Dandruff, Cradle Cap, and Other Scalp Conditions

Dandruff is white or yellow flakes from an itchy, greasy scalp — a mild form of seborrhoeic dermatitis. It is not caused by dry hair or poor hygiene; it is driven by normal scalp yeast (Malassezia) and the body's reaction to it. It is very common, not contagious, and manageable — though not fully curable.

Common scalp conditions

• Dandruff / seborrhoeic dermatitis — flakes, itch, sometimes redness. In infants, the same condition is called cradle cap — yellow greasy scales on the scalp; resolves by 6–12 months.
• Scalp psoriasis — thicker, silvery scales, sharp edges, often on hairline and behind ears. See Psoriasis.
• Fungal ringworm of scalp (tinea capitis) — common in children; patches of hair loss with scaling and broken hairs; needs oral antifungal (creams alone won't work).
• Head lice — itchy scalp with small nits glued to hair shafts near scalp. Common in school-age children. See Head Lice.
• Folliculitis — red, pus-filled bumps on scalp, often bacterial.
• Scarring alopecia — itchy red scalp with hair loss that doesn't regrow; see a dermatologist early.

Managing dandruff

• Medicated shampoos — ketoconazole, ciclopirox, zinc pyrithione, selenium sulphide, coal tar. Use 2–3×/week; leave on for 5 minutes before rinsing.
• Rotate between 2 different active ingredients every few months to avoid tolerance.
• Oil massage can help but don't leave oil on overnight — it feeds the yeast and worsens dandruff.
• Topical steroid lotion or antifungal solution for flares — under a doctor.
• Diet/stress play a role for some; dairy reduction has weak evidence.

Cradle cap in infants

• Apply baby oil or plain emollient, wait 15 minutes, gently loosen with a soft brush, then wash with mild shampoo.
• Usually resolves without treatment by 6–12 months.
• Red, spreading, bleeding, or involving face — see a paediatrician.

When to see a doctor

• Dandruff that doesn't improve after 4 weeks of medicated shampoo.
• Thick silvery scales, bleeding, or extending onto face and ears — probably psoriasis.
• Patchy hair loss with scaling in a child — ringworm, needs prescription.
• Scalp redness, painful pustules, hair-loss scarring.