Ever found yourself scratching your head uncontrollably, worrying about those annoying flakes that just keep falling off your head? You’re not alone — Dandruff can be quite a nuisance, making you feel conscious about wearing dark-coloured shirts.
Also known as Pityriasis Capitis, dandruff can bring your confidence down and lower your self-esteem. But fortunately, it is a quite common scalp condition that can be treated.
What causes dandruff?
Often misunderstood as an outcome of poor hygiene, dandruff is actually a complex and multifaceted problem. If you’re struggling with stubborn dandruff that just won’t go away, it might be more than just the usual flakes – it could be a benign case of seborrheic dermatitis (SD), which is basically a chronic form of eczema that targets the oiliest areas of your body.
But dandruff isn’t a one-size-fits-all problem—there is a myriad of factors contributing to it. One is a yeast-like fungus called Malassezia globosa that thrives on scalp oils, activating an inflammatory response that leads to skin cell accumulation and flaking. Furthermore, skin conditions like eczema, psoriasis, rosacea, acne, and other reasons like stress, as well as contact dermatitis, can contribute to your dandruff woes, making it even trickier to deal with. Not to mention excessive oil production on your scalp.
Washing your hair infrequently or using too many hair products can worsen dandruff by causing an oil build up that leads to irritation and allergies. Moreover, in my career, I have observed that dandruff typically occurs in people with lower levels of immunity—like those who’ve had an organ transplant, alcoholic pancreatitis, Hepatitis C, or contracted HIV/AIDS. Moreover, individuals affected with Alzheimer’s disease, epilepsy, traumatic brain injury, Parkinson’s disease, and spinal cord injury are especially prone to SD and dandruff.
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What are the different types of dandruff?
Dry skin dandruff: It is a typical form of dandruff that often appears during the winter months when the cold weather and indoor heating cause your scalp to dry out. It looks small, flaky, and white. What’s more, dry skin dandruff gets aggravated by hot-water baths. Using a moisturising shampoo and home remedies such as a relaxing coconut oil scalp massage can help.
Oily skin dandruff: This form of dandruff may occur if you have an oily scalp, as the sebaceous glands under your skin create excessive sebum, which causes your hair to be greasy. Excess oil build-up leads to scalp discomfort and dandruff. Oily skin dandruff is larger and may seem yellowish. To tackle this, try using a salicylic acid-based dandruff shampoo and washing your hair regularly.
Fungus-related dandruff: Malassezia, a common fungus, is naturally present on human skin and can induce an inflammatory response in certain people, resulting in dandruff and other skin diseases such as eczema. Look for shampoos that have Malassezia-inhibiting chemicals like zinc pyrithione to treat this kind of dandruff. Research says that these kinds of shampoos assist with other scalp ailments such as SD, psoriasis, and eczema. You can even consider diluted tea tree oil treatments or use shampoos containing the same.
Disease-related dandruff: Skin disorders like psoriasis, eczema, and SD can cause dandruff troubles; SD can even result in red, scaly areas marked by flakes. Using a shampoo containing zinc pyrithione is the most effective technique to treat dandruff caused by SD. Flaky patches and itchy skin on eczema patients may even be much larger than dandruff flakes on those with dry skin.
Choose gentle, moisturising shampoos to tackle the problem. But if necessary, a doctor may prescribe a more critical topical treatment. You may see thin, silvery flakes or inflammatory, scaly areas on the scalp if you have psoriasis, an autoimmune illness that causes fast skin cell development and thick, scaly patches. But don’t fret — corticosteroids and shampoos containing salicylic acid or zinc pyrithione can help relieve the symptoms of scalp psoriasis to an extent.
Some things to keep in mind
A plethora of options for dandruff treatment is available in the market. Read the label and follow the directions on the bottle to assess whether it can help your symptoms or not.
Use a product specifically for dandruff twice a week if you are Caucasian or Asian. If one shampoo doesn’t work, try alternating between those with different active ingredients such as coal tar, salicylic acid, selenium sulphide, zinc pyrithione, piroctone olamine, or ketoconazole.
Use lukewarm water to wash your hair, and shampoo regularly to control oil build up on the scalp.
Managing stress, maintaining a healthy diet, and limiting hairstyling products can promote scalp health.
Avoid scratching your scalp with your nails and practise stress management.
Home remedies like tea tree oil, baking soda, curd, and anti-fungal shampoos prescribed by a dermatologist may also be effective in tackling dandruff.
If you exercise regularly or play a sport — and have an itchy, sweaty scalp — using apple cider vinegar as a conditioner once or twice a week can prove to be an excellent solution.
Those with coloured hair can mix 1 tsp of cetrimide solution with 5 tsp of water in a bowl and dab it on the scalp and leave it on overnight. Wash your hair in the morning with an anti-dandruff shampoo, and follow this routine for 3 to 5 days, depending on the severity of your condition.
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One important point: Dandruff can also appear on the beard! It may appear as peeling and flaking of the skin and be accompanied by greater sensitivity, itching, burning sensation, and redness. Your problem may worsen if you have sensitive skin, poor immunity, or sweat excessively. Use haircare products with the above-mentioned active ingredients to tackle the issue.
Severe dandruff can also cause flakiness in the eyebrows, around the nose, and in the ears. In extreme situations, tablets such as fluconazole or itraconazole may be required, with the dose and duration determined by the severity of your dandruff.
A good haircare routine, along with a healthy diet and adequate hydration, makes a big difference. However, if you’re always battling dandruff and an itchy scalp, visit your nearest dermatologist. They can provide personalised remedies and skilled advice to help you overcome this frustrating problem and achieve a flake-free scalp.
Dr Deepali Bhardwaj is a dermatologist, anti-allergy specialist, laser surgeon and internationally trained aesthetician. She tweets @dermatdoc. Views are personal.
(Edited by Humra Laeeq)