The Difference Between Dandruff and Seborrheic Dermatitis
Unlike acne, the problems that plague your scalp don’t get a ton of attention — even though your scalp is technically an extension of your skin. Comparing spot treatments amongst your best friends is a totally normal and relatively helpful thing to do, but bringing up the best tricks for combating some underlying scalp situation, like dandruff or scalp acne? Not everyday conversation.
Though scalp health doesn’t exactly make for a light lunch talk, it does play a critical role in how great your hair looks on a daily basis. And even though you may be able to hide your issue underneath your hair, that doesn’t solve the problem. But, know you aren’t alone — pretty much everyone you know and love has had to or will deal with some sort of scalp saga at some point, so there’s no reason to be embarrassed. Sure, they’re super awkward to talk about, but some require more serious attention than others. And how would you know the difference if you didn’t tell anyone?
“Though scalp conditions are caused by a variety of different factors, they can look similar to each other,” notes Anabel Kingsley, a hair and scalp expert. Take seborrheic dermatitis, for example. It sounds like a horrible, scary, debilitating condition, but in actuality, it’s simply a more advanced form of dandruff that most people mistake for psoriasis or standard dandruff. How could you possibly know the difference if you never officially have it checked out? “Each condition requires a different treatment approach, so it’s best to see a trichologist or dermatologist to definitively diagnose the cause before self-treating,” Anabel says.
Which brings us back to seborrheic dermatitis. If all the dandruff-specific shampoos, conditioners, and treatments you’ve been slathering all over your head haven’t nearly alleviated your “dandruff,” you probably self-diagnosed incorrectly. (Or, you’re swapping out your dandruff shampoo for a regular cleanser when your dandruff seems to disappear, which is a definite DON’T — it’ll just come back).
A telltale sign of dandruff is the formation of itchy, white flakes on the scalp that come off easily if you give your scalp a little scratch. “Dandruff doesn’t cause inflammation,” Anabel says. “So if your scalp is red and enflamed, you likely have a different condition, potentially seborrheic dermatitis.” Anabel notes that people with seborrheic dermatitis typically find flakes, too, but the flakes are “often sticky, slightly yellow, and firmly stuck to the scalp.” Patricia Wexler, a New York-based dermatologist and founder of Wexler Dermatology, agrees that the nature of the flake can be extremely telling of your condition. “What’s interesting about seborrheic dermatitis is how truly scaly it appears,” she says. “Dandruff, on the other hand, is flaky, wispy, and very fine.” It’s not uncommon to find scaling on other parts of the body, particularly in areas with the most oil-producing glands like the sides of your nose, behind your ears, and even on your eyebrows.
A quick science lesson for you: The condition crops up when there’s an overgrowth of a certain yeast on the scalp, interestingly labeled “malassezia furfur.” Don’t freak out — this type of yeast is found naturally on all scalps, but an overgrowth of malassezia furfur causes skin cells on the scalp to divide too rapidly, ultimately resulting in the buildup of flakes, Anabel says. Like pretty much every condition in life, high stress levels, hormonal fluctuations, or poor diet can trigger the overgrowth, though it tends to be hereditary. Try cutting inflammatory foods like dairy products, cheese especially, and highly spicy or sugary snacks out of your diet, since these are some of the most common triggers.
Many people mistake seborrheic dermatitis for an extra dry scalp because of the flakes, but at its roots (literally), the condition is an oil problem. “Since most people think it’s dry skin that’s causing the scales, they put oil on their scalps hoping to hydrate them. All this does is feed the fire,” Dr. Wexler cautions. “It’s the exact opposite of what they need.” Anabel also adds, “Rubbing oils into your scalp will just make flakes stickier, and can even cause irritation.” You should also avoid using any fragranced styling products on your scalp, since these most oftentimes result in even more irritation. “Hairsprays and gels can increase the growth of the fungus,” Dr. Wexler notes.
As mentioned, the scalps of those with seborrheic dermatitis typically appear crimson in color. “You can use a topical cortisone to treat redness, but we try not to because it can increase fungal growth,” Dr. Wexler says. “You want to attack the fungus, rather than treat redness.”
Don’t shampoo any less than you usually do; in fact, make it a point to shampoo daily with an anti-microbial shampoo like Philip Kingsley Flaky Scalp Shampoo or Head and Shoulders Classic Clean Shampoo. “Shampooing aids in the removal of an accumulation of dead skin cells,” Anabel says. Follow up with an anti-microbial, anti-inflammatory scalp toner, but make sure you’re using one that contains an astringent, like witch hazel, to sop up excess oils lurking in the scalp.
Here’s to a happy, healthy scalp.
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