What does YOUR dandruff say about your health? Expert decodes the clues your hair is giving you - from large waxy flakes caused by scalp fungus to discharge that points to vitamin deficiency

 While we may dismiss dandruff as a minor annoyance, or more of a cosmetic problem, but in fact paying closer attention could give you valuable insights into your overall health. 

Consultant dermatologist Dr Eva Melegh has identified the different types of dandruff and what they mean, from large, waxy flakes caused by a fungal infection to small, non-itchy white flakes caused by a burned scalp. 

While the common skin condition is non-harmful, an itchy scalp with fine, white flakes could indicate an allergy while yellow flakes and an inflamed scalp may mean eczema. 

Here, Femail reveals how to decode the clues that could be lingering in your hair.

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Consultant dermatologist Dr Eva Melegh has identified the different types of dandruff and what they mean. Stock image

LARGE WAXY FLAKES  

Could mean: Scalp fungus 

A common cause of dandruff is the fungus called Malassezia globose that feeds off the oils on our skin and hair. It produces oleic acid, which can irritate our skin. 

In some people, this sets off an immune response which can lead to a rapid turnover of skin cells, producing fungal dandruff. It is more common among those with greasier hair. 

Anti-dandruff shampoos typically contain pyrithione zinc, the most common anti-fungal ingredient. However over use of anti-dandruff shampoos can lead to a dry and sensitive scalp and cause different sort or dandruff, so their use should be limited. 

SMALL DRY WHITE FLAKES WITH ITCHING  

Could mean: Scalp allergy  

Small dry and white flakes with an itchy, tight-feeling scalp that is often worse soon after washing hair could be down to an allergy. 

Studies show that around 10 per cent of the population suffer from an allergy to a common preservative used in most standard shampoos called MITT (Methylisothiazolinone). In addition, allergies to perfumes and detergents in shampoos and can also trigger scalp allergies.  

I suggest chemical-free and reparative scalp treatments to reduce irritation, improve scalp moisturisation and repair skin barrier function through the use of prebiotic ingredients. 

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Small dry and white flakes with an itchy tight feeling scalp that is often worse soon after washing hair could be down to an allergy. Stock image

SMALL DRY WHITE FLAKES WITHOUT ITCHING 

Could mean: Burned scalp

While we all slather on the sun cream, few of us realise how exposed and sensitive the scalp is to UV damage. 

Sunburn to the scalp is very common, especially if you have thin hair, and even hot water from the shower can mildly burn the scalp. 

So if you have been out in the sunshine at the weekend or on holiday or have been turning up the heat in the shower and a week later you have a flaky scalp without itching, chances are you may have suffered burning. 

The solution is moisturising shampoos without perfumes and leave-in scalp serums for improved scalp conditioning. Stick to tepid showers and wear a hat during sunlight hours until things improve.

YELLOW FLAKES WITH INFLAMED SCALP 

Could mean: Eczema

Seborrheic dermatitis is an underlying inflammatory skin condition caused by damaged skin barrier function moisture loss and then usually secondary bacterial infection form the oil of the hair follicles. 

It’s likely that patches of eczema will be present on other areas of the body, most likely the cracks of the arms and knees and behind the knees, although sometimes it can appear just on the scalp. 

A prescribed mild corticosteroid scalp wash can calm the inflammation though corticosteroids are not suitable for use over long periods. 

As a preventative for daily use to use in use a chemical free, perfume-free and scalp cleansing shampoo that helps repair skin barrier function. Try Hydrosil Scalp Shield Shampoo with prebiotics for scalp barrier repair. Avoid any sticky or perfumed hair products. 

SMALL WHITE FLAKES WITH HAIR LOSS

Could mean: Vitamin deficiency  

Small fine white flakes with increased and sudden hair loss could point to a vitamin deficiency. 

Iron, copper and zinc deficiencies as well as a lack of essential fatty acids, often as a result of low-calories weight loss diets, can cause your scalp to flake and hair loss. 

Try taking Vitamin B12, biotin, zinc and omega fatty acids supplements or The Ordinary Multi-Peptide Serum for Hair Density. 

LARGE SILVERY FLAKES WITH GREY AND RED SCALING ON SCALP 

Could mean: Scalp psoriasis

Scalp psoriasis is one of the most common places for psoriasis to appear first and is often mistaken for normal dandruff. 

Large silvery flakes with red and greyish round skin plaques on the scalp are indicators of the condition, which affects around 2 per cent of the UK population.

It is caused by an acceleration of skin cell production. Normally a skin cell matures in 21-28 days. Psoriatic cells, however, turn over in 2-3 days and in such profusion that the live cells reach the surface and accumulate with the dead cells still in visible plaques.  

Solution Coal tar shampoos are commonly prescribed for treating scalp psoriasis but are messy, smelly and not particularly effective. Instead try Oregon Shampoo & Conditioner two hair care products developed by a UK trichologist and trailed at Bath University for use on scalps prone to psoriasis.  

GREASY SMALL YELLOWY FLAKES WITH SPOTS ON THE SCALP

Could mean: Folliculitis

Greasy yellowy flakes with spots or cysts on the scalp could be a warning sign of folliculitis, a common skin condition in which hair follicles become inflamed.

Scalp acne occurs when hair follicles become blocked with oil and dead skin cells, or bacteria, and subsequently become inflamed or infected. 

Hormonal changes such as puberty, pregnancy and menstruation can be a trigger for scalp acne. In addition, sticky or pore clogging hair products like gels and hair sprays can also add to the problem.   

 Prescription medicated shampoos normally containing salicylic acid and or glycolic acid can help treat the problem or in more severe cases benzoyl peroxide.

Shampoos or scalp tonics containing tea tree oil or birch water can also help as preventatives for everyday use.