Symptoms of Dandruff

Dandruff announces itself plainly - the real skill is telling ordinary dandruff apart from the scalp conditions that imitate it.

The typical picture

• White or yellowish flakes on the scalp, hair and shoulders - the calling card
• Itching: mild to maddening, often the first sign
• A scalp that feels oily yet flaky at the same time - the combination that surprises people
• Mild redness in patches when scratching has been vigorous
• Worse in winter and during stressful stretches; better in summer for many

How it behaves

• Fluctuating course: calm weeks and flaky weeks
• Often starts in the teens or twenties, peaks in young adulthood, frequently eases after fifty
• Purely a scalp story in its mild form - eyebrows, nose creases and ears staying clear

When it is probably NOT simple dandruff

• Thick, silvery, well-defined plaques - think scalp psoriasis
• Greasy yellow scales with obvious redness spreading to eyebrows, nose creases, behind ears, or chest - seborrheic dermatitis
• Fine white dustiness over a genuinely dry, tight scalp with dry skin elsewhere - simple dry scalp
• Ring-shaped patches with broken hairs - fungal infection (tinea), which IS contagious
• Intense itch with tiny eggs glued to hair shafts - head lice
• Thick crusts, oozing, or pain - needs a doctor promptly

See a dermatologist when

• No improvement after 4 weeks of correctly used anti-dandruff shampoo
• Redness and scaling spreading beyond the scalp
• Noticeable hair shedding alongside the flakes
• Anything crusted, oozing or painful

One-line summary

Ordinary dandruff is flakes plus itch on an oily scalp that waxes and wanes - silvery plaques, spreading greasy redness, ring patches or stuck-on eggs point to a different diagnosis worth a doctor's visit.