What is Dandruff?

Skin exfoliation is a normal, natural feature of the lifecycle of skin cells. The white flakes from a dry scalp are the fragments of the uppermost layer of skin – the superficial stratum corneum, which have been shed as part of the process. Some amount of flaking is expected, but excessive flaking is not. There are several causes for this condition.

Causes of Dandruff

Skin renewal is a continuous process. New cells are produced, and old ones are shed to stay healthy. However, when this renewal cycle speeds up for reasons exactly unknown to us, the patches of dead skin cells in the form of dry white flakes get dislodged into the hair- making for an unpleasant situation which is embarrassing and itchy, to say the least. Both men and women face dandruff, and the causes of dandruff in men and women could be due to several reasons. There could be several reasons for this excessive flaking of the skin on the scalp, which we call dandruff. And correspondingly, there are several courses of treatment. Dandruff gets worse in extreme heat and cold weather conditions and also when you are sick or stressed.

Often, we ask – what causes dandruff in men and women? A common misconception is that dandruff is caused by poor hygiene, which is so not true. Dandruff is not caused by poor hair hygiene, but the flakes may become less apparent after a wash since the build-up of oils and skin cells will drop off after shampooing.

Often, dandruff is caused by the overgrowth of a common yeast-like fungus known as Malassezia. This fungus grows on the scalp of most people, and it thrives on skin oils, making those with oily scalps more susceptible to dandruff. In addition, Oleic acid, a metabolic by-product of this fungus, produces an increased turnover of skin cells, which in turn causes those unwanted white flakes.

Oiliness, by itself, could also cause dandruff when the oily sebum secreted by the scalp accumulates. Irregular or improper shampooing is generally the reason for this pile-up, and the sebum combines with the dead skin cells and dirt to form itchy flakes.

A dry scalp can also cause dandruff. Especially during the winter season when we often tend to wash hair with warm water. The heat in the water dries out the hair and scalp, making the scalp flaky. Flakes of dandruff caused by dry skin are generally less oily and smaller in size with no redness and inflammation than those caused by other triggers.

Skin conditions like seborrheic dermatitis or seborrhea, which is associated with an increased yeast growth on the skin, also cause dandruff. It causes the scalp and face to become greasy, red, scaly, and itchy. The flakes of skin could be white or yellowish.

Another fungal infection that causes dandruff is scalp ringworm, also known as tinea capitis. It is characterized by severe itching of the scalp and bald patches in the areas where the fungus lives.

Contact dermatitis is an allergic reaction and sensitivities to certain chemicals used or present in hair or skin products. Products like hair colour, hair spray, gel, or mousse often trigger the response. Excessive production of skin cells in these conditions leads to scaly skin, which, when shed, combines with dirt and sebum to cause flaky and itchy dandruff.

Skin ailments like psoriasis significantly increase dandruff. Psoriasis gives rise to crusty patches of skin that are red, flaky, and have silvery scales.

Eczema also makes the skin red, flaky, and dry. In addition, it also gets itchy, causing the flaking to be more noticeable when scratched.

Hormonal changes and stress have been known to stimulate dandruff production. Neurological conditions- like Parkinson’s disease, suppression of the auto-immune system, and chronic conditions like strokes have also displayed similar reactions.

Diagnosis of Dandruff

Diagnosis of dandruff is a critical task so that you can begin treatment for the same. It is often advisable to visit a dermatologist while getting your dandruff diagnosis. Detecting the existence of dandruff is generally an easy task since the effect of this condition can be seen with less effort, owing to the presence of flakes on your person. The reason why you should visit the dermatologist to get your dandruff diagnosis is because the cause of this condition could require a skin sample for biopsy, which can only be decided by your presiding medical professional.

Dandruff Treatment (How to Get Rid Of Dandruff)

Dandruff solutions and dandruff treatments involve regular brisk brushing of hair to prevent oil build-up in the scalp and using a good anti-dandruff shampoo. The dandruff treatment may take trial and error to arrive at the optimal solution. It will take some time to identify the right shampoo, and you may also need to switch between types of shampoo if it loses efficacy.

Mild cases of dandruff may clear out with regular shampooing using a gentle cleanser. In the case of seborrheic dermatitis, you may require an aggressive treatment like a  specialized shampoo for that stubborn dandruff and also to find relief from the itching, redness, and flaking. The choice of shampoo will depend on the cause of dandruff. You may need some expertise to determine the most suitable product since each has its distinct mode of action.Tar-based shampoos may help deal with psoriasis and seborrheic dermatitis by slowing down the rate at which cells die and flake off. Also, you will need to exercise care and caution when you try a coal-tar-based shampoo because while it may be a great dandruff solution, it may have the following repercussions,

  • some of you may develop an allergic reaction to coal tar
  • Coal tar can change the colour of skin, fingernails, lighter-colored hair, and clothes too.
  • Makes skin super sensitive to sunlight. Upon usage, you must stay away from direct sunlight for at least 24 to 72 hours.
  • Coal tar is harmful to pregnant women and nursing mothers.

Shampoos containing zinc pyrithione are antifungal and antibacterial. They also help tackle dandruff-causing fungus and seborrheic dermatitis.

Whereas a shampoo containing selenium sulphide retards the growth of the problematic skin cells on the scalp. It slows down the death of skin cells.

Salicylic acid in shampoos helps scrub off the scale but may make the scalp dry and exacerbate the flaking.

The shampoos that contain ketoconazole target dandruff-causing fungus. Ketoconazole may work even when other shampoos have failed since it is a broad-spectrum antifungal agent.

Apart from shampoos, there are also some cortisone-based creams and lotions that reduce skin inflammation. For the fungus, anti-yeast lotions are used to deter its proliferation.

A whole host of home remedies also help defend against dandruff- the application of curd, lemon, salt, garlic or apple cider vinegar, aspirin, baking soda or mouthwash, coconut oil, olive oil, tree-tree oil, or aloe vera.

Cutting back on styling products, such as hair sprays, gels, and mousses, has also proven to be effective. These products trigger contact dermatitis and build up on hair and scalp, causing oiliness, which the fungus thrives on.

If the dandruff does not clear out with over-the-counter shampoos and home remedies or if the scalp becomes red or swollen, a visit to the dermatologist is called for. The dermatologist will thoroughly examine the scalp and, if the causes are not apparent, perform a scalp biopsy to determine the root cause of dandruff.

Don’t let the effects cascade.

Timely medical intervention is essential, especially since conditions like seborrheic dermatitis could also affect areas like the eyebrows, sides of the nose, back of the ears, the breast, groin, and armpits.

Temporary hair fall is also associated with dandruff since hair follicles get damaged when the scalp is scratched due to the itching.

Further, flakes of dandruff fall on the face, blocking pores and increasing the likelihood of a breakout of pimples. The forehead, where the hair often touches the skin, is the most susceptible area.

Regardless of what causes your specific dandruff condition, there’s nothing that the right advice cannot clear. Talk to your dermatologist and be confident that you will get the weight of dandruff off your shoulders with the right dandruff treatment.

Despite all medical interventions and home remedies to treat dandruff, if you still suffer from scratching and a flaky scalp, do consult a dermatologist for a thorough dandruff treatment that may include topical medication and prescription shampoo to get to the root of the problem and fix it.

– By Kaya’s Expert Dermatologists

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