Is your dry scalp something more serious? (2024)

What it is: According to Danny Del Campo, MD, FAAD, a board-certified dermatologist in private practice in Chicago, psoriasis is a chronic skin condition that causes skin cells to grow too quickly, making them pile up on the surface of the skin in patches called plaques. "There are many genes that increase the risk of developing psoriasis. Hence, psoriasis is generally considered to be a genetic disease that is triggered by other factors," says Dr. Del Campo. Infections, skin injuries, some medications, and lifestyle factors such as drinking alcohol or smoking are common triggers for psoriasis.

What to look for: If you have scalp psoriasis, you may have it in small areas; however, it can also cover your entire scalp. You might have reddish or dark-reddish patches called plaques that can be elevated or inflamed; flakes of skin that seem like dandruff but have a silvery sheen, called scale; a dry, itchy, or burning scalp; or temporary hair loss.

How to treat it: Based on the severity of the condition and your medical history,Dr. Del Campo says a dermatologist will typically prescribe medicated ointments and creams you apply to the scalp; medicated shampoo; light therapy (phototherapy) to decrease inflammation; products that can soften the thick patches called scale softeners; or medications that work throughout the body.

What it is: Tinea capitis is a fungal infection of the scalp skin, also called scalp ringworm, that can be transmitted through contact with others, says Julia Tzu, MD, FAAD, a double board-certified dermatologist in private practice in New York. "Sharing hats, combs, and other hair accessories can increase your risk. This condition also tends to be more common among children 5-14 years of age," she adds.

What to look for: According to Dr. Tzu, symptoms of tinea capitis include scaly patches on the scalp, usually combined with patches of hair loss (or broken hair shafts). "There can be inflammation (pink skin) or itchiness, as well."

How to treat it: You need prescription antifungal medicine to treat tinea capitis. Everyone you live with may also need to be seen by a dermatologist, as tinea capitis is very contagious. Dr. Tzu warns that tinea capitis can continue to spread across the scalp and cause additional hair loss if not stopped in its tracks.

What it is: Dr. Tzu describes AKs (also referred to as solar keratoses) as a form of precancerous sun damage that is caused by unprotected sun exposure. "While both men and women of any age can develop actinic keratoses, on the scalp I tend to see them more frequently in older men who have experienced hair loss, and therefore have had less protection against the sun. Genetic predisposition (such as fair skin, red or blond hair, and family history) can also factor in," she explains. While AKs often occur on the scalp, the condition can appear on any part of the body. AKs are most common in people who are 50 or older and have spent a lot of time outdoors without sun protection.

What to look for: Dr. Tzu says AKs often appear as dry, scaly, rough patches or bumps that can be skin-colored or pink. They might feel like sandpaper or be crusty. "Sometimes, actinic keratoses are easier to identify through touch, feeling like scaly, uneven skin that may not necessarily be itchy or painful, which some inflammatory skin conditions are," she adds.

How to treat it: If you find a scaly growth on your scalp, or anywhere on your body, that you think might be an AK, Dr. Tzu suggests seeing a board-certified dermatologist for a thorough skin exam. "Treatments for actinic keratoses include topical medications such as 5-fluorouracil (a chemotherapy agent) or imiquimod (an immune response modifier), or procedures such as minimally invasive cryosurgery (liquid nitrogen), which destroy precancerous cells," she says. AKs can also be treated using photodynamic laser therapy. Dr. Tzu also cautions that, if left untreated, some AKs turn into squamous cell carcinoma, the second-most-common form of skin cancer.