Scaly Scalp Patient Information Fact Sheet

What is scaly scalp?
Scaly scalp is a common problem and usually causes flaking and itching.

What causes scaly scalp?
A number of different conditions can cause scaly scalp:

Dandruff. Skin cells are lost from everyone’s scalp each day, but if more cells than usual are lost, they clump together to form white or grey flakes of dandruff. Dandruff affects men and women equally and can cause irritation and itching.

Psoriasis .This skin condition is very common and while people of any age can be affected, it usually begins between the ages of 15 and 35. Psoriasis often affects the scalp, where red areas covered in thick silvery scales appear under the hair. Scalp psoriasis can be stubborn and difficult to treat and may look unsightly, but it is not infectious.

Seborrheic eczema. This may also be called seborrheic dermatitis. In children and adults, seborrheic eczema causes itchy, scaly patches on the scalp. It can also affect the eyebrows, face, ears, and the upper parts of the body.

“Cradle cap”. In babies this condition causes greasy, yellow scales to appear on the scalp, giving a crusty appearance. This can spread to the face and body.

How is scaly scalp treated?
The treatment will obviously depend on the cause of the problem. For psoriasis, your doctor may give you a steroid lotion or shampoo (eg, fluocinolone [Capex Shampoo] or clobetasol [Clobex Shampoo]). Anthralin, synthetic Vitamin D3 and Vitamin A are used in prescription topical treatments to help control psoriasis lesions. Your doctor may also refer you to a dermatologist. Seborrheic eczema may require treatment with a steroid preparation or sometimes with antibiotic tablets or cream. Recently, the FDA approved a new class of drugs, topical immunomodulators (TIMs), with two FDA approved non-steroid drugs: tacrolimus (Protopic) and pimecrolimus (Elidel). An antifungal shampoo containing ketoconazole (Nizoral Shampoo) or ciclopirox (Loprox Shampoo) can also be effective. Cradle cap is usually treated with simple shampoos but sometimes needs treatment with hydrocortisone cream or an antibiotic cream.Combination products that include the Vitamin D derivative calcipotriene in combination wtih the steroid betamethasone (Taclonex Scalp) may also be prescribed.