What is dandruff?
Dandruff is the name of the small particles of dead skin in a person’s hair. Dandruff is the medical name for the shedding of dead skin cells from the scalp. When the skin cells die, it is natural to expect some amount of flaking. But in case of dandruff the flaking is unusually excessive, maybe chronically or as a result of certain triggers. It can also be accompanied by redness and irritation. Dandruff is a very common problem occurring to people from any age or ethnicity and requires dermatologists’ intervention only in extreme cases. In simple terms, dandruff is the excessive shedding of the skin in the scalp.
What are the common misconceptions?
- Dandruff is related to poor hygiene – Dandruff is a condition of itchy scalp flaking but it is not related to poor hygiene though it can be embarrassing.
- Dandruff is due to dry skin – Dandruff is because of dry skin. In fact people with oily skin are more prone to skin flaking.
- Dandruff is more common in men than in women – It can occur both in males as well as females.
- Cosmetic products can cure dandruff – Dandruff shampoos and hair care products do not ‘cure’ dandruff. They only remove the visible symptoms, not the root cause.
What are the causes of dandruff?
Dandruff outbreaks can have a lot of causes including certain habits and allergies.
- Seborrheic Dermatitis – This disease affects many areas of the skin including the backs of ears, eyebrows and side of the nose. The red, greasy skin is covered with flaky white or yellow scales that look like dandruff when they fall off. Seborrheic dermatitis affects the areas of the skin that are rich in oil glands and can happen even in groin and armpits.
- Malassezia – Malassezia is a type of fungus that lives on the human scalp and feeds on the oils secreted by the hair follicles. It is present on almost everybody’s scalp and is not problematic at controllable levels. But if it goes out of control, the scalp gets irritated and starts producing extra skin cells that die quickly and fall out. These flakes of skin mix with the oil from the hair and scalp and shed as what we call as dandruff. The main cause behind malassezia going out of control is unknown. But it is thought to be due to an impaired immune system.
- Contact Dermatitis Due To Hair Care Products – Hair care products including shampoos and conditioners are a curious combination of a lot of individual ingredients, each trying to treat a particular scalp problem, including hair fall and thinning hair. But one or more of the ingredients might not agree with a particular skin type and can cause allergies that may lead to the skin becoming red and itchy, causing a scaly scalp and subsequently dandruff.
- Not Washing Hair Properly – Most of the times, people either over shampoo, causing dry skin and hair, or don’t shampoo enough, causing oil and dead skin build up on the scalp which causes dandruff. Lack of shampooing can increase dandruff because it allows the flakes to accumulate on the hair.
- Not Brushing Hair Regularly – Brushing hair has a lot of benefits, including increasing blood supply to the scalp and helping hair growth. But regular brushing also has one more effect. It removes the dead skin cells in the scalp making the underlying good skin cells to come up. Frequently removing the dead skin cells helps in nourishing the scalp and preventing the build up that eventually causes dandruff.
- Dry Skin – People who actually have dry skin are more prone to dandruff. The flakes from a dry skin, though, are smaller and not very oily like other types of dandruff. This condition also does not result in redness or inflammation. The presence of dandruff is accompanied by a mild itching. It is easier to identify dry skin because it is similar in other parts of the body too.
- Diseases – Certain diseases including eczema or psoriasis also increase chances of dandruff because these are in turn caused due to other conditions that affect the skin in general. The diseases which particularly encourage excessive production of skin aggravate dandruff.
What is the treatment for dandruff?
There are many treatments for controlling dandruff, and it is best to consult a dermatologist who can identify the root cause and choose the treatment methods accordingly. The first step of treatment is always physical examination to determine the causes. If there is a doubt of a serious deeper cause, dermatologists then recommend a scalp biopsy to identify the main cause, as sometimes stubborn and persistent flaking could be due to other underlying causes like psoriasis or seborrheic dermatitis. All the treatment methods available for dandruff focus on reducing the inflammation by either using lotions (or cortisone based creams) or topical anti yeast lotions and shampoos that affect the presence of dandruff.
Moisturizing does not help dandruff because it only smoothens out the visible scales and not the actual cause. Changing the shampoo or hair care products has little effect in extreme cases of dandruff. The ‘right’ shampoo is a myth. What happens instead is less of an allergic reaction to the ingredients in some cases, reducing the manifestation of the symptoms.
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Dr. Rinky Kapoor is a cosmetic dermatologist and consultant cosmetologist in Mumbai, India. She has expertise in the area of all dermatological problems and is the co founder of The Esthetics Clinics. She is a consultant with the Fortis Hospitals in Mumbai, India, and is actively working towards treating common and uncommon skin problems using revolutionary techniques.