Dandruff is a condition where dry skin flakes off of your scalp. Eczema is a chronic, inflammatory skin condition often associated with allergies. Flakes are often a symptom of eczema. But dandruff and eczema aren’t the same thing.

Dandruff and eczema (also called atopic dermatitis) are two common types of skin conditions that can affect your scalp, which often results in itchy, and sometimes dry, flakes. In some cases, dandruff may be mistaken for eczema, and vice-versa.

Dandruff is a condition where dry skin flakes off of your scalp. You may notice these skin flakes stuck in your hair, or they may fall onto your shoulders and become visible on clothing.

Eczema, on the other hand, is a chronic, inflammatory skin condition often associated with allergies. Depending on the type of eczema, you may notice dry or greasy flakes, along with redness, burning, and swelling.

With all the possible conditions that can affect your scalp, you may be wondering if your symptoms are an indication of occasional dandruff, or if you may be dealing with a more long-term condition, such as eczema. Read on to learn the key differences and similarities between the two.

Dandruff and eczema may both cause an itchy scalp, along with flakes. Here’s how to tell the difference between the two:

Dandruff symptoms

If you’re noticing white or gray-looking flakes on your scalp or clothes, you may have dandruff. Unlike eczema, occasional dandruff tends to make your scalp dry, too. Unlike other skin conditions, dandruff is restricted to just your scalp.

Eczema symptoms

Scalp eczema is also itchy. Unlike dandruff, though, you may also notice the following symptoms:

Despite their symptoms, dandruff and eczema aren’t contagious, and neither one is caused by poor hygiene. Understanding the possible causes of each condition may help you get effective treatments and avoid possible triggers.

Dandruff causes

While the exact causes of dandruff may vary, it’s thought that underlying dry scalp may be worsened by cold weather or stress. The flakes can also be more obvious if you don’t wash your hair regularly, but dandruff is not caused by a lack of hygiene.

Dandruff may be mistaken for certain scalp conditions such as:

Eczema causes

Eczema is an allergic, inflammatory skin condition that often begins in childhood. It’s thought to be associated with a leaky skin barrier that dries out your skin. If you have allergies, asthma, or hay fever, you may be more likely to have eczema, too.

Seborrheic dermatitis is a common type of eczema that may develop on your scalp. It’s known for a rash that may be red and itchy, along with thick scales that may be greasy and crusty. In babies, seborrheic dermatitis is known as cradle cap.

Certain triggers may also cause your eczema to flare up from time to time. Possibilities include:

  • stress
  • heat or humidity
  • cold, dry air
  • allergies

Dandruff flakes and eczema scales may look similar, but dandruff is considered a separate condition from eczema. It’s common to self-diagnose yourself with dandruff when you may actually have another scalp condition.

The only way to know for certain whether you have dandruff or eczema is through a doctor’s diagnosis.

Despite some of their similarities in appearance, triggers, and management, dandruff will not lead to eczema. Unlike dandruff, eczema is an allergic skin condition that’s often genetic.

One indication that you might have eczema and not dandruff is that you continue to experience symptoms despite using medicated antidandruff shampoos.

Dandruff is a common condition that’s associated with a dry scalp. When you have dandruff, you may notice that the associated flaking is dry, and sometimes itchy. It may come and go, but you can control it with medicated shampoos.

Eczema and psoriasis, on the other hand, are both inflammatory skin conditions that can affect your scalp. They tend to be lifelong skin conditions that may have periods of flares and remission. Both may also cause symptoms in other parts of the body besides the scalp.

Like eczema, psoriasis can cause a rash that may be reddish in appearance and become itchy and sore. But unlike eczema, psoriasis is an autoimmune condition that causes rashes that are flaky and covered with thick, silvery scales. Psoriasis may even cause temporary hair loss.

Dandruff and eczema may be treated with over-the-counter (OTC) medicated shampoos. Look for shampoos with the following ingredients:

Dandruff treatment

In most cases, OTC medicated shampoos can help clear up occasional dandruff by getting rid of flakes, treating dry scalp, and providing itch relief.

You may need to try multiple products until you’ve found the best shampoo for your dandruff. Follow the manufacturer instructions, and consider switching products if you don’t notice any improvements.

A note on ethnicity:

The American Academy of Dermatology Association recommends that people of white or Asian ethnicity use antidandruff shampoos twice weekly, while using regular shampoo every other day in between. They also recommend that People of Color only shampoo once a week with antidandruff shampoo.

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If you have light-colored or color-treated hair, you may want to avoid shampoos with coal tar, because these may cause discoloration. Coal tar may also cause sun sensitivity, so be sure to take precautionary measures when outdoors, such as wearing hats or scarves.

Eczema treatment

Eczema on your scalp may be treated with the same OTC medicated shampoos as dandruff to help provide relief from itching and scales.

Additionally, you may need other eczema treatments as recommended by a doctor. These may include:

  • topical moisturizers, creams, or ointments
  • prescription steroids (either topical or oral) to help control inflammation
  • topical immunomodulators
  • antihistamines to help control allergies
  • allergy shots
  • antibiotics to treat infections caused by scratching

In most cases, dandruff doesn’t require medical attention. However, if you aren’t seeing improvements in your scalp health despite using antidandruff shampoos, this could be an indication that you’re dealing with a skin condition other than dandruff.

No scalp improvements after a month of using medicated shampoos may warrant seeing a dermatologist. This type of doctor specializes in diagnosing and treating conditions of the skin and hair, and they can help you determine how to proceed.

You may also consider seeing a primary care doctor or dermatologist if your scalp is:

  • extremely itchy
  • red
  • swollen
  • burning
  • showing signs of infection, such as oozing, painful sores

Due to flakes and itchiness, dandruff and eczema may look and feel similar at first. But while dandruff is a common condition exclusive to the scalp, eczema is a chronic allergic skin condition that may affect other parts of the body and require long-term care.

If you’re experiencing frequent or recurring itchy or flaky scalp despite using OTC medicated shampoos, it may be time to see a doctor for diagnosis and treatment.