Donald Trump is very sensitive about his reportedly under-sized hands, notably his short fingers. But gosh, those little hands have a propensity to go wherever they like.

Just ask French President Emmanuel Macron. No doubt his skin crawls when he thinks back to April 2018, when he and then US President Trump met in the Oval Office, many cameras watching.

“They’re all saying what a great relationship we have, and they’re actually correct,” Trump said to Macron.

“We do have a very special relationship. In fact, I’ll get that little piece of dandruff off – we have to make him perfect. He is perfect.”

And that’s what he did – brushed off some little white flakes with his fingertips.

Did President Macron really have dandruff, or just a dry scalp? Photo: Getty

Two questions remain unanswered: Why didn’t Macron give Trump a poke in the eye – or at least a steaming Gallic rebuke?

And was it really dandruff? Or just some dry, flaky skin coming away from his scalp?

There is a difference

A dry scalp is caused by a lack of moisture in the skin. This leads to irritation and skin cells being shed as flakes. These tend to be small and white. We tend to call these flakes dandruff, but technically they’re not.

In Macron’s case, it’s possible that his scalp dried out on the flight over from France, and this was exacerbated by the cool spring air and exposure to indoor heating. And he may have been washing and styling his hair too often in hot water.

The itchiness associated with dry scalp isn’t usually severe. If it does become severe, then you should get checked out by a doctor who may find you have a more serious condition.

To help control dry scalp flakes, use a moisturising shampoo and conditioner. Popular home remedies such as tea-tree oil or coconut oil, can help relieve itchiness and the dryness.

This is a very common condition and you will tend to call it dandruff. The difference is, dry scalp doesn’t required medicated treatments. True dandruff does.

Dandruff flakes are oily, not dry

Dandruff (Pityriasis capitis) is a mild, non-inflammatory form of seborrheic dermatitis. About half the world’s population will deal with dandruff at some point in their lives.

‘Seborrheic’ refers to the sebaceous or oil glands.

Seborrheic dermatitis flares up when excessive oil cause causes itchy red patches and greasy scales on your skin.

The scales flake off as true dandruff, and the flakes tend to be crusty or powdery, oily, larger than dry-scalp flakes, and more yellow than white.

Seborrheic dermatitis, which can appear on other parts of the body, is a common, life-long skin condition that can’t be cured. And because dandruff is a mild form of seborrheic dermatitis, it can’t be cured either.

But it is easy to manage. It’s not contagious, and it doesn’t indicate that the person is unclean or infected. So don’t flinch if someone you love breaks out.

Dandruff isn’t contagious or evidence of poor hygiene. But it’s not curable either.

If President Macron had dandruff, the flakes would have shown up more clearly.

By the way, babies can get seborrheic dermatitis. If your baby has a scaly, dry scalp, it’s called cradle cap. It tends to disappear in a short amount of time.

What causes dandruff?

Seborrhoeic dermatitis can be caused by a microscopic fungus called malassezia.

Malassezia is normally present on healthy skin, around the areas where oil is produced. According to the federal government’s online health advice, some people develop an immune reaction to malassezia for reasons that remain unknown.

Malassezia can cause other conditions, including eczema.

It’s also thought that stress, poor diet, and lack of exposure to fresh air aggravate seborrhoeic dermatitis.

Treatment

According to the Victorian government’s online health advice, regular washing of the scalp with a medicated shampoo is sufficient treatment for most cases.

The most common anti-dandruff shampoos contain one or more of these chemicals:

• Zinc pyrithione or zinc omadine, these are antifungal drugs
• Selenium sulfide lowers the amount of fungus and prevents too many skin cells from dying off
• Piroctone olamine is the most recent addition to medicated shampoos, and is known as a ‘second generation’ anti-dandruff agent – it is less toxic than zinc pyrithione and safer for family use
• Coal tar has been used in shampoos for years for more severe scalp conditions. In older preparations, the coal scent put some people off.  However, newer preparations are well tolerated.

For potential home remedies, see here.

If the dandruff is severe then your doctor may prescribe topical corticosteroid lotions for symptomatic relief.

Finally, avoid brushing dandruff off the clothes of people you don’t know very well.