1 What is Dandruff?

Dandruff is a chronic condition of the skin of the scalp, whose main characteristic is skin-flaking.

Despite being rather uncomfortable, this condition is non-contagious and infrequently severe.

In most cases, Dandruff is a controllable condition.

Mild cases are treatable with daily use of ordinary shampoo, whereas more persistent cases require special medicated shampoos.

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2 Symptoms

Dandruff symptoms are easily recognizable: they include flakes of dead skin covering your hair and shoulders and, in most cases, itchy and dry scalp. The condition has a tendency to worsen in dry air (especially in winter and fall due to indoor heating) and improve when the air is humid.

A special kind of dandruff called cradle cap, which is described by presence of a scaly and crusty scalp, can be found among newborns and during infancy. Though it looks serious from the parents perspective, it has a tendency to heal on its own by the age of 3. In most cases, dandruff does not require medical care.

In case the ordinary products don’t help, scratching intensifies, or your scalp becomes red and swollen, you should consult your doctor. By inspecting your hair and scalp, your doctor will be able to diagnose the problem.

In differential diagnosis, seborrheic dermatitis or another similar condition should be considered.

3 Causes

Dandruff has various known causes:

Dry skin

The most prevailing cause of dandruff is dry skin. It is marked by smaller and less oily flakes combined with signs ans symptoms of dry skin on the other parts of the body

Seborrheic dermatitis

This condition is characterized by irritated, red and greasy skin with flaky white or yellow scales. Predilection areas for this condition include scalp, sides of your nose, your groin area, armpits etc. Basically all the areas rich in oil glands can be affected.

Not using shampoo often enough

Insufficient use of shampoo results in building up of oils and skin cells on the scalp, which leads to dandruff.

Other skin conditions

Eczema - a chronic, inflammatory skin condition in which patches of skin become rough and inflamed with blisters which cause itching and bleeding. Malassezia ( type of fungus) – it can be found on the scalps of most adults, but in some cases it irritates the scalp and causes skin cell growth. Afterwords, these cells die and fall off which creates dandruff.
Contact dermatitis – inflammatory condition of the skin which can be caused by different agents. In the case of dandruff it is mostly induced by hair care products and their ingredients.

Psoriasis - a skin condition that causes itchy or sore patches of thick red skin with silvery scales.

4 Making a Diagnosis

Your doctor should be able to diagnose dandruff easily, simply by inspecting your scalp and skin.

Please provide information on your hair care products or other conditions and diseases that you have.

5 Treatment

You should be able to treat dandruff, but you are expected to be patient and persistent. The first-line therapy is consisted of daily use of suitable shampoo, in order to prevent oiliness and skin cell build up.

In case this therapy proves unsuccessful, you should choose a suitable special dandruff shampoo.If these products result in developing of itching, stinging, redness or burning, stop using it and switch to the other one. Bear in mind that allergic reaction can develop as well, and in case it does, seek urgent medical attention!

Dandruff shampoos are classified according to the medication they contain:

  • Zinc pyrithione shampoos – antibacterial and anti-fungal agents.
  • Tar-based shampoos – these slow down dying of skin cells and prevents them from flaking off.
  • Shampoos containing salicylic acid – these eliminate scale but can make your scalp dry and lead to more flaking.
  • Selenium sulfide shampoos- these slow dying of skin cells and can work as anti-fungal agent. Are known to cause hair discoloration.
  • Ketoconazole shampoos - broad-spectrum anti-fungal agent.
  • Alternative therapies - one of the most prominent alternative therapies that has been shown to successfully help in treating dandruff, is tea tree oil shampoo. This product comes from the leaves of the Australian tea tree (Melaleuca alternifolia) which has been know for centuries.

6 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with dandruff.

One of the factors that makes you more susceptible to developing dandruff is stress. You should learn to avoid and manage stress, which is a well-known underlying cause of various conditions and diseases.

If you have an oily scalp, regular shampooing should become your daily routine.

Reduce the use of hair-styling products such as hair sprays, hair gels and waxes. These make your hair oilier and prone to developing dandruff.

Regulate your diet. Increase the intake of B vitamin complex, unsaturated fats and zinc.

Get enough sunlight. Pay attention not to exaggerate and use sun lotions and sunglasses.

7 Risks and Complications

Several risk factors that exist for dandruff are:

  • Age – although the problem can be lifelong, in most cases it is associated with young-adulthood.
  • Oily hair and scalp – this represents an ideal medium for the Malassezia fungus to develop.
  • Being male – this can be contributed to the presence of larger oil-producing glands and male hormones among males.
  • Oily hair and scalp - Malassezia feeds on oils in your scalp. For that reason, having excessively oily skin and hair makes you more prone to dandruff.
  • Poor diet - lack of vitamins, Zinc and unsaturated fatty acids.
  • Other illnesses – neurological ( Parkinson’s), HIV infection, people with immunodeficiency .