What should you know about oily itchy flaky scalp?

Dandruff commonly presents with scalp flaking and may be more noticeable when oil causes scale to cling to hair. Seborrheic dermatitis can add greasy scale and redness. Scalp psoriasis may produce thicker, sharply defined plaques that extend beyond the hairline. Scalp ringworm can cause scale with broken hairs, tender areas or patches of hair loss and needs medical treatment. These conditions can look similar in a description, so the pattern, examination and sometimes testing matter.

Use a gentle shampoo and rinse well; avoid scratching, picking scale and applying strong household remedies. If a clinician recommends medicated shampoo treatment, follow the directions for application and contact time. Do not share combs, brushes, hats or towels while infection is a possibility, and wash items that touch the scalp. Photographing the scalp before treatment can help show whether redness, scale or hair loss is changing.

Arrange a dermatology review for thick plaques, intense itch, bleeding, pus, swelling, significant pain, broken hairs or patchy hair loss. Seek prompt advice if symptoms spread quickly, another household member develops a scaly patch, or the scalp becomes tender and boggy. These features are not a reason to guess at the diagnosis or keep changing shampoos.

Ask whether the pattern is consistent with dandruff, seborrheic dermatitis, scalp psoriasis or scalp ringworm, and whether examination or testing is needed. Mention contact with affected people or animals, new products, skin rashes elsewhere and any hair breakage.