Scalp Psoriasis vs Dandruff: What's The Difference?

At first glance, scalp psoriasis and dandruff may almost seem the same. However, dandruff is significantly more common than scalp psoriasis, as it affects roughly half of the general population.

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Sophia Akbari

Though scalp psoriasis and dandruff can sometimes be confused, the two have distinctly different causes, symptoms, and recommended treatments.

What is scalp psoriasis?

There are about 125 million people suffering from psoriasis globally, according to the National Psoriasis Foundation. Psoriasis is an autoimmune disease characterized by scaly, red, discolored or flaky patches (also known as plaques) on your skin. Inverse psoriasis produces red, inflamed skin covered with silvery scales and a crust on the scalp that may bleed when removed. It can occur more often in overweight people and is worsened by friction and sweating.

Plaque psoriasis can often be found on the scalp. It can look relatively similar to plaque psoriasis on other areas of the body, and can cause thick build-up of scaly skin and dandruff-like flakes of skin to fall. Scalp psoriasis may also be visible on the scalp's hairline, forehead, neck, and behind the ears, making the scalp feel itchy and tight. It may cause thinning of the hair in severe cases, but this usually occurs temporarily and can be treated.

Plaques can appear anywhere on your body, but typically appear on the:

  • Scalp
  • Elbows
  • Knees
  • Back
  • Scalp
  • Face
  • Hands and feet (palmoplantar psoriasis)

P.S. Psoriasis is NOT contagious.

Psoriasis cannot be transmitted sexually or by physical contact. Psoriasis is also not caused by diet, or bad hygiene.

What are the causes of psoriasis?

In spite of the fact that the exact cause of psoriasis is unknown, researchers believe environmental, genetic, and immune system factors are involved in the cause of the disease. For example, environmental factors, such as cold weather and trauma, can exacerbate the disease. Moreover, trauma, infections, high alcohol consumption and drugs can play a role in the establishment of psoriasis.

Psoriasis often runs in families and certain genes are associated with it. An autoimmune disease, psoriasis occurs when the immune system is misdirected to cause inflammation of the skin. The current treatments available are often based on the concept to improve psoriasis by modifying immune responses. Furthermore, it is known that, occasionally, following an immunological event (for example, recovering from strep throat, stopping antimalarial drugs, or discontinuing steroid therapy) there can be an increased chance in activation of psoriasis.

The triggers of psoriasis can differ from person to person. In general, avoiding the following common triggers may help you prevent scalp psoriasis flare-ups.

  1. Certain foods

Psoriasis diets do not exist, but you may want to stay away from the following to avoid the chance of flare-ups:

  • Nightshade plants, such as tomatoes, eggplants, and white potatoes
  • Gluten
  • Foods with white or refined flour
  • Dairy products
  • Sugary and fatty foods
  1. Stress

Psoriasis can be exacerbated by stress, therefore, it's crucial to manage stress through yoga, meditation, or other relaxation techniques in order to prevent symptoms from getting worse.

  1. Alcohol

Despite limited research, alcohol has been shown to cause inflammation in the body and thus trigger psoriasis flare-ups. Therefore, if you suffer from scalp psoriasis, it could be beneficial to reduce your alcohol intake.

  1. Excess sun

When moderately exposed to the sun, psoriasis symptoms can be alleviated. To avoid sunburns and psoriasis outbreaks, make sure you are protected from the sun by wearing sunscreen and a hat.

  1. Cold, dry weather

Cold and dry air can strip moisture from your skin, resulting in scaling and itching. The colder months are ideal for investing in a high-quality humidifier and minimizing outdoor time.

  1. Hormones

Psoriasis may worsen during puberty and menopause due to low estrogen levels, while symptoms improve during pregnancy due to higher estrogen levels. It is impossible to predict how the condition of your scalp will change with time, but talking to your doctor about your options is a good start.

  1. Certain medications

Medications that can affect your autoimmune response include:

  • Beta-blockers and angiotensin-converting enzyme (ACE) inhibitors, used for treating high blood pressure
  • Antimalarial drugs
  • Lithium
  • Interferon-alpha used to treat hepatitis C

If a medical professional prescribes one of these medications, make sure to inform them of your scalp psoriasis.

Scalp psoriasis vs dandruff?

Essentially, psoriasis can affect your scalp, and the red, scaly patches it causes can flake off like dandruff does.

However, psoriasis is..

  • Chronic: Psoriasis is a long-lasting disease whereas dandruff is typically short-term and comes and goes.
  • Scaly. Scalp psoriasis tends to be more scaly than flakey. If it’s mild, scalp psoriasis looks like scaly, silvery, or powdery patches that may come off in tiny pieces. It also tends to be a more serious outbreak and can be red and painful.
  • An autoimmune disease: Psoriasis is caused by your body’s immune system, these white blood cells that should fight against diseases instead attack your skin cells.

On the other hand, dandruff is a common condition that causes the skin on the scalp to flake. It is not contagious or serious. Typically, mild dandruff can be treated with a gentle daily shampoo (the ingredient, which you can find in shampoos like Nizoral, helps specifically target fungus). If that doesn't work, a medicated shampoo prescribed by a medical professional can help.

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