Question about a very dry Scalp

Question: I'm a stylist who has been doing hair for 15 years. I have a client who has a very dry scalp, which is not unusual since we live in a very dry climate. I was reading up about dry scalp remedies here on this site, and it seems that "dandruff" is apparently the same thing. I'm obviously not a medical doctor, however I was taught that dandruff is the result of having overactive sebaceous glands ( oil producing glands) that produce thick, yellow flakes which have a pungent odor. Quite the opposite of white, dry flakes. Shouldn't the treatment options be different for these 2 very different disorders?

Posted by Kristin on October 22, 2010 at 10:37 AM under

• 139 comments

Dr. Stephen Schleicher on October 22, 2010 at 10:39 AM said:

Dr. Schleicher: The medical term for dandruff is seborrheic dermatitis. This condition tends to affect hair-bearing regions and facial furrows; it is not a disorder of hair but of the underlying skin. Seborrhea literally means “freely flowing sebum,” and the problem occurs in those areas with a large number of oil glands. Common sites include the scalp, eyebrows, central face, external ear, mid chest, upper back, belly button, and genital areas. The most common form of seborrhea consists of slight redness coupled with an itchy, greasy, scaling dandruff, with white flecks that rain down on dark-colored clothing. Seborrheic dermatitis may become more severe, producing bright-red, inflamed, scaling patches on the face and chest that may spread under the arms and even to the groin. No cure exists for seborrhea, but in most cases, the disorder is easily controlled. Seborrheic areas are very sensitive and readily irritated. Scratching and rubbing the skin only serves to prolong the condition and may lead to infection. People with excess oil and scaling of the scalp must shampoo regularly. A shampoo especially formulated to control dandruff should be used at least twice weekly. Active ingredients in dandruff shampoos include tars ( DHS Tar, Health911 Tar Shampoo, Neutrogena T/Gel), zinc pyrithione (DHS Zinc, Health911 Zinc Shampoo), selenium sulfide (Head & Shoulders Selenium, Selsun Blue), ketoconazole (Nizoral), ciclopirox (Loprox), and topical steroids (Clobex). The latter two are available only by prescription. To be effective, a dandruff shampoo should remain on the scalp for at least five to ten minutes before rinsing. Over time, a shampoo may lose effectiveness. Should this occur, the best course of action is to switch to another type of shampoo. Those with a more severe form of seborrhea may require cortisone in the form of a gel, foam, spray, or lotion prescribed by a physician. Sebopsoriasis is a variant of psoriasis that manifests as dry, white scales. In this case the condition is caused by increased turnover of epithelial cells. At times the scalp may become red as well. Prescription topical steroids and tar shampoos are the treatments of choice.
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Sammannthaa on February 17, 2012 at 8:57 PM said:

Kid, it's the same thing! Dandruff is caused by a dry scalp(not oily hair who told you that?). You have a dry scalp. That is why you have dandruff.
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Girl for real we are on the same page! I actually just took down most of my locs last night but I for caretin should have looked up some YouTube videos on it before hand. My loctician kept telling me that I shouldn't wash often. But I know people who washed often during the beginning stages of locing and their hair still looked great. Case in point is a YouTuber alexiscentric . Check out her hair. After the first month or so she washed and twisted it every week during the process.
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A remedy for me has been to shampoo hair, rinse and dry, with a cotton ball rub in extra virgin coconut oil. Leave on scalp for a few nights or even overnight with a shower cap. Shampoo the oil out. I have also used apple cider vinegar diluted after shampooing with a squirt bottle apply to scalp rinse and condition.
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