Dandruff
Dandruff is characterized by the excessive flaking of dead skin cells on the scalp, which often leads to itching and the presence of visible white or yellow flakes. While not considered a serious medical condition, dandruff can be bothersome and may cause embarrassment for those affected. Various factors contribute to the development of dandruff, including infrequent hair washing, dry skin, skin conditions like eczema or psoriasis, and irritation from hair products. A fungal presence, specifically the Malassezia fungus, can also play a role.
Certain demographics, such as young to middle-aged individuals and males, are more prone to dandruff, and external factors like nutritional deficiencies, stress, and hormonal fluctuations can heighten the risk. Symptoms primarily include flakes of varying sizes and textures, which can become noticeable on clothing and in hair. Treatment options range from regular washing with gentle shampoos to the use of medicated shampoos containing antifungal or antibacterial ingredients. Preventative measures emphasize maintaining scalp cleanliness, utilizing specialized shampoos, and managing health through proper nutrition and stress reduction.
Dandruff
- ANATOMY OR SYSTEM AFFECTED: Hair, scalp, skin
- ALSO KNOWN AS: Pityriasis simplex capillitii, scurf, seborrheic dermatitis
Definition
Dandruff is the excessive scaling of dead cells on the scalp, which produces itching and white or yellow flakes. Though not a serious condition, dandruff can be a nuisance and an embarrassment to the person with it.
Causes
Infrequent hair washing can result in an oily scalp and dead scalp cells flaking. Dry skin on the head may cause itching, which produces small dry flakes. Persons with eczema or psoriasis can experience dandruff. Irritation from hair products can cause contact dermatitis, resulting in itching and flaking. Seborrheic dermatitis occurs with irritated oily skin and results in white flaking wherever there is hair and in excess oil, such as on the scalp, the eyebrows, or the groin area. A fungus called Malassezia, or Pityrosporum ovale, sometimes results in an itchy head and flaking. Newborns and infants experience a form of dandruff called cradle cap that usually resolves on its own. There are several additional causes of dandruff, including nutritional deficiencies, stress, hormone fluctuations, and certain medications.
Risk Factors
All persons are at risk for dandruff, but certain factors are associated with getting dandruff. Young and middle-aged persons tend to have more dandruff than older adults. Males exhibit more dandruff than females, possibly because of hormones and oil-producing glands in the scalp. An oily scalp provides a fertile breeding ground for fungi, resulting in dandruff. A diet that lacks zinc and B complex vitamins may put a person at risk for dandruff. Certain conditions, such as Parkinson’s disease, can predispose a person to dandruff. Other factors, including a stressful lifestyle, living in a certain climate, genetics, hair products, yeast overgrowth, chronic disease, or lowered immunity, can increase the chance of dandruff.
Symptoms
Dandruff manifests with excessive flaking of dead cells and scalp itching. Flakes vary in size, texture, and color based on the causative factor. They can be observed on the shoulders of dark clothes, on hair, and on the scalp.
Screening and Diagnosis
Dandruff rarely requires the attention of a physician. It is diagnosed by physical examination of the hair and scalp for white or yellow flakes and itching.
Treatment and Therapy
Dandruff can be controlled by different therapies based on the cause and extent of the problem. Frequent washing with a mild shampoo, tea tree oil, or apple cider vinegar may control dandruff caused by an oily scalp. Some cases require an antibacterial or antifungal shampoo that contains ketoconazole, zinc pyrithione, salicylic acid, selenium, or tar. However, if the scalp becomes red and swollen, a physician may provide a prescription-strength shampoo or a topical steroid lotion.
Prevention and Outcomes
The key to preventing dandruff is to address the cause. One should keep the scalp clean with frequent hair washing; use a special shampoo for dandruff and leave it on the scalp for three to five minutes to assist with cleansing; and avoid chemical treatments of the hair, including permanents, hair color, and hair products that contain chemicals such as hair spray. Dandruff may present less in the summer when the head is exposed to sunlight. Basic good health with proper diet and stress management can help prevent this condition.
Bibliography
Borda, Luis J., and Tongyu C. Wikramanayake. "Seborrheic Dermatitis and Dandruff: A Comprehensive Review." Journal of Clinical and Investigative Dermatology, vol. 3, no. 2, 2015, doi.org/10.13188/2373-1044.1000019. Accessed 11 Oct. 2024.
"Dandruff." Mayo Clinic, 25 Aug. 2023, www.mayoclinic.org/diseases-conditions/dandruff/symptoms-causes/syc-20353850. Accessed 11 Oct. 2024.
Khalsa, Karta. "Brush Off Dandruff." Better Nutrition, vol. 70, no. 4, Apr, 2008, pp. 34, 36.
Slomka, Megan, and Ashley Marcin. "Dandruff: Causes and How to Get Rid of It." Healthline, 19 July 2024, www.healthline.com/health/dandruff-itchy-scalp. Accessed 11 Oct. 2024.
Weedon, David. Skin Pathology. 3d ed., New York: Churchill Livingstone/Elsevier, 2010.
Wolff, Klaus, and Richard Allen Johnson. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology. 6th ed., New York: McGraw-Hill Medical, 2009.