe or suggest the necessary treatments that can help manage the condition. If however, you suspect the cause is environmental or stress related, then the associated symptoms can be safely managed at home using simple self-help techniques (*see; Is there anything I can do to help prevent dry scalp?)
  • There are many different treatments available for dry scalp conditions. The most appropriate for you will depend on both the cause and the severity of your symptoms.
    • Conditioning treatments – if the scalp isn’t producing enough natural oil (sebum), then using a deep conditioning treatment will help replenish the scalp’s moisture level. Deep conditioning treatments and hot oil conditioning treatments are readily available in most supermarkets and pharmacies.
    • Dandruff shampoos – if your dry scalp is only presenting with a spot of dandruff, then this can be effectively managed using an over-the-counter medicated shampoo. Anti-dandruff shampoos containing Ketoconazole, Coal Tar, Selenium Oxide, or Zinc Pyrithione can help alleviate dry, flaky skin on the scalp. Examples of anti-dandruff shampoos include; Nizoral, Selsun, T-Gel.
    • Corticosteroid treatments - Corticosteroids are a group of medicines used to reduce inflammation. Scalp treatments containing corticosteroids will be effective at treating dry scalp conditions caused by eczema or psoriasis. Examples of scalp treatments containing topical corticosteroids include; Betnovate Scalp Application and Betacap Scalp Application (both contain the corticosteroid Betamethasone).
  • Scalp psoriasis and eczema of the scalp are two conditions that affect the same area and share similar symptoms.
    Eczema of the scalp causes inflammation of the skin. Typically, the condition will cause the scalp to feel itchy and sore, which will lead to dry skin developing on the scalp. In more severe cases, eczema of the scalp can cause blistering and weeping lesions to form. For a lot of sufferers, the condition will usually go through periods of being mild to non-existent, which will be followed by periods where the symptoms will flare-up.
    Eczema of the scalp can have a variety of triggers, the most common being:
    Irritants, such as shampoos and haircare products
    The environment-specifically cold or dry weather
    Dry skin
    Heavy sweating
    Greasy skin/hair
    Stress/anxiety
    Psoriasis of the scalp usually develops in patches. It presents as red, flaky areas of skin that are covered with grey/silvery scales. The severity of these symptoms will vary from person to person.
    For some, the condition will only cause mild and infrequent irritation. For others, scalp psoriasis can be far more frequent and severe. Scalp psoriasis is caused by the body producing too many skin cells. The normal rate of skin cell renewal is between 3-4 weeks. For a psoriasis sufferer, this process happens a lot quicker (3-7 days). This causes the build-up of skin cells that psoriasis sufferer’s experience.
  • If your dry scalp is the result of psoriasis or eczema, then sadly these conditions tend to be lifelong and cannot be prevented outright. However, there are a number of self -help techniques that can help manage flare-ups and reduce the severity of your symptoms.
    If your dry scalp is being caused by environmental or product based factors, these same techniques can help prevent dry scalp from developing in the first place.
    • Avoid cold, dry weather
    • Avoid stress
    • Switch to a mild shampoo
    • Reduce the frequency of shampooing (every other day)
    • Use a deep conditioning treatment once or twice a week
    • Do not wash your hair using hot water, instead use warm water
    • Use a humidifier during dry weather to help the skin retain moisture
    • Stimulate the scalp with gentle massage
    If these techniques fail to relieve symptoms or prevent recurrent flare-ups, then it would be advised to schedule an appointment with your doctor or dermatologist.

Guides for Dry Scalp

Scott McDougall

Authored by

Scott McDougall
Scott McDougall
MPharm
2079324
Director & Registered Manager

Scott is one of the two founders of The Independent Pharmacy. He is a registered pharmacist and the registered manager of our service with the CQC.

Daniel Hurley

Reviewed by

Daniel Hurley
Daniel Hurley
MPharm IP
2078790
Pharmacist Independent Prescriber

Dan is an experienced pharmacist having spent time working in both primary and secondary care. He currently supports our clinical team by providing robust clinical governance review of our internal processes and information.

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