Dandruff or fungal infection? Doctor shares how to spot the difference

Hindustan Times

22-06-2025

Dandruff is a common scalp woe, but surprisingly, not every flake is what it seems. Many may dismiss dandruff as just a haircare misstep, but it may also point to a more serious scalp issue, like a fungal infection. It's easy to mix them up, but by understanding the key differences, one can get the right diagnosis and treatment before the problem worsens. In an interview with HT Lifestyle, Dr BL Jangid, Dermatologist, Hair Transplant Surgeon at SkinQure Clinic, New Delhi, outlined the key differences between dandruff and fungal scalp infections. Don't dismiss particles in your hair as just dandruff, because the treatment may differ.(Shutterstock)
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Pointing out how alike they can sometimes look, he explained, "To the casual eye, dandruff looks like a dusting across the hair and shoulders, while strands catch the light and show tiny piles resting on the skin. But sometimes, dandruff can also be something else. Because dandruff and fungal infections look so alike, both itch, flake, and leave the scalp feeling uncomfortable, many people mistake one for the other. Yet knowing which problem is what really matters, because the underlying trigger can be different and the best way to treat it may change." It is vital to tell them apart, as Dr Jangid also reminded, that the treatments are different. For fungal infections, doctors prescribe antifungal medication, not just any dandruff shampoo.
Dr BL Jangid simplified the differences with the help of a comprehensive guide, outlining the key distinctions along with signs that may indicate the need for a dermatologist visit. Here's the guide he shared:
What is dandruff?
Dandruff, in contrast to a healthy scalp, looks like a dusting across the parting and shoulders, tiny white or yellowish flakes that shed easily on the shoulders. (Shutterstock)
Dandruff itself is a widespread scalp nuisance that causes loose white or light yellow flakes to drift off the head.
Its roots vary. Skin that is too oily or too dry, sensitivity to shampoos or gels, and even that same Malassezia yeast living on everyone up there, which, in some people, sparks mild inflammation.
So while the fungus sits on most scalps without fuss, it can provoke symptoms in the unlucky few and snow-balling flakes follow.
What is a fungal scalp infection?
It may itch, yet the urge tends to stay faint, stopping short of the full-body scratching seen with deeper infections.
Fungal infections on the scalp, most often tinea capitis or scalp ringworm, grow when dermatophytes-small, skin-loving fungi-take hold in the skin, hair, and follicles.
As the fungus spreads, the scalp can turn very red, flake or crust over, lose hair in patches, and, in severe cases, swell or fill with pus.
Unlike ordinary dandruff, a fungal infection can pass from one person to another and tends to show up more in kids, although grown-ups catch it, too.
Because of this, treatment usually requires prescription antifungal pills or ointments that a doctor writes, not the over-the-counter products found on a drugstore shelf.
What are the key differences between dandruff and fungal scalp infections?
A trained dermatologist is still the only person who can give you an official diagnosis, yet a few rough clues may point you toward the right trouble:
Flake texture: Ordinary flakes feel dry and drift-free, while fungal scales are thicker, greasier, and cling harder to the skin.
Ordinary flakes feel dry and drift-free, while fungal scales are thicker, greasier, and cling harder to the skin. Location and spread: Dandruff sticks almost exclusively to the scalp; a fungus may creep onto the temples, neck, or even the ears.
Dandruff sticks almost exclusively to the scalp; a fungus may creep onto the temples, neck, or even the ears. Hair loss: Patchy bald spots show up with infection, but are rare if your scalp problem is just flakes.
Patchy bald spots show up with infection, but are rare if your scalp problem is just flakes. Inflammation: Extra redness, swelling, heat, or tenderness usually signals fungus instead of plain dandruff.
When to visit a doctor?
When these persist for more than a week:
Itching
Burning
Unexplained patches
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.