VERIFIED CONTENTAuthor: lek. Katarzyna Banaszczyk

Although scalp psoriasis and dandruff have one thing in common, that is, scaly skin, they are two completely different diseases. What is psoriasis and what is dandruff? What are the differences between the two conditions?

Psoriasis can affect up to 3 to 5% of the population, and the most common clinical subtype of this disease is the so-called psoriasis vulgaris. The most important difference that distinguishes dandruff fromscalp psoriasisis the lack of inflammatory changes - i.e. erythematous. In the case ofof scalp psoriasis , reddish papules that are covered with scales are visible, while in the case of dandruff, the skin shows whitish, fine-lipped, loose scales on the skin.

Psoriasis - what is this disease? What are the causes of psoriasis?

Psoriasis is a disease that affects not only the skin. It is a chronic inflammatory disease that can also affect the joints and lead to an increased risk of cardiovascular diseases and diseases of other body systems.

What are the causes of psoriasis? Despite many scientific studies, it is still not possible to precisely answer this question. The appearance of this skin disease in a given patient is influenced by both immunological, genetic and environmental factors, including:

  • smoking,
  • stress,
  • viral and bacterial infections,
  • UV radiation,
  • alcohol consumption.

These factors lead to immune disorders and, as a consequence, abnormal division of epidermal cells (more precisely, keratinocytes), which ultimately results in the appearance of characteristic skin lesions in the form of erythematous lesions covered with scales.

Eruptions can appear anywhere, but they are most often located in the vicinity of:

  • hairy scalp,
  • butt fissure,
  • extends elbows and knees.

Scalp psoriasis - symptoms of the disease

It is worth noting that skin lesions typical of psoriasis may appear only on the scalp or accompany eruptions located elsewhere on the body. The most common areas are the occipital area, ears and the hairline, i.e. the place wherethe hairless skin becomes the scalp.

The appearance of erythematous eruptions (i.e. redness visible to the naked eye) and papular lesions (i.e. changes above the level of the skin), which are covered with silvery scales, is typical on the hairy skin. These changes may be accompanied by peeling, alopecia and intense itching, which results from inflammation within the skin.

Scalp dandruff - what is it?

Dandruff is a broad term that includes any fine flaking scalp. Scalp dandruff is conventionally divided into:

  • dry dandruff - it is characterized by a slight secretion of sebum,
  • oily dandruff - it is accompanied by severe seborrhea.

In the case of dry dandruff on the scalp, we see whitish, fine, loose scales. However, oily dandruff looks a bit different. In this case, yellowish, greasy scales with a lower tendency to flake off are visible on the scalp, especially around the top of the head, compared to dry dandruff.

An important difference that distinguishes dandruff from psoriasis is the most common location of lesions - in the case of dandruff, these are typically the temples and the top of the head, not the hairline and poll area, as in psoriasis.

Dandruff - causes

Dandruff also differs from psoriasis in terms of etiology, i.e. the reasons for its appearance. In the case of dandruff, flaking of the scalp is mainly due to the action of the yeast-like fungus Malassezia. These fungi irritate the skin and accelerate the renewal of epidermal cells, which is manifested by fine flaking.

Factors that predispose to the appearance of dandruff are:

  • hormonal and metabolic disorders,
  • diet low in magnesium, selenium, zinc and calcium,
  • iron deficiency.

Studies also show that the appearance of dandruff may also be significantly influenced by a deficiency of Propionibacterium anaerobic bacteria and an excess of aerobic Staphylococcus bacteria.

Moreover, the intensification of changes in dandruff takes place in the fall-winter period, and such a tendency is not observed with regard to psoriasis.

Dandruff and scalp psoriasis - differences in treatment

The medical conditions discussed in this article also differ in terms of their treatment. In the treatment of scalp dandruff, the following are typically used:

  • antifungal preparations - such as ketoconazole, imidazole, ciclopirox, these compounds are found in many shampoos commonly available in pharmacies,
  • preparations with an exfoliating effect - including acidlactic acid or salicylic acid, which not only removes scaly lesions, but also reduces the secretion of sebum, which is particularly useful in the treatment of oily dandruff,
  • preparations that inhibit the division of epidermal cells (i.e. anti-proliferative) - for example ichthyol or octopyrox.

Psoriasis - what is its treatment?

In the case ofof scalp psoriasis , we have both topical and systemic (orally) therapies, and the choice of a specific treatment method depends primarily on the severity of the symptoms of the disease. The most commonly used topical preparations are:

  • exfoliating (keratolytic) preparations - here we use substances such as in the treatment of dandruff, i.e. salicylic acid and lactic acid,
  • topical steroids - they act as an antipruritic and also reduce inflammation, examples of such substances are mometasone (available as a liquid and emulsion), hydrocortisone (additionally available as a lotion), and betamethasone (available as a gel or fluid),
  • vitamin D analogues - for example, calcipotriol, which is often combined with topical steroids. Calcipotriol has an anti-inflammatory effect and also reduces the proliferation of epidermal cells,
  • calcineurin inhibitors - these are substances with anti-inflammatory properties and modifying the immune system - an example of such a compound is tacrolimus.

It is also worth mentioning thatof scalp psoriasisuses phototherapy, i.e. therapy with the use of light (ultraviolet rays).

Psoriasis and systemic diseases

You should be aware that, unlike dandruff, the appearance ofscalp psoriasisincreases the risk of developing other chronic diseases. Scientific research shows that psoriasis increases the likelihood of developing:

  • cardiovascular diseases such as ischemic heart disease, and consequently also myocardial infarction,
  • metabolic syndrome - consisting of abnormal blood lipids (including cholesterol), obesity, diabetes, and hypertension,
  • chronic kidney disease,
  • Crohn's disease and ulcerative colitis - diseases belonging to inflammatory bowel diseases.

Psoriasis is a systemic disease that is much more complex than dandruff. That is why people with psoriasis require a holistic approach and very often the care of various specialists.

In addition, psoriasis can also developjoint involvement, which is not observed in the case of dandruff. Joint involvement can lead to significant restrictions on movement and significantly worsen patients' quality of life.

Dandruff or psoriasis - what to do? Which doctor to go to?

To sum up, if there is something more than fine-flaky exfoliation on our scalp, i.e. erythematous changes or papules, i.e. changes above the skin level, it is definitely worth going for a dermatological consultation.

If small-flake changes persist after typical anti-dandruff preparations available in pharmacies, it is also an indication for a dermatological consultation. It is worth knowing that registering for an appointment with a dermatologist under the National He alth Fund requires a referral that can be obtained from your family doctor. That is why we should go to him in the first place with our skin problems.

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Category:

Dermatology