Scalp Psoriasis vs Dandruff: Learning To Spot The Difference

When I was initially diagnosed with psoriasis, it didn’t occur to me (or my doctors at the time) that it could affect my scalp as well. And had I not been diagnosed with plaque psoriasis, I may have not seen the connection right away. So, how can we, the patient, spot the difference between scalp psoriasis and dandruff?

What is dandruff?

Dandruff is a common skin problem. It is not contagious and, contrary to popular belief, it has nothing to do with poor hygiene. Much like psoriasis, your scalp may itch and you might notice flakes falling from your scalp and clinging to your clothing (bye, bye my favorite black shirt!). The exact cause of dandruff is unknown (sound familiar?).

What is scalp psoriasis?

The skin on your head is really no different from the skin on your body. So it should be of no great surprise that this too can be affected by psoriasis. And while scalp psoriasis does sound similar to dandruff, there are a few differences:

• It’s an autoimmune disease. Scalp psoriasis is caused by your body’s immune system. This means that the white blood cells in your body that should be fighting off infections are attacking your skin cells instead. Old news, right?
• It’s chronic. Dandruff can come and go. Psoriasis is long-lasting.
• Psoriasis is scaly, Dandruff is flaky. Speaking from personal experience, my scalp psoriasis comes off in similar fashion to the psoriasis on the rest of my body; in small patches. I often find myself pulling out large scales of skin from my hair. Dandruff is more snow-like.
• It can spread. Wait, what!? Yup. If you didn’t know, now you know. Scalp psoriasis can spread. But it can also retreat. I have had it creep down my neck at times but I have also had periods when it cleared up and only had a small patch or two on my scalp.

Speak with your doctor

Go to your doctor. I love the internet for all sorts of things but please see a medical professional for this. If a dermatologist can’t spot the difference right there in the office, they can send out a small piece of skin from your scalp to a lab for confirmation. The appropriate diagnosis is vital for going forward with the best treatment options.

Discuss your treatment options

Again, I can’t stress enough the importance of speaking with your doctor about treatment options. There is so much we can do today to help tame our skin, from topical creams to UV therapy to altering our diets, it’s endless. Talk all the options over with your physician and talk them over with fellow members in the psoriasis community.