Why Scratching Out Dandruff Is A Bad Idea

Up to 30% of the population in the United States at one time or another develops a flaky or itchy scalp.  Not a day goes by that a TV commercial for a dandruff shampoo is visible over and over again.

A high percentage of individuals who develop flaky scalps also develop itching which leads to frequent scratching and rubbing of the affected areas of the scalp.

As with most medical conditions there can be a range of severity from mild to moderate to severe.  The milder cases of an itchy flaky scalp oftentimes clear up with shampooing alone, however the medicated shampoo might have to be used on a daily basis to keep things under control.

When shampooing alone does not work, there are a variety of topical treatment products containing ingredients such as sulfur, tar, salicylic acid, or hydrocortisone that can be added to the treatment program to get better results.

One of the other tactics that is oftentimes used to conquer the flaking of the scalp is to scratch out the dandruff.  This might be done at home using a comb to try to raise all of the flakes followed by brushing them out.  In a salon setting, a hair stylist or barber might use their fingers to vigorously scratch the flaky areas of the scalp to remove the flakes which can then be washed away during the shampooing process.

However, scratching out the dandruff does not really correct the process that caused the flaky areas to develop in the first place.  As mentioned earlier, milder cases of dandruff usually clear with shampooing and when that alone doesn’t work; there are a couple of medical diagnoses that should be considered.

The first is seborrheic dermatitis which is characterized by the presence of dry scaly flaky areas and redness that frequently develops on the scalp around the margins or edges and also is associated with areas of inflammation with scaling inside and behind the ears as well as the corners of the nose and between the eyebrows.

Another medical condition associated with severe flaking and scaling of the scalp is psoriasis.  With this condition, the scalp has localized or diffuse plaques with thick areas of silvery scales that are heaped up and raised above the skin. Peeling away these scales can frequently reveal areas of pinpoint bleeding or irritation.

One of the peculiar things about psoriasis in particular and seborrheic dermatitis as well is a process called Koebnerization or the isomorphic phenomenon.  What this term means is that any type of trauma or injury to the skin can activate the inflammatory process that initiates the onset of this disease condition.

So, with regards to scraping away the flakes on the scalp and scratching out the areas that look like dandruff the disease process triggers the Koebner  phenomenon so the area of disease activity is actually being stimulated to become more and more active.  After, the visible flakes are removed, the scalp might look better, but this improvement is temporary at best.  As a result of the Koebner process, the body increases the rate of production of new skin cells which build up more intensely so that the scalp condition progressively gets worse and worse.

The only way to effectively manage these conditions is to eliminate the itching and scratching with anti-inflammatory and anti-itch medications and resist the temptation to try and scratch the flakes away because of the process mentioned above.

So, if you find yourself with a stubborn itchy, flaky scalp condition that you cannot control with medicated shampoos or products from a pharmacy, don’t scratch it out; see your dermatologist to get a specific diagnosis and prescription strength medications that can provide relief.