What should you know about terrible dandruff?

Dandruff produces visible flakes from the scalp and may come with itching or irritation. It can be more noticeable on dark hair or clothing, while scratching can make the scalp sore and create small breaks in the skin. Oily scale around the scalp, eyebrows, ears, or sides of the nose can fit with [Seborrheic Dermatitis](/conditions/seborrheic-dermatitis/), which needs a slightly broader skin-care plan.

Flaking may also follow irritation from hair products, psoriasis, eczema, or a fungal infection. The cause matters because changing shampoos repeatedly may not address it.

Wash the scalp regularly with lukewarm water and avoid scratching with nails. A clinician or pharmacist may suggest [Medicated Shampoo Treatment](/treatments/medical-dermatology/medicated-shampoo-therapy/) and explain how long to leave it on the scalp. If inflammation or a yeast-related process is suspected, [Topical Antifungal Treatment](/treatments/medical-dermatology/topical-antifungal-therapy/) may be considered. Keep products away from the eyes, follow label directions, and stop if significant irritation develops.

Arrange an appointment if scale is thick, the scalp is painful or weeping, symptoms spread beyond the scalp, or careful shampoo use does not help. Seek prompt care for sudden patchy hair loss, pus, marked swelling, fever, or a rapidly worsening rash. A clinician can examine the scalp and separate dandruff from psoriasis, eczema, or infection.

Does this look like dandruff or seborrheic dermatitis? Which active ingredient and schedule suit my scalp? Could a hair product, psoriasis, eczema, or infection explain the change?