Dandruff is a condition of the scalp that causes flakes of skin that is often accompanied by itching to appear.
The exact cause is unknown, but various factors are known to increase the risk. It is not related to poor hygiene per say, but it may be more visible if a person does not clean their hair often.
Dandruff can be embarrassing and hard to treat, but it is a very common skin condition that nearly all people experience at some point in their lives regardless of age or ethnicity.
Other names for dandruff are seborrheic dermatitis and seborrhea and can affect the scalp, the ears, eyebrows, sides of the nose, beard, and less commonly the central hair-bearing part of the chest.
In fact, dandruff can affect any hair-bearing area or an area with even very small hair follicles, and more advanced cases may cause intense itching, burning, and unstoppable scratching.
Dandruff is seen in all ages from babies to the elderly. In babies, dandruff is commonly known as “cradle cap.”
Some people are more prone to dandruff, while others experience periodic clearing cycles and periodic flare-ups of the condition.
Some people are more prone to dandruff, and although it is not curable, it is generally quite easily controlled with proper skin and hair hygiene. In babies, cradle cap usually clears after a few months.
For some, dandruff may worsen with time, although it may occur for a short period, tends to recur throughout a person’s life.
Severe dandruff may be a very difficult and frustrating condition, and a combination treatment of shampoos, washes, and creams and lotions may be required to treat such cases.
The best shampoo choices include those containing zinc pyrithione, selenium sulfide, and tar-based shampoos.
Causes of Dandruff
Dandruff can have several causes, including:
Irritated, Oily Skin (Seborrheic Dermatitis)
This condition is one of the most frequent causes of dandruff. It is marked by red, greasy skin covered with flaky white or yellow scales. Seborrheic dermatitis may affect your scalp and other areas rich in oil glands.
Not Shampooing Often Enough
If you don’t regularly wash your hair, oils and skin cells from your scalp can build up. This can cause dandruff. A yeast-like fungus, Malassezia, lives on the scalps of most adults, but, for some, it irritates the scalp and can cause more skin cells to grow.
These extra skin cells die and fall off, making them appear white and flaky in your hair or on your clothes
Flakes from dry skin are generally smaller and less oily than those from other causes of dandruff, but redness or inflammation is unlikely.
Sensitivity To Hair Care Products (Contact Dermatitis)
Sometimes, someone’s sensitivities to certain ingredients in hair care products or hair dyes can cause a red, itchy, scaly scalp.
Risk Factors For Dandruff
Almost anyone can have dandruff, but certain factors can make you more susceptible to the condition:
- Age: Dandruff usually begins in young adulthood and continues through middle age, but the problem can be life-long, for some people.
- Being male: more men have dandruff than women, and as a result, some researchers think male hormones may play a role.
- Oily hair and scalp: as mentioned earlier, Malassezia feeds on oils in your scalp, and that makes you more prone to dandruff.
- Certain illnesses: it has been observed that adults with neurological diseases, such as Parkinson’s disease, are more likely to develop seborrheic dermatitis and dandruff. So are people who have compromised immune systems from other conditions.
Read: Itchy Eyebrows
What Are the Symptoms of Dandruff?
Dermatologists commonly refer to dandruff as seborrheic dermatitis, and the signs and symptoms include:
- White flakes on heads and shoulders
- Eyebrow rash
- Beard rash
- Itchy scalp
- Scaly facial skin
- Recurrent ear eczema
- Oily scalp and facial skin with dry flakes
- Chest rash with dry flakes and red spots
- Facial rash over eyebrows, nose, and ears
Home Remedies For Dandruff
Most treatment for dandruff aims to stop dandruff by slowing down the reproduction of skin cells or counteracting the yeast production that might be the cause.
The strategy usually depends on the patient’s age and the severity of the condition. But, the following lifestyle changes and home remedies can help:
- Managing stress: stress can be a trigger of dandruff in some people. So, managing it better can reduce symptoms.
- Shampoo more often if you have oily hair and scalp. Washing daily can significantly help.
- A little exposure to sunlight can also help.
- Tea tree oil: There is little evidence, but some people believe that a mixture that includes tea tree oil can help reduce symptoms of dandruff.
Medical Treatment for Dandruff
Once a healthcare practitioner has confirmed an individual has dandruff (seborrheic dermatitis), the main treatment includes antidandruff shampoos, cleansers, anti-inflammatory creams, and lotions.
The most effective dermatologic treatments are combination treatments using several different medicated ingredients used simultaneously.
Over-the-counter shampoos and steroid cream medications are the usual treatments, and more frequent shampooing and cleansing is usually recommended.
For severe resistant cases not responding to a combination of steroid creams, foams, sprays, or lotions, a dermatologist may be very helpful for such cases that have not cleared with alternative treatments and standard therapy.
Rare severe cases may require short-term treatment with oral steroids such as prednisone, but oral pills for dandruff treatment should not be routinely used.
Treatment or Skincare routine for mild to moderate dandruff:
- Wash scalp with dandruff shampoo daily
- use hair conditioner on hair as needed, and use more frequent daily shampooing when symptoms are more severe
- Rub in betamethasone or fluocinonide solution one or two times a day(depending on severity) into scalp for itchy skin
Medications for Dandruff
These shampoos can help decrease the yeast counts on the skin, but work no better than over-the-counter dandruff shampoos.
- ketoconazole (Nizoral) shampoo
- ciclopirox (Loprox) shampoo
Prescription-strength washes such as sulfacetamide help decrease the bacterial counts on the skin,
- sulfacetamide (Rosanil)
- sodium sulfacetamide and sulfur (Clenia)
- benzoyl peroxide (Benoxyl, Benzac AC, Benzac W, Benzagel, Brevoxyl, Desquam, Fostex, Persa-Gel, Triaz, Vanoxide, Zoderm) cleansers
- fluocinolone acetonide (Capex) shampoo
- clobetasol (Clobex) shampoo
- Cortisone shampoos – Prescription-strength steroid shampoos in rinse-off products help decrease the inflammation and decrease itching.
Prescription-strength cortisone preparations as a rub in products help decrease the inflammation and control the itching. These vary in strength.
Topical cortisones are safe when used appropriately under a physician’s guidance. There are some, possible long-term side effects of all steroids, and they should be used sparingly (only where needed).
Many cortisone preparations are available including ointments (more greasy, clear, petroleum-based) solutions (clear watery liquid, often alcohol-based), sprays (clear liquid in propellant), and foams (light, airy mousse), creams (thick, white, and lubricating), and lotions (light, flowing liquid),
- clobetasol (Olux) foam
- betamethasone (Luxiq) foam
- clobetasol solution (Cormax, Temovate)
- clobetasol lotion
- triamcinolone (Kenalog) spray
- fluocinonide solution
- betamethasone lotion