Signs and symptoms of dandruff

Dandruff or dry scalp?

Dandruff is not thought to be directly as a result of dryness affecting the scalp. The shed flakes associated with dandruff may be either dry or sometimes oily, dead skin cells, but they don’t form as a result of a dry scalp. Dry skin that occurs in a densely haired portion of the scalp defines the term ‘dry scalp’ – this is not considered a medical condition. Essentially a scalp that is dry does not have enough moisture in order to remain adequately lubricated / hydrated.

A dry scalp is not terribly common either due to the fact that the scalp is naturally a fairly oily portion of the body (due to normal sebaceous gland secretion). In order to remove enough moisturising lipids (fats) and sebum, numerous washes per day would be necessary (which is not a very common occurrence) to cause any significant dryness to the scalp.

A common indication of a dry scalp may be dry hair (especially during the colder months of the year). Those with a dry scalp may also be prone to other scaling skin conditions like eczema. Dandruff prone scalp can, however, be affected by some dryness.

What does dandruff look and feel like?

Mild dandruff

• Dandruff flakes are small (or fine) and powder-like.
• Dandruff flakes appear to partially stick to the scalp and hair shafts.
• Flakes may be white / slightly yellowish and oily or dry in appearance.
• Flakes occur in small patches on the scalp and / or hairline which may or may not be accompanied by erythema (redness of the skin) or some dryness of the scalp.

Moderate dandruff

• Flakes of dandruff appear a little more scale-like and are loosely sticky / attached to the scalp and hair shafts.
• Flakes are small, white (or slightly yellowish) and often oily (sometimes dry).
• Dandruff flakes may be accompanied by erythema (redness) and some itching in localised patches of the scalp and or / hairline (This may be mildly bothersome for the affected person).

Severe dandruff

• Dandruff flakes or scales are larger (some almost disc-like and very large in size) and more pronounced, as well as crusty. Scales which are very big may form thick clumps on larger portions of the scalp and / or hairline (attached to the scalp and hair shafts).
• Various sizes of flakes or scales may also occur on larger portions (more widespread or spread out) of affected scalp (and the hairline).
• Flakes or scales attached to the scalp and hair shafts are white and or/ slightly yellowish and oily (or dry).
• Flakes may be accompanied by erythema / inflamed skin and severe itching.

Once severe, most self-care measures used to treat the condition may prove ineffective.

Note: In darker complexions, affected areas of the scalp may appear lighter than the normal skin colour (resembling hypopigmentation).

Dandruff symptoms may be worse during certain periods, such as the winter months and during early spring.

Additional symptoms may involve:

• Emotional or psychological distress (dandruff may be very obvious to others and this may be embarrassing for the affected person)
• Low self-esteem (due to distress associated with one’s personal appearance)