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Dandruff

Introduction

Dandruff is one of the most common skin conditions that affect many people around the globe. It is a mild skin condition that can be managed well with proper care. It occurs when the dead skin cells of your scalp are shed off as a natural process. A mild level of dandruff is a common occurrence and happens to everyone during their lifetime. However, severe cases of dandruff can occur due to multiple factors, and they require suitable treatment and care. The majority of the people with dandruff seek treatment options for it because it is considered embarrassing in social settings. Due to this reason, dandruff is also the most commercialized skin condition across the world.

Causes

Shedding of dead skin cells is a natural process that occurs on the skin of your whole body. When this process occurs in your scalp, the uppermost layer of skin with dead cells sheds off and forms flakes or small white patches. It is not much prominent in regular cases and doesn’t cause any skin irritation. However, certain factors may trigger excessive shedding of your scalp skin cells resulting in dandruff. These factors may be metabolic, pathological, hormonal, or genetic. 

Generally, most cases of dandruff occur due to a pre-existing condition of dry skin. Dehydration or certain nutritional deficiencies can make your skin prone to dryness. Environmental factors such as cold weather or low humidity may also contribute. The dry scalp sheds off more often than normal skin, leading to visible flakes of dandruff. Some micro-organisms, such as specific yeasts, feed on the natural oils produced by your scalp. This may be another cause of dandruff. Variable hormonal levels during stress or anxiety may also contribute, although this is usually linked with a lack of dehydration during such conditions. Dandruff may also occur due to allergies to certain hair products such as shampoos, hair sprays, hair styling gels, etc. 

Risk Factors

Risk factors for dandruff are linked with its causes. Infrequent shampooing is one of the risk factors which results in the accumulation of dead skin cells that appear as dandruff. On the other hand, too-frequent shampooing may also lead to dry scalp skin which is a causative factor for dandruff. People with excessively oily skin are also at risk because skin micro-organisms may feed of these oils and yield products that result in dandruff. Frequent usage of hair products such as hair sprays, hair gels, etc., may result in an allergic reaction in the skin of your scalp. Cold weather, low humidity, or air pollutants in the environment are also considered contributing risk factors. 

Dandruff is a fairly common skin condition that can occur at any age. However, research shows that it begins after puberty in most cases and may occur until the late stages of life. It has been noticed that it is more prevalent among males than females. 

Signs and Symptoms

The most common symptom of dandruff is white flakes or scales found either on the scalp’s surface or dispersed in hair. These flakes may also be noticed in eyebrows or facial hair. They might shed off on your clothes or pillow in severe cases. You may also experience a certain degree of itchiness or irritation on your scalp, depending on the severity of this condition. It is also common to find white or grey patches of dead skin cells on the surface of your scalp. In severe cases, it may also present with inflammation of scalp skin or redness, which may signify another underlying skin condition. 

Diagnosis

The diagnosis of dandruff requires no specific tests. Your doctor or dermatologist will identify dandruff by taking a history of symptoms experienced and clinical examination of the scalp. The scalp is often found dry and coated with white scales or patches. If any other skin lesion is present or suspected, your doctor may perform suitable tests to confirm the diagnosis. 

Differential Diagnosis

Dandruff may occur as one of the symptoms of seborrheic dermatitis. Other diseases with similar symptoms include psoriasis, eczema, atopic dermatitis, tinea capitis, xerosis, etc. Auto-immune diseases such as HIV or lupus may also cause signs of the scalp skin similar to dandruff. 

Treatment

There is no permanent cure for dandruff. It can be controlled and managed with medicated or non-medicated treatment options. The primary treatment option is to wash your hair with a suitable shampoo that removes the layer of dead skin cells off your scalp. The frequency of hair washing depends on the severity of dandruff and other personal factors. It is suggested not to wash your hair too often if you already have dry skin or hair. Such people are advised to use a conditioner or hair mask afterward to nourish the skin of the scalp. Oiling your scalp and avoiding dehydration are also suggested to reduce the occurrence of dry skin. 

Medication

Medicated shampoos or ointments are available to control dandruff which contains an antifungal agent to prevent the growth of fungal microorganisms. The active ingredient of such shampoos includes ketoconazole, zinc pyrithione, selenium sulfide, etc. These shampoos or ointments should be used in frequency as directed by your dermatologist. If any product causes an allergic reaction, it is best to consult your dermatologist to switch to an alternative option. 

Prognosis

Despite the use of anti-dandruff products, there are still chances of recurrence of dandruff once such products are stopped. Therefore long-term care is suggested for this condition.

Prevention

The use of anti-dandruff products can prevent dandruff to some extent, although recurrence may occur. Washing your hair and using a moisturizing conditioner or mask is helpful, especially if you have dry skin and scalp. People with oily skin are suggested to wash their hair once daily or on every alternate day to avoid the growth of fungal micro-organisms. Dietary sufficiency and frequent hydration are also necessary to prevent the development of dandruff. 

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 1, 2023.

Reference

https://www.mayoclinic.org/diseases-conditions/dandruff/symptoms-causes/syc-20353850

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887514/

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