Dandruff

Dandruff  is due to the excessive shedding of dead skin cells from the scalp. A small amount of flaking is normal and in fact quite common. Some people, however, either constantly or as a result of certain triggers, experience an unusually large amount of flaking, which can also be accompanied by redness and irritation. Most cases of dandruff can be easily treated with specialized shampoos. Dandruff is not like lice; it is just dead skin that accumulates in the scalp. Dandruff is unlikely to be the cause of hair loss.

Excessive flaking can also be a symptom of seborrhoeic dermatitis, psoriasis, fungal infection or excoriation associated with infestation of head lice.

Dandruff is a global phenomenon and many people find that dandruff can cause social or self-esteem problems. Treatment may be important purely for psychological reasons.

As the epidermal layer continually replaces itself, cells are pushed outward where they eventually die and flake off. In most people, these flakes of skin are too small to be visible. However, certain conditions cause cell turnover to be unusually rapid, especially in the scalp. For people with dandruff, skin cells may mature and be shed in 2 - 7 days, as opposed to around 28 days in people without dandruff. The result is that dead skin cells are shed in large, oily clumps, which appear as white or grayish patches on the scalp, skin, and clothes.

Dandruff has been shown to be the result of three factors:

1)Skin oil commonly referred to as sebum or sebaceous secretions
2)The metabolic by-products of skin micro-organisms (most specifically Malassezia yeasts)
3)Individual susceptibility

Rarely, dandruff can be a manifestation of an allergic reaction to chemicals in hair gels/sprays, hair oils, or sometimes even dandruff medications like ketoconazole. So if you have changed a hair product which would correspond with the start of your symptoms then the first step would be to change the product.

There is no convincing evidence that food (such as sugar or yeast), excessive perspiration, or climate have any role in the production of dandruff. However, certain oily foods or excessive intake of 'junk food' can trigger the appearance of dandruff.


 Seborrheic dermatitis
Flaking is also a symptom of seborrheic dermatitis. Redness and itching which frequently occurs around the folds of the nose and the eyebrow areas, not just the scalp.

Dry, thick, well-defined lesions consisting of large, silvery scales may be traced to the less common psoriasis of the scalp.

There have been many strategies for the control of dandruff. Simply increasing shampooing will remove flakes. However, elimination of the fungus results in dramatic improvement. Regular shampooing with an anti-fungal product can reduce recurrence.

Anti-fungal/anti-dandruff shampoos containing ketoconazole (nizoral) have been shown to be the most effective.

Other products include Selsun, a selenium based shampoo,  Neutrogena T-Gel shampoo and Polytar liquid which are coal tar based shampoos to treat flaky scalp, scalp psoriasis and seborrheic dermatitis.

This page was last updated: Monday 25 September, 2017