This article was originally published in American Spa.
Hair restoration expert Anil Shah, M.D., a board-certified facial plastic surgeon and founder of Aesthetic Scalp in Chicago, shares insight on the differences between dry scalp and dandruff, as well as misconceptions and treatment options.
“Dry scalp and dandruff are often confused, but they’re actually opposites,” says Shah. “Dry scalp is caused by poor hydration and low humidity, while dandruff is driven by excess oil and a fungal overgrowth.”
The Key Difference
Dry scalp develops when cold outdoor air and indoor heating strip moisture from the scalp, leading to fine, white flakes and tight, itchy skin. Dandruff, on the other hand, thrives in oil-rich environments.
“Dandruff flakes are typically larger, yellow, and oily,” says Shah. “In winter, hats trap moisture, people shower less, and the body produces more oil to compensate for dryness. All of these feed the fungus responsible for dandruff.”
Common Winter Scalp Mistakes
One of the biggest contributors to worsening symptoms is hot showers. “Switching from cold outdoor air to hot indoor heat, combined with scalding water, strips the scalp’s protective barrier,” says Shah.
“Hot water removes natural oils and worsens dryness and irritation.”
Another frequent mistake is treating all flaking as dandruff. “Using antifungal shampoos on a dry scalp can further irritate the skin," he says. "Sometimes the scalp doesn’t need medication, it simply needs moisture.”
Scalp care should change with the seasons, he says.
- Winter: Wash hair about twice a week, use gentle cleansers, and focus on hydration
- Summer: Increased washing is often helpful due to sweat and oil buildup
Ingredients That Help and What to Avoid
For dandruff, Shah recommends ketoconazole as the best, with zinc and selenium also playing a role. For dry scalp, he recommends humectants, ceramides, hyaluronic acid, and aloe vera.
“Colloidal oatmeal and vitamin B3 help calm irritation and support the scalp barrier,” he says. Shah cautions against certain ingredients, particularly in winter: “Alcohol, sulfates, and heavy fragrance can significantly dry and irritate the scalp.”
When to See an Expert
Shah advises trying over-the-counter treatments for about six weeks but urges earlier evaluation for concerning symptoms.
“Silver scaling, patchy hair loss, or yellow, oozing crusts could indicate conditions like psoriasis, alopecia areata, or infection and should be assessed promptly,” he says.