“Dandruff” on only one side of head?

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I don’t know if you can call it dandruff, but I have it showing up on only one side of my head. There’re little to no flakes on any other parts of my scalp. I use anti-dandruff shampoo as well. What possible reasons could there be as to why that is? And what steps should I take to remedy this problem?

thank you!

Dr. Teo Wan Lin Answered question June 24, 2021

Do you have an itch, redness or pain on your scalp? An undiagnosed inflammatory scalp disease such as seborrheic dermatitis, scalp eczema or psoriasis can be responsible.

Seborrheic dermatitis is caused by a yeast known as malassezia furfur in an individual with excess production of oil, and can be worse in tropical and humid climates such as Singapore. Malassezia under normal conditions does not cause disease of the skin or scalp. Under humid environments, it can cause moderate to severe scalp inflammation and flaking. When severe, it can even cause hair loss. If you have tried over the counter anti-dandruff shampoos and are not better, promptly seek the care of an accredited dermatologist rather than self medicate or DIY.

Scalp eczema, an excessively dry scalp/skin condition is another cause of scalp inflammation. If one has a family history of psoriasis, scalp psoriasis can also cause scaling on the scalp similar to dandruff. 

At a dermatologist’s office, your dermatologist may recommend medicated shampoos containing zinc pyrithione, selenium sulfide, coal tar, ciclopirox, ketoconazole and salicylic acid should be used twice weekly for at least a month. Steroid scalp applications are seen to reduce itching. Calcineurin inhibitors such as tacrolimus can be used as steroid alternatives. Coal tar cream can be applied to scaling areas and removed several hours later by shampooing. Combination therapy is often advisable.

Dr. Teo Wan Lin Answered question June 24, 2021
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