Flaky scalp Dr Rob Hicks "Is it snowing outside?" is just one of many comments that mates think are funny if you have a flaky scalp. This common and frustrating condition can be caused by dandruff, seborrhoeic eczema or psoriasis.

In this article

What is it? Why does it happen?

Can I stop it? Should I see a doctor?

Treatments

It's normal for old skin cells to be lost from the scalp as part of the skin's life cycle. But if these clump together, the result is dandruff.

Greasier flakes, often yellow in colour, may also appear around the eyebrows, face, ears and the upper body. This is called seborrhoeic eczema and is a more severe form of dandruff; often it's very itchy, too.

Red patches covered with thick, scaly, silvery-looking areas - commonly known as plaques - are characteristic of psoriasis.

Dandruff is now believed to be caused by a fungal infection. A fungus called Pityrosporum ovale lives on the scalp and feeds off the excess sebum produced by the glands in the skin, which explains why teenagers and those with oily skin tend to suffer more often. Dandruff is also believed to run in families.

Seborrhoeic eczema tends to be more severe because the glands and the skin become inflamed as well.

In psoriasis, new skin cells are made too quickly. They pile up on the scalp, causing the red itchy patches to form.

A number of lifestyle factors are believed to contribute to dandruff. It's worth trying to identify which factors may be responsible and avoiding them to see if things improve.

• Diets that are too salty, sugary and spicy can make it worse, so it's worth reducing these for a while.
• Too much alcohol may also increase dandruff. Some people find their dandruff gets worse when they're stressed or travel to a different climate.
• Skin needs a good supply of vitamin E, selenium and zinc to keep it healthy.
• When shampooing, massage your scalp gently rather than scratching.
• Rinse thoroughly - twice is ideal.
• Some hair products can irritate the skin or bind the skin cells together. If you're using hair products such as gels, try using something different for a while or not using products at all.

If these measures don't work then ask your doctor to confirm the diagnosis. You might need a different treatment, particularly if the problem is psoriasis.

The first course of action should be to modify your diet and lifestyle and use an anti-dandruff shampoo.

It often helps to use an anti-fungal shampoo a few times a week. But it can take up to six weeks before any improvement, so be patient.

This article was last medically reviewed by Dr Rob Hicks in April 2007.
First published in October 1997.