By Kathi Valeii 

Published on September 23, 2021

 Medically reviewed by Leah Ansell, MD

A dry scalp can be uncomfortable, and when it leads to itching and peeling, it can be embarrassing.

There are several causes of dry scalp, including dermatitis, dandruff, and psoriasis. Finding out the cause of your dry scalp will help you and your doctor determine which treatment option is best.

This article will discuss each condition that can cause a dry scalp, treatment options, and when to see a doctor.

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Dermatitis

Dermatitis describes dry, itchy skin.1 Several types of dermatitis can lead to a flaky scalp, including contact dermatitis and seborrheic dermatitis.

Contact dermatitis is a red and itchy rash caused by contact with an allergen, while seborrheic dermatitis causes scaly patches and red skin, mainly on the scalp, eyebrows, beard area, and nasolabial folds on the face.

Symptoms of contact dermatitis include:2

  • Dryness

  • Itching

  • Rash

  • Cracking skin

  • Blisters that may have crusts and scales

  • Tender, burning skin

Seborrheic dermatitis, on the other hand, is characterized by greasy, red patches. The rash develops yellow or white scales that often flake.3

 Are Your Flakes From Seborrheic Dermatitis or Dandruff?

Causes

Contact dermatitis develops when your skin comes into contact with a substance that irritates it. Often, this is something you are allergic to. 

Common skin irritants and allergies that contribute to contact dermatitis include:4

  • Cosmetics, including shampoos and hair products

  • Detergents, bleach, and other chemicals

  • Fragrances

  • Latex

  • Nickel and other metals

  • Plants like poison ivy, poison oak, and poison sumac

  • Topical medications

Some people are more prone to developing contact dermatitis, including people who work with harsh chemicals and those who have other skin conditions.4

It’s not clear what the exact cause of seborrheic dermatitis is. It can be caused by a type of yeast, increased levels of the hormone androgen, increased levels of skin oil, inflammatory reaction, and family history of seborrheic dermatitis.5

Some factors may increase your risk of developing this skin condition, including:6

  • A cold, dry climate

  • Genetics

  • Certain health conditions

  • Some medical treatments

  • Stress

Seborrheic dermatitis most commonly occurs in babies under 3 months old and adults between the ages of 30 and 60. It is not caused by personal hygiene or an allergy.6

Treatment

The primary way to treat contact dermatitis is to avoid the offending irritant. In addition, topical steroids, oral steroids, or immunosuppressive medications are sometimes necessary.7

To treat seborrheic dermatitis, you may need to use an anti-dandruff shampoo. Topical steroids and antifungals can also help.

If avoiding irritants and using dandruff shampoo doesn’t help, talk to your doctor. They can help you develop a treatment plan that is safe and effective. Topical creams, such as corticosteroids and antifungals, should only be used in the short term and under the guidance of your doctor. 

Dandruff

Dandruff and seborrheic dermatitis are similar conditions. Both affect the oily regions of the body, including the scalp, and both cause a dry, flaky scalp. However, whereas seborrheic dermatitis can affect other parts of the body, dandruff is only found on the scalp.

Seborrheic dermatitis and dandruff, combined, affect more than half of the adult population in the United States.8

Similarly, dandruff and psoriasis share common symptoms. They both cause itching and scalp peeling, but psoriasis is an autoimmune disease where skin cells build up and form plaques.

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Causes

A mild form of seborrheic dermatitis, dandruff shares the same causes. In addition, dandruff is more prevalent:8

  • Among males

  • Between puberty and 20 years of age (and is less common after 50)

Dandruff is not the result of poor hygiene or washing your hair too little.9 However, infrequent hair washing can make dandruff more obvious and worse because frequent hair washing helps to naturally exfoliate the dead skin on your scalp.

 Dandruff Causes and Treatments

Treatment

Most of the time, you can manage dandruff with over-the-counter (OTC) shampoos. However, severe cases may indicate that another skin condition is causing your dandruff. If OTC products are not helping, you should seek advice from your doctor.

Around 50 million Americans spend $300 million annually on over-the-counter products to treat dandruff.8

Psoriasis

Psoriasis is a chronic inflammatory condition that produces a scaly rash. Scalp psoriasis may be mild to severe and can extend beyond the scalp to the ears, neck, and forehead. 

Of those who experience psoriasis, 80% have it on their scalp.10

Symptoms of scalp psoriasis include:10

  • Red, thickened plaque

  • Flaking that is white

  • A rash along the hairline, forehead, ears, or neck

  • Severe itching

In some cases, scalp psoriasis can result in alopecia, sudden hair loss that starts with one or more circular bald patches that may overlap. Fortunately, the hair loss is usually reversible with treatment.10

Causes

The exact cause of psoriasis is unknown. However, genetics may play a role.11

Certain triggers often bring on psoriasis flares. Common triggers include:11

  • Allergies

  • Cold, dry weather

  • Environmental factors

  • Illness

  • Skin injury

  • Stress 

Treatment

Management of scalp psoriasis may require a combination of treatments. Some options include:11

  • Coal tar used topically or in shampoo

  • Salicylic acid used topically or in shampoo

  • Clobetasol propionate shampoo

  • Dithranol used topically

  • Corticosteroids

  • Immunosuppressive medications

  • Phototherapy

Seeing a Doctor

It’s a good idea to see a doctor any time your skin condition disrupts your life or doesn’t respond to at-home treatment. Some skin conditions can lead to infection. If that happens, you will need medical treatment.

Some things that indicate you should call your doctor include:12

  • Itching that interferes with your life or sleep

  • Redness and swelling

  • Pain

At your appointment, your doctor will examine your skin. They will also want to understand your symptoms, including:

  • How long you have been experiencing symptoms

  • Where on your body they occur

  • How often symptoms occur

  • What triggers (if any) you’ve noticed that bring on symptoms

  • Whether anything you have tried has provided any relief 

 What Are Scalp Infections?

Summary

Scalp peeling can be a result of dermatitis, dandruff, or psoriasis. Of all types of dermatitis, seborrheic dermatitis and contact dermatitis most commonly cause peeling on the scalp. If your symptoms are not alleviated with home or OTC treatments, you should see your doctor for diagnosis and treatment.