A Comprehensive Guide To Dandruff and How To Treat It

Dandruff is a scalp condition that affects over half of the population in the world.¹ It occurs when tiny fragments of dry skin drop off from your scalp. These flakes can be observed on your shoulders or in your hair. Additionally, dandruff may cause your scalp to itch. Whilst this is a common experience, it may not always be as simple as it sounds. Because its appearance often coincides with seborrheic dermatitis, a chronic form of eczema, and other skin disorders that can cause a scaly scalp, dandruff can be challenging to differentiate.²

Causes

Depending on a person’s predisposition and vulnerability to the condition, several factors determine the cause of dandruff.

Seborrheic dermatitis

Individuals with seborrheic dermatitis tend to possess oily, itchy skin and are more susceptible to dandruff. The skin may also grow to become red, oily, and covered in flaky yellow or white scales.

This condition can affect the chest, the area behind the ears, the eyebrows, the scalp, and other body parts.³

Dry skin

If the cold air causes your skin to dry, the scalp could also be affected, leading to dandruff.

The flakes caused by dandruff that occur like this are generally smaller and less oily than dandruff caused by seborrheic dermatitis. However, dry and cold environments can exacerbate this condition.¹

Fungal causes

Dandruff is believed to be primarily caused by Malassezia furfur, a fungus that can cause dandruff through one or both of the following mechanisms:

Malassezia activates the Lipase enzyme on the scalp, which leads to the oxidation of the sebum’s triglycerides to yield saturated and unsaturated fatty acids. The fungi use saturated fatty acids for growth and self-propagation. Arachidonic Oleic acid and oleic acid are examples of unsaturated fatty acids. Oleic acid irritates human skin, but arachidonic acid contributes to the potentiation of inflammatory reactions. As a result, fungal growth, inflammation, and skin irritation on the scalp cause dandruff-like dry flakes to form.²
The regular shedding of dead skin cells is altered, which is another way this fungus produces dandruff. A few enzymes on the scalp break down the links between dead skin cells so they can be shed separately. Malassezia alters how the enzymes work and prevents the severing of the links. This causes corneocytes to group together and shed off in masses, leaving behind noticeable white flakes.²
Shampooing and skincare

Some hair care products have the potential to cause the scalp to itch and potentially result in dandruff. You should consider switching to a mild, non-medicated shampoo if you discover a product irritates you.

Some claim that not shampooing frequently enough might result in an accumulation of oil and dead skin cells, which causes dandruff. Others claim that washing too frequently will remove the natural oils. Neither of these statements holds any genuine merit. Without examination of the underlying scalp condition. individuals should know that they can have different needs for how frequently they should wash their hair. This should be adjusted according to the individual’s clinical condition and diagnosis.

While some individuals’ scalps may become irritated and react adversely to certain products, frequent shampooing is typically beneficial.³

Treatments

Whilst dandruff tends to be a chronic condition, its treatment is exceedingly possible and fairly straightforward.

Over-the-counter shampoo

To minimise oil and the buildup of dead skin cells, you can use a regular shampoo to wash your head daily, gently massaging the scalp and loosening the flakes. If that doesn’t work, you should purchase an anti-dandruff shampoo for a more targeted approach.²

See a healthcare professional

Ask your dermatologist if an anti-fungal shampoo or topical corticosteroid lotion should be prescribed to you if consistent and proper use of OTC shampoo over several weeks does not reduce dandruff. A class of medications known as calcineurin inhibitors offers an alternative to corticosteroids for dandruff treatment. Together with Protopic (tacrolimus topical) and Elidel (pimecrolimus topical), these function by aiding in the suppression of the immunological response.²

Go outside

Short bursts of sunlight can aid in reducing yeast growth on the scalp. However, the scalp is particularly susceptible to sunlight. Therefore avoid direct sunlight if you are also utilising a tar-based dandruff treatment.²

Conclusion

Even though most people will experience dandruff sometime in their lives, this scalp condition can cause high levels of self-consciousness and discomfort in people. Fortunately, dandruff is highly treatable with the right tools and counselling.

Angeline Yong Dermatology is a dermatology clinic that offers invaluable aid and effective treatment plans for dandruff and other conditions. Contact us to learn more.

References:

Narshana, M., & Ravikumar, P. (2018). International Journal of Pharmaceutical Sciences and Research, 9(2). https://doi.org/10.13040/ijpsr.0975-8232.9(2).417-31

Pevzner, H., Lawler, M., Derrow, P., Groth, L., Salomon, S. H., Farah, A., & Benjamin, J. (n.d.). What is Dandruff? symptoms, causes, diagnosis, treatment, and prevention. EverydayHealth.com. Retrieved November 16, 2022, from https://www.everydayhealth.com/dandruff/guide/

Brazier, Y., & Patel, R. (2020, October 26). Dandruff: Causes and treatments. Medical News Today. Retrieved November 16, 2022, from https://www.medicalnewstoday.com/articles/152844

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A Comprehensive Guide To Dandruff and How To Treat It