White Piedra: How is it Different from Dandruff?

HK Vitals

Medically Reviewed By Dr. Aarti Nehra

For many, long, lustrous hair is just a dream. While they do everything to remain on course, hair concerns pop up from nowhere. One of the most common hair concerns is dandruff, affecting almost 50% of the population. Thankfully, dandruff is not a serious medical condition. But white piedra, which looks like dandruff, can make things nasty. But what is white piedra? Let’s take a look.

What is White Piedra?

White piedra is an infection affecting the hair shaft. It is a fungal infection caused by a fungus known as Trichosporon, which typically thrives on soil and dirty water. The fungus grows on the nodules surrounding the hair shaft, leading to a formation of white, gray, or tan-colored flakes that are soft and loosely clump together (like soft nodules) on the scalp and hair strands. 

What Triggers White Piedra?

Unlike dandruff which starts from a fungal infection that thrives on the scalp oils, white piedra exists in nature. It spreads and grows in soil and dirty water. Therefore, poor hygiene is seen as its transfer point from the environment to the human scalp. 

The most common causes for the spread of white piedra include:

  • Use of dirty water
  • Infrequent hair washing
  • Use of contaminated combs and hair accessories
  • Covering or tying up wet hair

Early Signs of White Piedra

The flakes of piedra look much like those of dandruff. But the pearly-like nodules are about 1 mm in size, much bigger than dandruff flakes. Other signs and symptoms of white piedra include brittle hair, dirty-looking/discoloured hair, and/or pain and itching on the scalp.

How is White Piedra Different From Dandruff?

To be candid, dandruff is not a serious skin concern. Though it is widely prevalent, it is easy to manage. On the other hand, white piedra is a medical condition that requires attention. 

Secondly, dandruff has a telltale sign – falling off on the shoulders. But flakes of piedra do not fall off. They remain clumped together in the hair. 

While dandruff is not contagious, white piedra can spread from person to person through contaminated water and the exchange of hair accessories and infected combs. 

Dandruff typically occurs on the scalp and face as these have the highest concentration of sebaceous glands. Conversely, white piedra can infect the scalp, facial and body hair including pubic hair.

How is White Piedra Diagnosed?

The diagnosis of white piedra is done by certified dermatologists after a thorough examination of the hair shaft and hair nodules. A series of laboratory tests that include culture of hair samples is done to identify the fungus variant.

How is White Piedra Treated?

Unlike dandruff, white piedra cannot be treated effectively through home remedies or over-the-counter hair care products. White piedra treatment involves careful medical intervention. 

The first line of treatment typically includes shaving off all infected hair. Subsequent treatment options include prescribing antifungal creams and shampoos, and putting the patient on an oral antifungal medication plan until the fungal growth is completely eradicated. 

White Piedra Risk and Complications

White Piedra affects people of all ages and gender. However, studies show that young men are at the highest risk of developing the condition. 

The complications associated with its outbreak are brittle and weak hair. Immuno-compromised people are more prone to develop an intense burning sensation. The embarrassment linked to shaving off hair has psychological effects. If left untreated, the condition can spread uncontrollably and lead to hair loss.

Prognosis of White Piedra

White piedra is generally a harmless condition and gets settled with proper medical intervention. Once corrected, people recover well from its health consequences and begin to grow healthy hair. 

And for all those who have questions like ‘Does dandruff cause white hair or ‘Does white piedra cause white hair’, the answer is ‘no’. While these do give a whitish-flaky appearance to the hair, they do not affect the melanin in the hair follicles. 


White piedra and dandruff share similarities. However, their nature, cause, and plan of treatment differ. Proper diagnosis and medical intervention are important for recovery from piedra.

HK Vitals


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