What are the common signs of dandruff. How can you treat dandruff at home. What underlying conditions may cause dandruff. When should you see a doctor about dandruff. What are the best anti-dandruff shampoo ingredients.

Understanding Dandruff: More Than Just Flakes

Dandruff is a common scalp condition characterized by the shedding of dead skin cells from the scalp. While it’s often seen as a simple cosmetic issue, dandruff can be more complex than it appears. Many people experience dandruff at some point in their lives, but its persistence and severity can vary greatly from person to person.

The condition is not contagious or harmful to overall health, but it can be embarrassing and uncomfortable for those affected. Understanding the causes, symptoms, and treatment options for dandruff is crucial for effectively managing this common scalp issue.

Recognizing the Signs: How to Identify Dandruff

Identifying dandruff is typically straightforward, but it’s important to distinguish it from other scalp conditions. The primary signs of dandruff include:

• White or grayish flakes of skin in the hair and on clothing
• An itchy scalp
• Dry or oily patches on the scalp
• Redness or irritation of the scalp (in more severe cases)

These symptoms can range from mild to severe, and may worsen during cold or dry weather. In some cases, dandruff flakes may be more noticeable in darker hair or when they fall onto dark clothing.

Is dandruff always visible?

Not always. In milder cases, dandruff may only be noticeable when combing or styling hair. However, more severe cases can result in visible flakes on the scalp, in the hair, and on clothing.

The Root Causes: What Triggers Dandruff?

Contrary to popular belief, dandruff is not caused by poor hygiene. While infrequent hair washing can exacerbate the condition, the underlying causes of dandruff are more complex. Some common factors that contribute to dandruff include:

1. Seborrheic dermatitis: A skin condition that causes oily, irritated skin
2. Malassezia: A yeast-like fungus that feeds on oils on the scalps of most adults
3. Dry skin: Particularly common in cold or dry climates
4. Sensitivity to hair care products: Some individuals may react to certain ingredients in shampoos or styling products
5. Skin conditions: Such as psoriasis or eczema
6. Age and hormonal changes: Dandruff is more common in young adults and can be influenced by hormonal fluctuations

Can stress cause dandruff?

While stress itself doesn’t directly cause dandruff, it can exacerbate existing scalp conditions and potentially lead to increased flaking. Stress may also weaken the immune system, making the scalp more susceptible to fungal overgrowth.

Treatment Options: Combating Dandruff Effectively

Fortunately, there are numerous ways to manage and treat dandruff. The most common and effective treatments include:

• Anti-dandruff shampoos: These contain active ingredients that help control scalp flaking and itching
• Scalp treatments: Medicated oils or serums can help soothe and treat the scalp
• Lifestyle changes: Such as managing stress and improving diet
• Prescription medications: For severe cases that don’t respond to over-the-counter treatments

What are the most effective anti-dandruff shampoo ingredients?

The most effective anti-dandruff shampoo ingredients include zinc pyrithione, selenium sulfide, ketoconazole, salicylic acid, and coal tar. These ingredients work in different ways to address the underlying causes of dandruff, such as fungal overgrowth or excessive skin cell turnover.

Natural Remedies: Alternative Approaches to Dandruff Control

For those seeking natural alternatives to commercial anti-dandruff products, several home remedies may help alleviate symptoms:

• Tea tree oil: Known for its antifungal properties
• Apple cider vinegar: May help balance scalp pH and reduce fungal growth
• Aloe vera: Soothes scalp irritation and reduces inflammation
• Coconut oil: Moisturizes the scalp and has antimicrobial properties
• Baking soda: Acts as a gentle exfoliant to remove dead skin cells

While these natural remedies can be effective for some individuals, it’s important to note that they may not work for everyone and could potentially irritate sensitive scalps.

How often should natural remedies be applied to treat dandruff?

The frequency of application for natural remedies varies depending on the specific treatment and individual response. Generally, most natural treatments can be applied 1-2 times per week. However, it’s essential to monitor your scalp’s reaction and adjust accordingly to avoid over-drying or irritation.

When to Seek Professional Help: Recognizing Severe Dandruff

While mild dandruff can often be managed at home, there are instances where professional medical advice is necessary. Consider consulting a dermatologist or healthcare provider if:

• Over-the-counter treatments don’t improve symptoms after several weeks
• The scalp becomes severely red, swollen, or painful
• Dandruff is accompanied by hair loss
• The condition spreads beyond the scalp to other areas of the body
• Symptoms significantly impact quality of life

A healthcare professional can provide a proper diagnosis and recommend more targeted treatments for severe or persistent dandruff.

Can dandruff be a sign of a more serious condition?

In some cases, what appears to be dandruff may be a symptom of an underlying skin condition such as seborrheic dermatitis, psoriasis, or even a fungal infection. If dandruff persists despite treatment or is accompanied by other symptoms, it’s important to seek medical evaluation to rule out more serious conditions.

Prevention Strategies: Keeping Dandruff at Bay

While it may not be possible to prevent dandruff entirely, several strategies can help reduce its occurrence and severity:

1. Maintain good scalp hygiene: Regular shampooing helps remove excess oils and dead skin cells
2. Choose the right hair care products: Use gentle, non-irritating shampoos and avoid products that leave residue on the scalp
3. Manage stress: Practice stress-reduction techniques such as meditation or yoga
4. Eat a balanced diet: Ensure adequate intake of zinc, B vitamins, and omega-3 fatty acids
5. Limit hair styling products: Excessive use of gels, sprays, and other styling products can contribute to scalp buildup
6. Protect your scalp: Wear a hat in extreme weather conditions to prevent dryness or excessive oil production

How does diet impact dandruff?

While diet doesn’t directly cause dandruff, certain nutritional deficiencies may contribute to scalp health issues. A diet rich in B vitamins, zinc, and omega-3 fatty acids can support overall scalp health. Additionally, some individuals find that reducing their intake of sugary or processed foods helps improve dandruff symptoms.

The Impact of Dandruff on Hair Health and Growth

Beyond the visible flakes and potential embarrassment, dandruff can have broader implications for hair health and growth. The relationship between dandruff and hair health is complex and multifaceted:

• Scalp inflammation: Persistent dandruff can lead to scalp inflammation, which may impact hair follicle health
• Itching and scratching: Excessive scratching due to dandruff-related itching can damage hair follicles and lead to hair breakage
• Product buildup: Using multiple anti-dandruff products may result in residue accumulation, potentially clogging hair follicles
• Psychological stress: The emotional impact of dealing with chronic dandruff can indirectly affect hair health through stress-related hair shedding

While dandruff itself doesn’t directly cause hair loss, the associated behaviors and treatments can impact hair health over time. Managing dandruff effectively is crucial not only for scalp comfort but also for maintaining healthy hair growth.

Can treating dandruff improve hair growth?

Addressing dandruff can potentially improve hair growth conditions by reducing scalp inflammation and creating a healthier environment for hair follicles. However, it’s important to note that while treating dandruff may support overall scalp health, it’s not a direct treatment for hair loss or thinning.

Effective dandruff management, combined with proper hair care practices, can contribute to a healthier scalp ecosystem, which is beneficial for hair growth and maintenance. If you’re experiencing both dandruff and hair loss, it’s advisable to consult a dermatologist or trichologist to address both concerns comprehensively.

Dandruff in Different Hair Types: Tailoring Treatment Approaches

Dandruff can affect all hair types, but the manifestation and optimal treatment approaches may vary depending on hair texture, density, and care routines. Understanding these differences is crucial for effective management:

Dandruff in Straight Hair

Straight hair often shows dandruff flakes more visibly due to less texture to hide the flakes. Treatment for straight hair typically focuses on:

• Frequent shampooing with anti-dandruff products
• Lightweight scalp treatments to avoid weighing down the hair
• Regular scalp exfoliation to remove buildup

Dandruff in Curly and Coily Hair

Curly and coily hair types may experience more scalp dryness, which can exacerbate dandruff. Treatment considerations include:

• Gentler, sulfate-free anti-dandruff shampoos to avoid stripping natural oils
• Focus on scalp-only application of treatments to maintain curl pattern
• Increased use of moisturizing products to balance scalp hydration

Dandruff in Oily Hair

Oily hair types may be more prone to seborrheic dermatitis-related dandruff. Management strategies often involve:

• More frequent washing with clarifying anti-dandruff shampoos
• Use of astringent ingredients like salicylic acid to control oil production
• Avoiding heavy conditioning products near the scalp

How does hair type influence dandruff treatment efficacy?

Hair type can significantly impact the effectiveness of dandruff treatments. Factors such as hair density, oil production, and typical care routines all play a role. For example, individuals with very thick or curly hair may need to focus on scalp-only application of treatments to ensure the product reaches the skin effectively. Conversely, those with fine or straight hair may need to be cautious about over-treating, as some anti-dandruff products can be drying or leave residue that’s more noticeable in their hair type.

Tailoring your dandruff treatment approach to your specific hair type and needs can greatly improve results. This may involve experimenting with different product formulations, application methods, and treatment frequencies to find the optimal balance for your scalp and hair health.

The Psychological Impact of Dandruff: Beyond Skin Deep

While dandruff is primarily a physical condition, its effects can extend far beyond the scalp, impacting an individual’s psychological well-being and social interactions. Understanding and addressing these aspects is crucial for comprehensive dandruff management:

Self-Esteem and Confidence

Visible dandruff flakes can significantly affect self-esteem, leading to:

• Embarrassment in social situations
• Avoidance of dark-colored clothing
• Reluctance to engage in close physical contact
• Decreased confidence in professional settings

Social Anxiety and Isolation

Persistent dandruff may contribute to social anxiety, potentially resulting in:

• Withdrawal from social activities
• Difficulty forming or maintaining close relationships
• Increased stress, which can exacerbate dandruff symptoms

Body Image Concerns

Dandruff can impact an individual’s body image, leading to:

• Obsessive checking or grooming behaviors
• Negative self-perception
• Heightened awareness of scalp and hair appearance

How can individuals cope with the psychological impact of dandruff?

Coping with the psychological effects of dandruff involves a multifaceted approach:

1. Educate yourself and others: Understanding that dandruff is a common, manageable condition can help reduce stigma and self-consciousness.
2. Seek support: Talking to friends, family, or a mental health professional about your concerns can provide emotional relief and perspective.
3. Focus on treatment: Actively managing your dandruff with effective treatments can boost confidence and reduce anxiety.
4. Practice self-compassion: Remember that having dandruff doesn’t define you and doesn’t diminish your worth.
5. Use positive affirmations: Regularly remind yourself of your positive qualities and accomplishments unrelated to appearance.
6. Consider cognitive-behavioral techniques: These can help reframe negative thoughts and reduce anxiety related to dandruff.

By addressing both the physical and psychological aspects of dandruff, individuals can work towards not only managing their scalp health but also maintaining their overall well-being and quality of life. It’s important to remember that seeking help for the emotional impact of dandruff is just as valid and important as treating its physical symptoms.

Dandruff – NHS

Dandruff is a common skin condition. It’s not harmful and you cannot catch it.

Check if it’s dandruff

Dandruff causes white or grey flakes of skin to appear on the scalp and in the hair.

Credit:

DR P. MARAZZI/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/256156/view

The flakes are often more noticeable in darker hair and if they fall from your scalp onto your shoulders.

Your scalp may also feel dry and itchy.

How to treat dandruff yourself

Use an anti-dandruff shampoo to treat dandruff. There are several different types you can buy from pharmacies or supermarkets.

Look for a shampoo that contains 1 of these ingredients:

• zinc pyrithione
• salicylic acid
• selenium sulphide (or selenium sulfide)
• ketoconazole
• coal tar

A pharmacist can tell you how to use the shampoo.

Use the shampoo for a month to see if your dandruff gets better. You might need to try more than 1 type to find a shampoo that works for you.

Non-urgent advice: See a GP if:

• you still have dandruff symptoms after using anti-dandruff shampoo for a month
• your dandruff is bad or your scalp is very itchy
• your scalp is red or swollen
• you have flaky, itchy patches on your face or other parts of your body

The GP can check your scalp for skin conditions that could be causing your dandruff.

Causes of dandruff

Dandruff is not caused by poor hygiene, although it may be more obvious if you do not wash your hair regularly.

Stress and cold weather may also make dandruff worse.

Information:

Do not worry if you’re not sure what’s causing your dandruff. Follow the advice on this page and see a GP if things do not get better in a month.

Page last reviewed: 23 December 2022
Next review due: 23 December 2025

What Is Dandruff? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Dandruff occurs, essentially, when small bits of dry skin are shed from the scalp. You might spy these flakes in your hair or on your shoulders. Dandruff may make your scalp itchy, too. It’s a common problem, but it isn’t as simple as it seems. Dandruff is actually quite tricky to define because it overlaps with seborrheic dermatitis (a chronic form of eczema) and other skin conditions that lead to a scaly scalp. Here’s what you need to know.

Signs and Symptoms of Dandruff

The big tip-off that an individual may have dandruff are the telltale patches of white flakes on the scalp, made up of dead skin, that come loose in your hair. According to the Merck Manual, other signs include:

• At times, the scalp can be itchy
• Greasy or dry scales on the scalp
• Yellowish to reddish scaly raised bumps along the hairline (in severe cases)

Common Questions & Answers

How do I stop my dandruff?

Try washing daily with a gentle shampoo, an over-the-counter or prescription dandruff shampoo, and cutting back on styling products. Medicated shampoos might not be useful for healthy Black hair, however, but if used on the scalp alone they could be helpful.

What causes dandruff?

It’s caused by dry skin, or the buildup of oil. Skin conditions like seborrheic dermatitis, a weakened immune system, and certain neurological disorders, such as Parkinson’s disease, can also cause dandruff.

Is having dandruff healthy?

It’s not usually the sign of a serious medical problem, but if it’s a chronic condition due to something like a skin issue such as seborrheic dermatitis, it requires treatment.

How long can dandruff last?

It can’t be cured, and can be chronic, but in some cases, a change of habit — washing your hair more often, for example — can clear up flakes fairly quickly.

Is dandruff a fungus?

In some cases, it’s caused by yeast, which is a fungus. The yeast can feed on scalp oils, and bodies will mistake this breakdown of oils for an irritant. The scalp then speeds up skin cell renewal, which causes dandruff.

Causes and Risk Factors of Dandruff

Dandruff can happen for a number of reasons.

Seborrheic dermatitis If you have a particularly bad case of dandruff, it’s likely a mild case of seborrheic dermatitis (SD), according to the American Osteopathic College of Dermatology.

SD is a chronic form of eczema that affects areas of the body that secrete the most sebum, or oil, notes the National Eczema Association.

People with oily skin are often more prone to dandruff. The reason: A yeast called Malassezia globosa feeds on oils on the scalp. Some people’s bodies perceive this breakdown of oil as an irritant, so the scalp reacts by upping the speed at which skin cells renew, causing dandruff, notes Amy McMichael, MD, a professor of dermatology and the chair of the department of dermatology at Wake Forest School of Medicine in Winston-Salem, North Carolina. For those without dandruff, it takes a whole month for new skin cells on the scalp to mature, die, and shed. But for those with dandruff, this process occurs in a mere two to seven days, according to a report in the Journal of Medical Chemistry.

Still, it’s important to note that while M. globosa has long been thought to be the main risk factor for dandruff, a causal relationship has yet to be firmly established, noted a July 2019 report in the journal Experimental Dermatology.

Contact dermatitis Contact dermatitis is skin irritation caused by either an allergen or an irritant, resulting in an itchy, possibly painful rash. And in the case of dandruff, that reaction is on the scalp. This generally occurs because of hair-care products or dyes, according to the American Academy of Dermatology Association.

Dry skin If cold winter air dries out your skin all over, including your scalp, then dry skin may be the cause of your dandruff. When dry skin causes dandruff, the flakes are usually smaller and less oily than the flakes caused by SD. (In addition, cold and dry climates can worsen SD, according to the Cleveland Clinic.)

Almost anyone can have dandruff, but the following factors can make you more susceptible.

Shampooing habits “For those who are already at risk for dandruff, washing infrequently can worsen the condition,” says Dr. McMichael. Taking extended breaks can lead to a buildup of oil that can lead to dandruff.

Age Dandruff often begins at puberty and peaks around age 20, becoming far less prevalent among folks over 50 years old, according to a review published in the Journal of Clinical and Investigative Dermatology.

Sex Androgen hormones, such as testosterone, stimulate activity in the sebaceous glands. More oil means an increased chance of an inflammatory reaction and dandruff. Men are more frequently affected by dandruff than women.

Weakened immune system SD is more prevalent in individuals who’ve undergone an organ transplant and those with HIV or AIDS, hepatitis C, or alcoholic pancreatitis. For example, 30 percent to 83 percent of those with HIV report SD.

Neurologic and psychiatric conditions Parkinson’s disease, Alzheimer’s disease, epilepsy, traumatic brain injury, and spinal cord injury are among the conditions that elevate one’s risk of SD, including dandruff.

Those with Parkinson’s disease, for example, have an impaired autonomic nervous system that helps to control things like oil gland secretions, which can lead to an overproduction that leads to dandruff, according to the American Parkinson’s Disease Association.

History of other skin disorders Eczema, rosacea, psoriasis, or acne can trigger or worsen seborrheic dermatitis.

Oily skin If you have naturally oily skin, you’re at an elevated risk for seborrheic dermatitis.

Oiling your scalp “Certain oils applied to the scalp can cover the scale, but worsen the flaking and itching response,” notes McMichael.

How Is Dandruff Diagnosed?

A dermatologist can usually diagnose dandruff simply by looking at your scalp. If your dandruff does not respond to treatment, your healthcare provider may opt to perform a skin biopsy in order to rule out other possible issues, notes the Cleveland Clinic.

Duration of Dandruff

Dandruff due to seborrheic dermatitis is a chronic condition that warrants repeated or long-term treatment. As for dandruff that arises from contact dermatitis, dry skin, or shampooing habits, a change of habits should clear up flakes fairly quickly.

Treatment and Medication Options for Dandruff

Dandruff is an often chronic, but treatable, condition.

Gentle over-the-counter shampoo To reduce oil and skin cell buildup, wash hair daily with a gentle shampoo, lightly massaging the scalp to loosen flakes, per the Mayo Clinic.

(See the Black Women and Dandruff section, below, when daily washing isn’t recommended.)

OTC dandruff shampoo If gentle shampoo is not helping, try an over-the-counter (OTC) dandruff shampoo.

It’s best to alternate between two or three of these shampoos, notes the American Osteopathic College of Dermatology.

For mild to moderate cases, look for dandruff shampoos that contain the following active ingredients.

• Selenium sulfide This antifungal slows the death of skin cells. This active ingredient can be found in Head & Shoulders Clinical Strength and Selsun Blue, among other shampoos.
• Pyrithione zinc This antibacterial and antifungal combo is in Head & Shoulders, DermaZinc, and Jason Dandruff Relief 2 in 1.
• Salicylic acid Neutrogena T/Sal and Baker’s P&S both rely on salicylic acid to slough away flakes and promote healthier skin.
• Ketoconazole Nizoral A-D is a treatment that contains the antifungal ketoconazole; it can be found both OTC and via prescriptionand can be formulated as a shampoo, gel, or mousse.
• Tar Tar-based shampoos, like Neutrogena T/Gel, act as both an antibiotic and antifungal. But if you have blond, white, or gray hair, a tar shampoo can cause discoloration. This treatment can also make the scalp extra sensitive to sunlight.

Prescription Dandruff Treatment

If regular and proper use of OTC shampoo, for several weeks, does not alleviate dandruff, ask your dermatologist if you’d benefit from a prescription-strength antifungal shampoo like Loprox or Nizoral, or a topical corticosteroid lotion,

such as Capex or Synalar (fluocinolone topical), Luxiq (betamethasone topical), or Clobex (clobetasol topical).

An alternative to corticosteroids for dandruff treatment is a class of drugs called calcineurin inhibitors. These, like Protopic (tacrolimus topical) and Elidel (pimecrolimus topical), work by helping to suppress the immune response, according to Harvard Health.

Alternative and Complementary Therapies

Tea tree oil Shampoos or topicals that contain 5 percent tea tree oil (an antiseptic, antibiotic, and antifungal) appear to be a safe and effective treatment for dandruff, according to a small randomized study in the Journal of the American Academy of Dermatology.

Healthy fats Increasing your intake of omega-3 fatty acids, like those found in salmon, tuna, and mackerel, will help regulate oil production on the skin, notes Cedars-Sinai.

Additional Approaches

Get some sun. Brief bouts of sunshine can help reduce yeast production on the scalp.

But if you are also using a tar-based dandruff treatment, avoid direct sun exposure, as your scalp is especially sensitive to sunlight.

Cut back on hair products. Styling gels, sprays, pomades, and more can build up on the hair and scalp, increasing oiliness and dandruff.

Prevention of Dandruff

“You can prevent the signs and symptoms of dandruff, but there is no cure for dandruff,” says McMichael. If you’ve got an especially oily scalp, daily shampooing with a gentle cleanser, coupled with a light scalp massage, may help prevent dandruff in certain cases. If you’re using an OTC dandruff shampoo, talk to your dermatologist about how often to use it for maintenance and prevention. Finally, increased omega-3 intake, brief exposure to sun, and fewer hair products can help prevent dandruff as well.

Black Women and Dandruff

In a study in the Journal of Clinical and Aesthetic Dermatology, 44 percent of Black women reported a history of seborrheic dermatitis symptoms, such as excessive itching or scaling on their scalp.

Unfortunately, Black women also tend to face some common dandruff-treatment barriers. “Because many Black women do not wash their hair frequently through the week, this can make dandruff worse and treatment challenging,” notes McMichael, who recommends Black women aim to wash at least every two weeks, but once weekly is best. Another barrier: Medicated shampoos tend to be great for the scalp, but not for healthy Black hair, due to hair shaft dryness. “That means that using these shampoos on the scalp alone, not the whole head of hair, is often best,” says McMichael.

Research and Statistics: How Many People Get Dandruff?

Dandruff affects approximately 50 percent of the general adult population worldwide, according to past research.

Dandruff is more prevalent in males than females.

Conditions Related to Dandruff

“Sometimes what you think is dandruff is simply product debris, like hair gel or hair spray,” says McMichael. Other times, it may be one of these conditions.

Cradle cap Technically, seborrheic dermatitis and cradle cap and dandruff are all the same thing. Cradle cap affects infants between two weeks and 12 months old; they develop greasy, scaly, or crusty red or yellow patches on the scalp, according to KidsHealth. (The flaky rash can also appear on the face, diaper area, and other areas of the body.)

Scalp psoriasis About 50 percent of people who have plaque psoriasis experience a flare-up on the scalp at some point. On the scalp, you may have reddish patches, dandruff-like flaking, silvery-white scale, and dryness. Scalp psoriasis is often itchy, with the itch ranging from mild to intense, notes the American Academy of Dermatology Association.

Tinea capitis This highly contagious fungal infection is also called ringworm of the scalp and hair shafts. Symptoms may include itchy, scaly, and bald patches on the head. Tinea capitis is most common in toddlers and school-age children, per the Mayo Clinic.

Resources We Love

Skin of Color Society

This professional dermatologic organization is dedicated to promoting awareness of (and excellence within) the dermatological care of skin of color. SCS offers a Find a Doctor database to help those of Asian, Hispanic or Latino, African, Native American, and Pacific Island descent find local dermatologists who are especially knowledgeable about their skin concerns. Whether you’re struggling to find a dermatologist who can help treat persistent dandruff in Black hair or you’ve got another skin-related issue, SCS’s Find a Doctor database can help.

American Academy of Dermatology

The AAD is the largest dermatology group in the United States and its website is full of resources, tips, and more. Curious how to ease your itchy skin? Check out their Everyday Care section. Craving some insider secrets to tackle your rosacea? Try the AAD’s Diseases and Conditions area. Not sure how to combat your child’s dandruff? Go to the areas dedicated to Parents and Kids.

Editorial Sources and Fact-Checking

• Seborrheic Dermatitis. Merck Manuals: Consumer Edition. September 2022.
• Seborrheic Dermatitis. American Osteopathic College of Dermatology.
• Seborrheic Dermatitis. National Eczema Association.
• Hewitson KS, Vullo D, Scozzafava A, et al. Molecular Cloning, Characterization, and Inhibition Studies of a B-Carbonic Anhydrase From Malassezia Globosa, a Potential Antifungal Target. Journal of Medical Chemistry. March 19, 2012.
• Wikramanayake TC, Borda LJ, Miteva M, Paus R. Seborrheic Dermatitis — Looking Beyond Malassezia. Experimental Dermatology. July 16, 2019.
• 10 Reasons Your Scalp Itches and How to Get Relief. American Academy of Dermatology Association.
• Seborrheic Dermatitis. Cleveland Clinic. May 29, 2020.
• Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. Journal of Clinical and Investigative Dermatology. December 2015.
• Sweating and Other Skin Problems in People With Parkinson’s Disease. American Parkinson’s Disease Association. July 23, 2019.
• Seborrheic Dermatitis. Cedars-Sinai.
• Seborrheic Dermatitis Diagnosis and Tests. Cleveland Clinic. May 29, 2020.
• Dandruff Diagnosis and Treatment. Mayo Clinic. September 21, 2021.
• Dandruff. American Osteopathic College of Dermatology.
• Drugs and Supplements Ketoconazole (Topical Route): Description and Brand Names. Mayo Clinic. February 1, 2022.
• Seborrheic Dermatitis: Management and Treatment. Cleveland Clinic. May 29, 2020.
• What Is the Best Way to Treat Severe Dandruff? Harvard Health Publishing. May 2017.
• Satchell AC, Saurajen A, Bell C, Barnetson RS. Treatment of Dandruff With 5 Percent Tea Tree Oil Shampoo. Academy of Dermatology. December 1, 2002.
• Barak-Shinar D, Green LJ. Scalp Seborrheic Dermatitis and Dandruff Therapy Using a Herbal and Zinc Pyrithione-Based Therapy of Shampoo and Scalp Lotion. Journal of Clinical and Aesthetic Dermatology. January 2018.
• Dandruff: What It Is and What to Do About It. Cedars-Sinai. September 25, 2019.
• Gathers RC, Mahan MG. African American Women, Hair Care, and Health Barriers. Journal of Clinical and Aesthetic Dermatology. September 2014.
• Elewski BE. Clinical Diagnosis of Common Scalp Disorders. Journal of Investigative Dermatology Symposium Proceedings. December 1, 2005.
• Cradle Cap (Seborrheic Dermatitis) in Infants. KidsHealth. February 2019.
• Ringworm (Scalp) Symptoms and Causes. Mayo Clinic. January 22, 2022.

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causes, what it looks like, symptoms, signs, treatment, how to get rid of dandruff at home

Causes

Classification

Symptoms

Complications

Diagnosis

Treatment

Prevention

Dandruff – small scales of the epidermis, which, after peeling off, remain on the scalp. Almost every person has experienced this unpleasant condition. These small scales are formed due to the accelerated growth of the main cells of the epidermis in the process of renewal of the cellular layer of the skin.

Dandruff is considered a mild manifestation of seborrheic dermatitis. It is not contagious, most often occurs in people aged 15-25 years and very rarely in the elderly. It is believed that this is the result of non-compliance with the rules of personal hygiene. However, in most cases, dermatologists define this condition as the result of a disease.

Causes and triggers

Dandruff never appears on its own, there are always certain reasons for this. The main of them is the defeat of the scalp with a yeast fungus of the genus Malassezia furfur (Pityrosporum ovale). The favorite localization of these fungi is areas of the skin where sebum is present in large quantities.

Among the predisposing factors are:

• heredity – if there are people in the family who suffer from such a problem, then with a high probability it will be in children;
• increased work of the sebaceous glands, especially in the transitional adolescence with the onset of sex hormones;
• seborrhea – excessive formation of sebum;
• diseases of the nervous system;
• taking certain drugs used in the treatment of mental illness;
• emotional overload;
• intestinal dysbacteriosis;
• diseases of the digestive tract;
• avitaminosis;
• diabetes mellitus;
• the use of chemicals and thermal effects on the scalp.

Why does dandruff still appear? It can occur when using cheap and low-quality shampoos, which include aggressive surfactants, and also be the result of too frequent or, conversely, too rare shampooing.

Dandruff in young children is often the result of an allergic reaction, as well as the wrong choice of scalp care products. In adolescents, it is associated with the transition period and the strengthening of the hormonal system. Often it is diagnosed along with too oily facial skin, as well as acne.

Classification

According to the international classification, dandruff belongs to seborrheic dermatitis. It is customary to distinguish three options:

1. Oily dandruff (seborrhea) occurs against the background of increased sebum production. At the same time, the skin and hair are oily and shiny. This type of dandruff is divided into thick and liquid. In the first case, the scales stick together, the hair becomes hard and rough, there are comedones on the skin. The second is distinguished by enlarged pores and shiny skin, the scales fit tightly to the skin, and the hair sticks together in strands.
2. Dry dandruff (seborrhea) is the result of minimal sebum secretion by the scalp, which is associated with its increased viscosity. Because of this, the scalp becomes too dry, and the hair is thin and brittle, severe itching appears.
3. Mixed form (seborrhea) – when signs of both oily and dry seborrhea appear.

As a result, a lot of scales appear on a person’s head, their number significantly exceeds the norm, so they become visible to the naked eye. If this is accompanied by itching and irritation, and foci of redness appear, then the diagnosis is “Seborrheic dermatitis”. Scales are easily separated from the scalp, fall on clothes. The hair itself becomes thin, brittle, they have split ends.

Dandruff on the head is always an unpleasant phenomenon, and it will not be possible to cope with this problem with cosmetics. It is necessary to consult a dermatologist or trichologist and prescribe medications.

Symptoms

The symptoms of dandruff are easy to identify. It does not go unnoticed and is a real aesthetic problem for people with this diagnosis. Excessive shampooing and combing, as well as the use of a hair dryer, other chemical and thermal agents, will only exacerbate the existing problem.

The signs of dandruff are especially noticeable in people with dark hair, as against such a background, white scales will be clearly visible both throughout the scalp and along the length of the hair. Among the main manifestations are oily sheen of hair and peeling of the scalp with flaking of a large number of skin flakes. Also, patients note severe itching, redness and increased sensitivity of the skin. Some people start to lose their hair.

A large number of scales in the hair and on clothes is a clear sign that ordinary shampoos cannot cope with the problem. Moreover, their accumulation is not observed everywhere, but only in places of high pressure and in the forehead.

Complications

If dandruff of the scalp is not treated, then in the future, with the aggravation of the process, all kinds of complications can develop. Their list includes:

1. Sebopsoriasis with the transition of scaly plaques to other areas of the body.
2. Hair loss associated with the overlap of hair follicles with scales, due to which they do not receive oxygen. Sometimes this leads to the death of hair follicles, and then baldness forms in places where such dead tissues are concentrated.
3. Pyoderma as a result of constant scratching of itchy skin with nails. An infection gets into the wounds, which can cause suppuration with the formation of boils, abscesses.
4. A sebaceous gland cyst that develops due to blockage of its duct, and all the secret of the gland will accumulate inside it.

All this causes severe psycho-emotional discomfort, and a person with such a diagnosis tries to appear less in society. Even with daily shampooing, the problem remains unresolved.

Diagnostics

Identifying dandruff on hair is not difficult at all. It is important to conduct a survey, find the cause and provoking factors that will lead to the further development of seborrhea. Some patients are advised to take a blood test for glucose, thyroid hormones. Examination is performed using a dermatoscope. If necessary, consultations are held with a gastroenterologist, trichologist, endocrinologist.

Differential diagnosis is carried out with psoriasis, irritant dermatitis, trichomycosis, lichen.

Treatment

How to get rid of dandruff forever? Unfortunately, there is no single answer to this question. The first thing to do is to identify and eliminate the cause of the disease.

Dandruff is treated at home using special shampoos, which are bought only in pharmacies. The most popular and effective are:

1. “Kertiol” – with sulfur and salicylic acid in the composition. With regular use, it helps to get rid of flaking of the scalp, relieves itching and irritation, and eliminates oiliness.
2. “Seligel” – recommended for the treatment of dry dandruff in men. Thanks to selenium disulfide, it has a pronounced antifungal effect. The therapeutic component helps for a long time to eliminate the cause of increased peeling – a fungus.
3. “Friderm zinc” – has anti-inflammatory, antibacterial, antifungal activity. Gradually accumulating in the cells of the epidermis, zinc does not allow fungi to reactivate and again lead to inflammation.
4. “Kelual DS” – recommended for use in case of exacerbation of the disease. Most often used for dandruff in women in the autumn-winter period. Helps to neutralize the action of the fungus, reduces the production of sebum, eliminates itching and redness of the scalp.
5. Nizoral is one of the popular antifungal agents. However, after stopping use, the risk of recurrence of symptoms is high. Recommended for use in teenagers.
6. “Sebozol” is a popular remedy in the treatment of diseases caused by fungi that live on the skin and scalp. It also helps in the treatment of seborrhea and lichen.

Use dandruff shampoo only need a therapeutic effect. With it, you should wash your hair 2 times a week, and you need to not only apply the product to your hair, but also carefully rub it into the scalp, and then leave it for 5-10 minutes, then rinse with water. There is also a soap for dandruff, which can be based on the same medicinal ingredients as in shampoos. Most often, doctors recommend tar and sulsen for use.

If within 3 weeks of this treatment the number of skin scales does not decrease or does not disappear at all, you should seek medical advice.

What else should I do if I have dandruff? Dandruff remedies can be supplemented with a balanced diet, avoiding fatty and sugary foods. The diet must contain fermented milk products, as well as vitamin-mineral complexes and fiber.

Prevention

Unfortunately, there are actually no effective measures to prevent dandruff. Despite the fact that it is not so difficult to eliminate the main symptom, scales on the hair, it is necessary to identify and eliminate the cause of the disease. On the recommendation of a dermatologist, it is necessary to wash your hair often using a selected shampoo, eat right, not expose yourself to severe stress and give up bad habits. If you do not start treatment in a timely manner, then over time this problem will develop into a more severe form – dermatitis.

The author of the article:

Shapovalova Valeria Olegovna

cosmetologist, dermatologist, trichologist

work experience 7 years

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12 December

Small or large flaky scales in the scalp are called dandruff. With a significant amount, they crumble on clothes, causing disgust in others. There is an opinion that dandruff is the result of non-compliance with the rules of personal hygiene. However, in most cases, increased peeling of the skin is caused by a disease.

Varieties

The scales may be small and fall off easily. Layers may form that rise above the scalp and flake off when combed. Grayish-white foci of peeling may occur, located not only on the scalp, but also passing to the skin of the face, neck and trunk.

Possible causes

Normally, the upper layer of the skin (epidermis) is systematically renewed. At the same time, dying cells are sloughed off, which happens almost imperceptibly. Determining the condition of the scalp is simple: with light scratching, a small amount of scales remain under the nails. However, when exposed to adverse factors or the development of the disease, the number of dead cells can increase and form clusters. Based on the appearance of the scales, their size and localization, it is possible to roughly establish the causes of skin peeling.

Dandruff is not always a symptom of a disease. In some cases, it is caused by a negative effect on the skin: it is an incorrectly selected shampoo, a disturbed diet, and sudden changes in ambient temperature.

Provoking factors can also be stress, direct exposure to sunlight, the use of aggressive products in perm and hair coloring. In these cases, careful care and exclusion of harmful factors normalize the skin condition, which contributes to the disappearance of dandruff.

Doctors consider dandruff to be a harbinger of seborrheic dermatitis , which can develop under the influence of a number of factors. With seborrheic dermatitis, the formation of dandruff is caused by pathological processes: disruption of the sebaceous glands, accelerated death of epidermal cells and reproduction of microorganisms.

The scalp contains a large number of sebaceous glands. A change in their function can lead to either insufficient or excessive production of sebum.

Deficiency of fat is caused by an increase in the viscosity of the secretion of the sebaceous glands and the difficulty of its passage through the ducts of the gland.

At the same time, the scalp dries out, there is a feeling of tightness, itching, burning. Hair becomes dry and brittle, their ends are split.

Even if you rarely wash your hair, dandruff does not disappear. These are characteristic signs of dry seborrhea . Lesions with increased peeling are located in greater numbers along the hairline. Scales can occur on the eyebrows, eyelashes, beard and mustache. The color of the scales varies from white to yellow. Seborrheic dermatitis worsens in winter, which is facilitated by significant fluctuations in air temperature and overdrying of the skin. With the progression of the disease, pink spots appear on the skin, covered with white scales.

With oily seborrhea , sebum production increases, and dead cells stick together with fat to form conglomerates. In these clusters, microscopic fungi multiply, which normally live on the scalp in small quantities. By consuming sebum components, fungi secrete substances that irritate the skin, causing inflammation and flaking.

The reproduction of fungi is also facilitated by heat and high humidity. With active combing, crusts form on damaged skin, under which pathogenic bacteria multiply.

Violation of the sebaceous glands contributes to a change in hormonal levels in adolescence, during pregnancy or in postmenopause. Increased production of testosterone, which largely determines the work of the sebaceous glands, causes a greater spread of seborrhea in men. A decrease in the immune status is also accompanied by an increase in morbidity. It has been proven that in HIV-infected patients seborrhea occurs 4-10 times more often than in persons with normal immunity. It is noted that seborrheic dermatitis is activated when the nervous system is affected. In patients with paralysis, Parkinson’s disease, this disease is characterized by extensive distribution and difficult treatment.

Another possible cause of dandruff is psoriasis . Psoriasis is a systemic disease, which is based on a violation of the immune status.

At the same time, leukocytes, which usually destroy foreign agents, begin to mistakenly attack their own tissues, causing inflammation.

Such a failure can occur after a streptococcal infection, trauma, due to inflammatory bowel disease and dysbacteriosis. Psoriasis usually appears between the ages of 15-45, but it can also occur in very young children as young as 4 months of age.

It has been established that the early onset of the disease is accompanied by a more severe course and leads to damage not only to the skin, but also to the joints, heart, and blood vessels.

In mild forms of psoriasis, only the skin is affected, usually on exposed areas of the body and scalp. Clearly defined bright pink rashes are covered with whitish scales. Small foci of inflammation can merge, forming plaques, also covered with easily audible scales. In summer, rashes become smaller, and sometimes they disappear completely, but pigmentation remains in their place. In the cold season, with a decrease in immunity, stress, the symptoms of psoriasis may reappear.

Diagnosis and examination

If dandruff cannot be overcome by changing the shampoo, it is recommended to find out the causes of its appearance by contacting a specialist – a dermatologist or a trichologist. The doctor determines the size of the scales, examines the skin (discoloration, the presence of plaques, scratches), which makes it possible to make a preliminary diagnosis. In addition to the examination, a biochemical blood test should be performed, changes in the results of which may indicate a violation of the gastrointestinal tract.

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Elevated androgen levels or decreased estrogen levels may also confirm the diagnosis of seborrheic dermatitis.

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For the differential diagnosis of seborrheic dermatitis, a histological examination of scales or biopsies (microsamples) of the skin is performed.

The diagnosis of psoriasis is first made on the basis of visual manifestations of the disease, the so-called psoriatic triad:

– white stearic plaque surface;

– reddish shiny film after desquamation;

– dot protrusion of blood after removal of the film – “blood dew phenomenon”.

Which doctors to contact

A dermatologist deals with skin diseases, and a trichologist deals with diseases of the hair and scalp. If the diagnosis of psoriasis is confirmed, treatment can include
therapist,
endocrinologist, rheumatologist,
gastroenterologist and immunologist.

Treatment

Ways to get rid of dandruff, which is only a symptom of the disease, depend on the diagnosis. With seborrheic dermatitis, the basis of treatment is antifungal agents that are part of shampoos.

Their action is effective if the cause of dermatitis is not hormonal changes.

In some cases, your doctor may prescribe antifungal medications. Local treatment is supplemented with vitamins, antihistamines and sedatives.

Treatment of psoriasis involves complex therapy using ointments, phototherapy and systemic drugs as prescribed and under the supervision of a doctor.

What to do

When dandruff appears, first of all, you should pay attention to hair care products. Shampoo should match the type of hair, and after washing it is advisable to use softening balms, rinses, oils. It is necessary for a while to abandon aggressive means for creating hairstyles, allowing the skin to recover.

It is not recommended to use medicated shampoos immediately. They include drugs that can only be used with a confirmed diagnosis of seborrheic dermatitis.

With severe itching of the scalp and the presence of hard white thickenings at the hair roots, you should check for pediculosis.

Sources:

1. Clinical guidelines “Psoriasis”. Developed by: Russian Society of Dermatovenerologists and Cosmetologists.