Dandruff is a condition of the scalp that causes flakes of skin to appear. Dandruff is a common condition, which is marked by itching. In some cases it can be embarrassing and not easy to treat.
Fortunately, dandruff can be controlled. In mild cases, the person need only find a suitable shampoo which contains a gentle cleanser. When the dandruff is severe, a medicated shampoo will be required.
Fast facts on dandruff
Here are some key points about dandruff. More detail and supporting information is in the main article.
- A significant number of people with dandruff find it improves as they get older.
- It is estimated that about 50% of people in Western Europe and North America suffer from dandruff.
- Dandruff is more common in men than in women, and in people with oily skin.
- Some studies have suggested that diets that are too salty, sugary or spicy and accompanied by excessive alcohol may exacerbate dandruff.
- Dandruff does not contribute to hair loss.
What is dandruff?
Human skin cells are forever renewing themselves. As skin cells in the scalp are renewed, the old (dead) ones are pushed to the surface and then out of the scalp; they are literally expelled.
For people with dandruff, the new cells are produced at a faster rate than they die, resulting in more skin being shed, making dandruff more noticeable.
If the skin is exposed to extreme temperatures, the risk of developing dandruff is greater.
Dandruff can be chronic (long-term) or the result of certain triggers. People with dandruff may also experience irritation and redness on the scalp.
Excessive flaking may be caused by an underlying illness or condition, such as psoriasis, a fungal infection (Malassezia), seborrheic dermatitis, or even head lice.
Some individuals with severe dandruff may have social or self-esteem problems. Therefore, treatment may be important for both physiological and psychological reasons.
The word dandruff comes from (most likely) dand (origin unknown) and E. Anglian (England) dialect huff, hurf, meaning "scab". This is probably linked to the Old Norse word hrufa, meaning "scab". The Old High German word hruf means "scurf".
A dry scalp does not cause dandruff
A myth - some people think their dandruff is caused by their scalp being too dry. They try to deal with this by not washing their hair with shampoo, or wash it less often, believing that washing worsens the problem. This is a myth (not true). Dandruff differs from a dry scalp in that it usually gets better when you shampoo more frequently (with the right shampoos).
Seborrheic dermatitis
This is a skin condition in which the skin becomes inflamed or flaky. Seborrheic dermatitis of the scalp is a severe form of dandruff. When it affects the scalp most people refer to it as dandruff. When babies have it, it is referred to as cradle cap. Seborrheic dermatitis causes larger, greasier flakes than most other types of dandruff. Seborrheic dermatitis affects not only the scalp, but the skin in other parts of the body too.
Symptoms of dandruff
The hallmark sign of dandruff, or seborrheic dermatitis of the scalp, is white flakes on the scalp and in the hair. If the person is wearing dark clothes, the flakes will be more noticeable when they fall on their shoulders. The scalp may also feel itchy, tight or sore.
Adult individuals with seborrheic dermatitis of the scalp may have red, flaky, greasy patches of skin.
- There are while flakes of skin on the scalp, and in the person's hair
- Flakes may be oily looking
- Head may feel tight and itchy
- Head may feel tingly
- Head may feel sore
- Red, flaky, greasy patches of skin (adults, Seborrheic dermatitis of the scalp in adults)
- Crusting and scaling rash on scalp (babies with Seborrheic dermatitis, or cradle cap)
Most cases of dandruff do not require a visit to the doctor. However, those who still find themselves scratching their scalp, if parts of the scalp become red or swollen, after a few weeks of self-treatment should see their doctor. The person may have severe seborrheic dermatitis or another condition that has dandruff symptoms.
Symptoms of dandruff in babies and children
Often referred to as cradle cap, signs and symptoms may appear when the baby is between 2 weeks and 6 months of age, especially between the ages of 3 to 8 weeks - this usually disappears after a few weeks; in some cases it may take months. Although cradle cap may be alarming to parents, it is not dangerous.
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.
Dandruff: Causes and Treatments
The exact cause of dandruff, also known as scurf or Pityriasis simplex capillitii is unknown. However, most experts do agree that dandruff is not caused by poor hygiene.
Dandruff is a condition of the scalp that causes flakes of skin to appear. Dandruff is a common condition, which is marked by itching. In some cases it can be embarrassing and not easy to treat. If you would like to read more about what dandruff is, read our article here.
Causes of dandruff
The following are factors that may contribute to dandruff:
1) Not enough hair brushing
People who do not comb or brush their hair regularly have a slightly higher risk of having dandruff - this is because they are not aiding the shedding of skin that combing or brushing provides.
2) Yeast
People who are sensitive to yeast have a slightly higher risk of having dandruff, so it is logical to assume that yeast may play a part. Yeast-sensitive people who get dandruff often find that it gets better during the warmer months and worse during the winter. UVA light from the sun counteracts the yeast. Some say, that during winter the skin is drier because of cold air and overheated rooms (exposure to extreme temperatures), making dandruff more likely. So, it is sometimes not that easy to know whether it is yeast or just dry skin.
3) Dry skin
People with dry skin tend to get dandruff more often. Winter cold air, combined with overheated rooms is a common cause of itchy, flaking skin. People with dandruff caused by dry skin tend to have small flakes of dandruff; the flakes are not oily.
4) Seborrheic dermatitis (irritated, oily skin)
People with seborrheic dermatitis are very prone to dandruff. Seborrheic dermatitis affects many areas of the skin, including the backs of the ears, the breastbone, eyebrows, and the sides of the nose, not just the scalp. The patient will have red, greasy skin covered with flaky white or yellow scales.
5) Not enough shampooing
Some people say that if you don't shampoo enough there can be a buildup of oil and dead skin cells, causing dandruff. However, many experts doubt this is true.
6) Certain skin conditions
People with psoriasis, eczema and some other skin disorders tend to get dandruff much more frequently than other people.
7) Some illnesses
Adults with Parkinson's disease and some other neurological illnesses are more prone to having dandruff and seborrheic dermatitis. Patients recovering from heart attacks and strokes and some people with weak immune systems may have dandruff more often than other people.
8) Reaction to hair or skin care products
Some people react to some hair care products with a red, itchy, scaling scalp. Many experts say that shampooing too often may cause dandruff as it can irritate the scalp.
9) Malassezia
Malassezia is a fungus that lives on everybody's scalp. Generally, it will cause no problems at all. However, it can grow out of control. It feeds on the oils our hair follicles secrete. When this happens, the scalp can become irritated and produce extra skin cells. These extra skin cells die and falloff; they mix with the oil from the hair and scalp, and turn into what we see as dandruff.
10) Diet
Some experts say that people who do not consume enough foods that contain zinc, B vitamins, and some types of fats are more prone to dandruff.
11) Mental stress
Experts believe there may be a link between stress and many skin problems.
12) HIV
This study found that 10.6% of people with HIV have seborrheic dermatitis.
Diagnosing dandruff
You do not need a doctor to diagnose dandruff. You can do this yourself. If you see the characteristic white flakes on your scalp, you have dandruff.
If you still want to see a doctor, no special preparations are needed to help the doctor diagnose dandruff. Diagnosis will be confirmed by looking at the scalp and skin. Anybody who has started using some new hair care product may find it useful if they bring the bottles with them.
If your dandruff gets no better after some weeks of self-treatment, you should then consider seeing your doctor, especially if there are red, swollen patches on the scalp.
Treatments for dandruff
Two factors should be considered when you treat dandruff:
1. Your age
2. The severity of your dandruff.
Your aim will be to stop the dandruff by slowing down the reproduction of skin cells, or counteract the yeast production that might be the cause.
Shampoos and scalp preparations
Shampoos and products for the scalp are available OTC (over-the-counter, no prescription needed) at most stores and pharmacies. It is important to remember that seborrheic dermatitis can be controlled, but not cured with these products.
Before using an anti-fungal shampoo see if you can remove any scaly or crusty patches on your scalp - do this with care. If you manage to remove them, the shampoo will be more effective.
If you have dandruff on your beard, you can use dandruff shampoo on it.
Most anti-dandruff or anti-fungal shampoos contain at least one of the following active ingredients:
- Zinc pyrithione - an ingredient which slows down the production of yeast
- Selenium sulphide - this reduces the production of natural oils your scalp glands produce
- Coal tar - this has a natural anti-fungal agent. If your hair is dyed or treated remember that long-term coal tar usage can stain the hair
- Ketoconazole - a very effective anti-fungal. Most people who use this are pleased with the results. Experts say shampoos with this ingredient can be used with young and elderly people
- Salicylic acids - these help your scalp get rid of skin cells. They do not slowdown the reproduction of skin cells. Many "scalp scrubs" contain salicylic acids. Some people find salicylic acid treatments leave their scalps dry and eventually make the flaking of the skin worse
- Tea-tree oil - This oil comes from the Australian Tea Tree (Melaleuca alternifolia). A growing number of shampoos now include tea-tree oil as one of its ingredients. It has been used for centuries as an anti-fungal, antibiotic, and an antiseptic. However, some people are allergic to it
- Green Tea potential - Researchers from the Medical College of Georgia, USA, found that green tea may have potential for the treatment of dandruff and psoriasis.
Ideally, select a shampoo that has one of the above ingredients and shampoo your hair with it every day until your dandruff is under control. When that happens, use them less frequently. You may find a particular shampoo stops being so effective after a while, if this occurs switch to one that has another ingredient.
Make sure the shampoo has time to stay on your scalp before you rinse it off - perhaps about five minutes. If you rinse it off too quickly, the ingredient will not have enough time to work.
If after several weeks of treating yourself you still have dandruff, you should consider seeing your doctor or a dermatologist (skin specialist).
A study carried out by European researchers suggested that the addition of llama antibodies to shampoo could be a new strategy for fighting dandruff.
Possible complications of dandruff
A person with dandruff or seborrheic dermatitis will hardly ever experience complications. If one were to occur, it would more likely be caused by one of the dandruff treatments. If you find one of your dandruff shampoos or scalp treatments is causing irritation, stop using it and ask your pharmacist to suggest another one.
Bacteria can get in under your skin if there is a break on the skin of the scalp. If this happens, and you feel unwell, or that area of skin is red, tender and swollen, go and see your doctor.
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