What should you know about severe flaky scalp?

Fine, loose flakes with mild itch may occur with dandruff. Greasy scale and redness around the scalp, ears, eyebrows, or nose can fit seborrheic dermatitis. Thick, sharply defined scale may occur with scalp psoriasis, which can extend beyond the hairline. Scalp ringworm may cause scaling with broken hairs, tender areas, or patchy hair loss and needs medical treatment. Product irritation can also cause burning, redness, and peeling.

Wash the scalp gently and avoid scratching, picking, and fragranced or harsh products while the cause is unclear. A clinician may recommend medicated shampoo treatment and explain how long to leave it on the scalp and how often to use it. Do not share combs, brushes, hats, or towels if infection is possible. Arrange review when scaling persists, returns quickly, spreads, or is accompanied by hair loss or marked redness.

Seek prompt care for painful swelling, pus, fever, rapidly spreading redness, swollen glands, or sudden patchy hair loss. Urgent assessment is appropriate for severe pain, facial swelling, or feeling seriously unwell. Children with scaly patches and hair loss should be assessed soon because scalp ringworm can spread and may leave inflammation if untreated.

Does the scale look more like dandruff, dermatitis, psoriasis, infection, or product irritation? Should I use a medicated shampoo, and how should I apply it? Is hair loss or broken hair present? Could another household member need assessment?