Scalp problems and dandruff

Scalp problems are very common and can cause flaking, itching, redness, or irritation. Dandruff is often mild, but some people develop more persistent inflammation known as seborrhoeic dermatitis. Scalp symptoms may also be linked to psoriasis, fungal infection, or other skin conditions.

This page explains common scalp conditions, how they are assessed, and when to seek GP advice.

These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help with skin concerns, please book an appointment. We also offer specialist GP dermatology input at the Skin Clinic.

Skin Clinic

Symptoms of scalp problems

Common scalp symptoms include:

White or yellow flakes on the scalp or shoulders
Itching or irritation
Red or inflamed patches of skin
Greasy or dry scaling
Soreness or tightness of the scalp

Symptoms may worsen during stress, cold weather, or illness.

Urgent symptoms and red flags

Seek urgent medical advice if you develop:

Rapidly spreading redness or swelling of the scalp
Severe pain, oozing, or crusting
Fever or feeling generally unwell
Sudden hair loss associated with scalp pain or redness

Common causes of dandruff and scalp conditions

Dandruff

Simple dandruff causes dry or flaky skin without significant redness or inflammation. It is common and not contagious.

Seborrhoeic dermatitis

Seborrhoeic dermatitis is a more inflamed form of dandruff. It is linked to skin sensitivity and overgrowth of natural yeast on the skin. It may affect the scalp, eyebrows, sides of the nose, ears, and chest.

Other causes

Scalp symptoms may also be caused by:

Scalp psoriasis
Fungal infections
Contact dermatitis from hair products
Very dry skin

Correct diagnosis is important, as treatments differ.

How a GP assesses scalp problems

A GP will usually assess scalp problems based on history and appearance. They may ask about:

Duration and pattern of symptoms
Presence of redness beyond the hairline
Other skin involvement elsewhere on the body
Hair loss or broken hairs
Treatments already tried

Photographs are often sufficient for remote assessment.

Investigations

Most people with dandruff or seborrhoeic dermatitis do not need investigations.

Tests may be considered if fungal infection or another condition is suspected, or if symptoms are not responding to treatment.

Self care and lifestyle measures

Self care plays a key role in managing scalp conditions:

Use medicated anti dandruff shampoos as directed
Leave shampoo on the scalp for several minutes before rinsing
Avoid scratching the scalp
Use gentle, fragrance free hair products
Manage stress where possible

Improvement may take several weeks with consistent use.

Medical treatments a GP may recommend

Depending on symptoms, a GP may recommend:

Medicated shampoos containing antifungal ingredients
Short courses of topical treatments to reduce inflammation
Treatment for underlying scalp psoriasis or infection if present

Treatment is tailored to symptom severity and response..

When to seek GP review

You should consider a GP appointment if:

Dandruff does not improve with medicated shampoos
Scalp redness or itching is persistent or worsening
Symptoms spread beyond the scalp
You have associated hair loss
You are unsure of the diagnosis

Early review helps ensure the correct treatment is used.n.