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Hair health can feel very intuitive. Reaching for a shampoo regularly or keeping up with consistent trims are just a few of the hair care tips that comes naturally. The scalp, on the other hand, has long been a taboo topic. Scalp concerns can be uncomfortable, itchy, and even awkward to deal with. Whether you have oily buildup or dry flakes, you may not know where to start—and you’re not alone. Healthy hair starts with a healthy scalp, so how do you know when your scalp needs help? We turned to two dermatologists and one trichologist to better understand 6 of the most common scalp issues and how to treat them. Find their insights for maintaining a balanced scalp below.
Meet the Experts
- Dr. Iris Rubin is a Harvard-trained, board-certified dermatologist and the co-founder and chief medical officer of SEEN Haircare.
- Aga Tompkins is a celebrity hairstylist, board-certified trichologist, and the director of style services & education at Tricoci Salon & Spas.
- Dr. Geeta Yadav is a board-certified dermatologist and the founder of FACET Dermatology.
01 of 06
Oil and Buildup
One of the most common scalp concerns is excess oil production. Oily roots can leave your hair feeling heavy and dirty. According to celebrity hairstylist and board-certified trichologist Aga Tompkins, even a healthy scalp can experience an accumulation of oils, dead skin, and product residue, which can suffocate follicles and disrupt hair growth.
Some level of oil and buildup is normal, especially a few days after washing or exercise. However, in some cases, people struggle with an overproduction of oil that can weigh roots down rather quickly. This is typically due to overreactive sebaceous glands or improper product use, explains Tomkins.
The Solution: If you’re looking to battle normal oil build-up, dry shampoo is a great way to revive your roots quickly. Just remember to use a good clarifying shampoo to remove any residue on your scalp. For those who may have an overproduction of oil, Tomkins says you need to balance the scalp without stripping away the natural moisture. Avoid using a clarifying shampoo every day, as you may encourage oil production by removing necessary scalp oils.
02 of 06
Itchiness
We've all experienced some level of scalp itchiness. If your symptoms are consistent, our experts agree a trip to the dermatologist or trichologist is the best way to determine the best course of treatment.
An itchy, dry scalp is often caused by dehydration, harsh shampoos, or environmental factors, shares Tomkins. However, dermatologist and co-founder of SEEN Haircare, Dr. Iris Rubin, says one of the most prevalent culprits is allergic contact dermatitis. This is an allergic reaction caused by your scalp coming into contact with an ingredient that irritates the skin. This is why experts recommend patch-testing new products before applying them to your entire head.
The Solution: “For an itchy or sensitive scalp, the first treatment step typically involves gentle, non-irritating, sulfate-free shampoos and hair care,” explains Dr. Rubin. Then start to slowly reintroduce products to determine what is causing the reaction.
03 of 06
Dandruff
Believed to be caused by an overgrowth of yeast, dandruff can cause itchiness and flaking of the scalp. This results in small flakes that can coat the shoulders after the hair is brushed.
The Solution: While inconvenient, this is commonly managed at home with medicated shampoos containing ingredients like zinc pyrithione, ketoconazole, or selenium sulfide. If dandruff persists, it’s important to seek an expert opinion from a dermatologist or trichologist to make sure it is not something that requires prescription-strength treatment. “Everyone has a scalp type, just like a skin type, and personalized care from root to tip is key to achieving healthy, beautiful hair,” explains Tomkins.
04 of 06
Scalp Psoriasis
Scalp psoriasis is an autoimmune condition that manifests as red, scaly patches, explains Dr. Rubin. It is another common cause of scalp itchiness and flakiness. This is a chronic inflammatory condition that cannot be cured but rather managed. “Many people come into my practice believing that they have a stubborn case of dandruff when it is in actuality psoriasis,” explains board-certified dermatologist Dr. Geeta Yadav. “Dandruff looks like tiny, dry flakes while psoriasis is larger, dry scales that can be itchy.”
The Solution: While over-the-counter shampoos with ingredients like coal tar and salicylic acid can help, prescription-strength options are typically more effective at addressing the plaques. “Topical steroids and PDE4 inhibitors can also be helpful,” adds Dr. Yadav.
05 of 06
Seborrheic dermatitis
Seborrheic dermatitis is another inflammatory condition that is frequently mistaken for dandruff. Instead of the dry, tiny flakes of dandruff, seborrheic dermatitis produces large, oily scales that can leave your scalp very itchy. Seborrheic dermatitis can also be present in the eyebrows and ears in addition to the scalp.
The Solution: According to Dr. Yadav, seborrheic dermatitis can come and go and is often managed with the same over-the-counter shampoos and scalp treatments that can control dandruff. "Since dandruff and seborrheic dermatitis are believed to be caused by an overgrowth of yeast, these scalp conditions are commonly treated with medicated shampoos containing ingredients like zinc pyrithione, ketoconazole, or selenium sulfide," echoes Dr. Rubin. If you do not see improvement, book an appointment with your dermatologist.
Dr. Yadav explains the next steps will typically include prescription-strength iterations of the OTC formulas or topical steroids. Similarly, Dr. Rubin adds that inflammation plays a role in seborrheic dermatitis, so topical anti-inflammatory shampoos and topicals can also be helpful. Washing hair more frequently is also beneficial to remove oils, which malassezia can feed on.
06 of 06
Folliculitis
Scalp folliculitis is the inflammation or infection of the hair follicles, often triggered by bacterial or fungal infections, explains Dr. Rubin. “This inflammatory condition can be mistaken for acne by patients, but it is actually a bacterial infection of the hair follicles,” adds Dr. Yadav. Folliculitis can present as painful, swollen follicles that resemble blocked pores on the face. It can go away with proper treatment at home, but more serious or stubborn cases may require a prescription for a topical or oral antibiotic.
The Solution: Folliculitis can often be treated at home with regular use of shampoos that contain ingredients like salicylic acid and zinc pyrithione. Both ingredients are antibacterial and antifungal and can help combat the infection while helping to gently exfoliate within the hair follicle. “Sometimes I recommend a benzoyl peroxide body wash to be used on the scalp, but just remember that this can bleach your towels and hair,” says Dr. Yadav.
