Dandruff is a common scalp condition which causes itching and flaking of the scalp. It can be extremely embarrassing and distressing but for most people it is extremely easy to treat and be cured quickly. In some cases dandruff can develop into a more chronic condition or be symptomatic of another skin condition such as psoriasis or seborrheic dermatitis.

With the correct anti-dandruff treatment, the condition can be fully cured for some people or at the very least controlled and managed. It can be a condition which is related to age, hormonal imbalances or other medical conditions. There are both topical and medical treatments and home remedies for treating dandruff, dependent on the severity and preferences of the sufferer.

Dandruff is not usually a serious condition, but it can cause distress and upset. As it is common in adolescence it is particularly important to help children and young adults understand and manage the condition before it becomes a cause of distress and upset. Dandruff does not have to be a serious concern for any sufferer with the right treatments and many people get into a regular routine so managing it becomes as normal as brushing their teeth and other daily personal care tasks.

Table of Contents:

  1. Diagnosing Dandruff
  2. Aggravating Factors for Dandruff
  3. Symptoms of Dandruff
  4. Dandruff Treatments

Diagnosing Dandruff

Dandruff is rarely a condition which requires diagnosis and most people recognize the symptoms and are able to seek treatment in the form of simple shampoos and cleansers. An itchy, dry scalp can be symptomatic of other conditions though, so it is important to be mindful of any other symptoms. One condition which is often mistaken for dandruff is seborrheic dermatitis but there are marked differences which we’ll explore later in this piece.

The Cause of Dandruff

The main cause of dandruff is a combination of three main factors:

  • The presence of the microbe; Malassezia globosa
  • The natural oils on the scalp; sebum
  • A sensitive scalp

The microbe Malassezia globosa breaks down the sebum of the scalp it produced oleic acid. Around 50% of the world’s population has a scalp which is sensitive to this acid and then becomes irritated. This irritation leads to soreness and itchiness and the white dry flakes of skin we know as dandruff. Here is a closer look at the exact process which causes dandruff:

  • The microbe Malassezia globosa feeds on the scalp’s natural oils, sebum. Sebum is the oil which keeps hair and scalp well moisturized and healthy.
  • As the sebum is broken down and consumed by the Malassezia globosa, the by-product oleic acid is produced.
  • 1 in 2 people has a sensitivity to oleic acid and this results in irritation of the scalp.

  • This irritation leads to inflammation, itchiness and redness of the scalp.
  • This reaction sends a signal to the brain to shed skin most quickly than usual to get rid of the irritation.
  • Visible flakes of skin appear on the scalp and fall, causing what we recognize as dandruff.

Other Factors which Influence Dandruff Production

While the above process tells us what happens to result in dandruff, it doesn’t explain exactly what influences the condition and factors which can further exacerbate and increase dandruff production. Here are some possible factors:

Seborrheic Dermatitis

As already mentioned, seborrheic dermatitis is a chronic skin condition often mistaken for dandruff. Unfortunately for people with this condition, they are also likely to suffer from dandruff. The condition affects the scalp and other areas of the body including the nose, ears and eyebrows. The condition is once again closely linked with the microbe Malassezia globosa and the combination of the two can lead to excessive skin cell shedding.

Yeast Sensitivity

People who are prone to yeast sensitivity and commonly suffer from yeast infections may be slightly more prone to dandruff. There is no research which directly connects yeast and dandruff to date, but it may be related. Researchers argue that yeast may be linked to dandruff as the condition gets worse in the summer which could be due to ultraviolet-A light counteracting with yeast in the scalp.

Brushing Problems

People who excessively brush their hair and also those who do not brush their hair enough can see dandruff develop. Regular combing and brushing is essential for managing dead skin cells in the scalp but excessive brushing can loosen even more skin than necessary and not brushing enough can limit the natural shedding of skin.

Shampoo and Skincare Product Choice

Certain ingredients in skincare and hair products can aggravate the scalp. Similarly washing and shampooing the hair too often can cause irritation. While not all people may believe they have sensitive scalp, using abrasive or chemical-packed products can irritate even the most resistant scalp and result in the development of dandruff.

Dry Skin

People who are prone to dry skin or have naturally drier skin than normal are more likely to have dandruff. In winter months where cold air is combined with heated and air-conditioned rooms can also exacerbate dry skin and result in itchiness and flakes.

Certain Medical Conditions

People with certain skin conditions and certain medical conditions may be more prone to dandruff. Skin conditions such as psoriasis, eczema and tinea capitis (commonly known as scalp ringworm) are more likely to get dandruff than others.
Research has also found adults with Parkinson’s disease and some other neurological conditions may be more likely to get dandruff and also seborrheic dermatitis. Similarly, research has shown that people with HIV have a much higher rate of seborrheic dermatitis and related dandruff when compared with the general population.

Dietary Deficiencies

Certain vitamins and minerals missing from the diet can lead to issues with the scalp resulting in dandruff. People who do not consume enough foods containing B vitamins, zinc and some specific types of fats may be at increased risk of dandruff.

Age

There have been numerous studies linking increased dandruff production with the hormonal changes during puberty. It is much more likely during adolescence into middle age, although some people do suffer with it throughout their whole live. It is also more common in men which is believed to be due to hormone differences.

Aggravating Factors for Dandruff

There are certain things which can aggravate and exacerbate the development of dandruff. While they can’t always be avoided, it is good to know why the condition may become more pronounced at certain times.

Stress

Stress is blamed for a huge range of physical symptoms and it can be a factor in dandruff development too. The symptoms of sweat are known to aggravate a dandruff problem, and while it cannot cause the condition to develop from nowhere, its symptoms can make it work. Symptoms such as:
Hormonal changes: sebum production is controlled by the body’s hormones. Stress often causes changes to the body’s hormonal balance and this may cause it to product more sebum. As more sebum is produced the microbe Malassezia globosa has more to feed on and therefore the irritation and inflammation process that leads to dandruff is accelerated.
Sweating and overheating: hotter environments are exactly what the dandruff-causing microbe Malassezia globosa needs to thrive. Often stress results in additional sweating.

Warmer Environments

The summer months and even in overheated rooms and environments are the perfect conditions for dandruff production. As mentioned above, warmer temperatures are exactly what the Malassezia globosa microbe needs to flourish and cause dandruff production. This raises the chance of a dandruff flare-up and this is once again further accelerated by any additional sweating. Another exacerbating factor in the summertime and warmer months is pollution. People tend to spend more time outdoors during the warmer months meaning our skin and bodies come into contact with more pollutants. Pollutants, much like unnecessary chemicals, can irritate and damage the scalp’s natural defences. This makes it more prone to dandruff and other conditions.

Symptoms of Dandruff

The most common symptoms of dandruff have already been discussed at length, but it is important to recognise all potential signs of the condition. This allows you to treat it early and avoid the discomfort and embarrassment that many people associate with white flakes on the shoulders and in the hair. As the scalp becomes irritated it reacts like all human skin and symptoms will include:

  • Flaking skin
  • Redness of the skin
  • Dryness
  • Itchiness

Flakes are the most visible sign of the condition, but they are not usually the first sign. In fact, they are a final result of the irritation and inflammation that comes from the scalp’s lack of sebum and the development of oleic acid. Some people describe their scalp as feeling tight as it dries out and reddens and this can be a sign its time to look for treatment.

Home Remedies for Treating Dandruff

Many people look to treat dandruff naturally before turning to a topical or anti-fungal treatment. Treatments for dandruff aim to slow down the reproduction of the skin cells and soothe the irritation caused by the production of oleic acid. Dandruff treatments may also look to counteract yeast production in the scalp, which some believe is the ultimate cause of the condition.

Natural ways of managing and dealing with dandruff include:

Stress Management

As mentioned above, dandruff can be closely linked to stress. Finding ways to manage and mitigate stress and its related symptoms can slow the development of dandruff. This is often easier said than done but many of the stress management techniques out there can be learned and in turn, people can reduce the impact of the condition on their whole body, including their scalp.

Regular Shampooing

While it is important to avoid highly chemical-based cleansers, people with oily hair and scalp should consider shampooing more often. People with particularly oily hair may even want to consider washing every day to avoid the development of this oil and the related irritation it can cause.

Sunlight Exposure

Some research suggests that exposure to sunlight can be helpful. It is important to keep in mind overheating and sweating can actually be counterproductive so keeping the exposure minimal and just enough to help keep the scalp healthy is recommended.

Tea Tree Oil

Tea tree oil is a natural anti-fungal and anti-bacterial product which many people believe helps to reduce the symptoms of dandruff. Tea tree oil has moisturizing properties too and can alleviate some of the most unpleasant symptoms of dandruff including itchiness and large flakes shedding.

There are a whole host of other home remedies people consider too, including the tried and tested wonder ingredient coconut oil, which can help to improve skin hydration and remove the dryness associated with dandruff. Other people swear by ingredients such as baking soda which can quickly remove excess oil when massaged fully into the scalp. It can be used as an additional stage in the washing and shampooing process, as long as you remember to fully wash it out of the hair. It also leaves the hair feeling softer and entirely free of dandruff flakes. The home remedies people opt for do stem into the weird and wonderful, with some advocating mouthwash as a quick and easy way of treating the yeast which may cause dandruff. The anti-fungal nature of mouthwash means it can help to prevent yeast growing and dandruff forming.

Dandruff Treatments with Active Ingredients

Shampoo and scalp preparations are the most recommended treatments for dandruff. Most shampoos will contain anti-fungal ingredients but prior to this people should attempt to remove any large flakes and scaly patches on the scalp. This helps to make the shampoo more effective and while it may not be an enjoyable task, it ensures the treatment results in a much lower chance of shedding flakes and discomfort.

There are a wide range of anti-dandruff and anti-fungal shampoos on the market so it can be hard to choose the right one. When looking for an effective shampoo, people should make sure it contains one, if not more, of the following ingredients:

Zinc Pyrithione

This compound helps in slowing down the growth of yeast.

Ketoconazole

This ingredient is an effective anti-fungal medication. It is usually included in anti-fungal shampoos.

Selenium Sulfide

Selenium sulfide is used routinely to treat dandruff and seborrheic dermatitis. It works by limiting the production of natural oils by the scalp’s glands.

Salicylic Acids

Salicylic acids are useful ingredients as they help to get rid of skin cells. They don’t stop the production of cells but can help remove them in the washing process, so they don’t fall out loose in flakes. Many scrub treatments contain these acids and while they can be a good treatment occasionally, regular use can actually irritate the scalp further. Aspirin also includes salicylic acids which is a preferred way of increasing levels of the acids for some who don’t want to risk the drying impact of scrubs and shampoos.

Coal Tar

Coal tar is one of the best-known natural anti-fungal agents. It is often used in the treatment of psoriasis and other skin conditions. It should only be used in moderation as it does have some carcinogenic properties and it can make the scalp more sensitive to sunlight, so anyone using this ingredient should be particularly careful.

For the best treatment of dandruff many people recommend alternating between regular shampoos and dandruff shampoos. This can help control the condition long-term and avoid the need for any intensive treatment if the dandruff returns. Some people also find their chosen anti-dandruff shampoo stops working over time so it may be worth alternating between different brands of this too, ensuring that no brand becomes fully ineffective.

The Difference between Dandruff and Seborrheic Dermatitis

We’ve mentioned that the chronic skin condition seborrheic dermatitis can be closely linked to dandruff and in some cases even mistaken for it but in reality, they are very different. Dandruff is usually very easy to treat and manage whereas seborrheic dermatitis may require more intervention. Dandruff is more like a symptom of seborrheic dermatitis than a condition of the same kind.

The condition seborrheic dermatitis does not just appear on the scalp. It is known to affect around 3% of the US population, with much higher occurrences in people with HIV and AIDs as already mentioned. The condition is considered one of the more chronic forms of eczema and appears on the nose, upper back and other areas of the body where high levels of oil are produced. It is the correct medical name for the common infant condition “cradle cap” and is also common in adolescents.

Seborrheic dermatitis differs greatly from dandruff as it produces scales on the skin and scalp with a yellowish tint and oily consistency. They tend to stick to the skin and do not fall off in flakes as you would see with regular dandruff. Dandruff is 100% restricted to the scalp whereas seborrheic dermatitis can occur across different areas of the body as mentioned. It is important to be aware of both conditions so the right treatment can be sought but most people find their dandruff is easily cleared up without too much trouble and can be managed through regular cleansing and shampooing.

Treating Seborrheic Dermatitis

People who do have seborrheic dermatitis usually need to seek further treatment. Mild cases may be treated with a medicated shampoo including the ingredients mentioned and they may also opt to try topical anti-fungal creams. Where the condition is more severe prescription medication may be needed in the form a corticosteroid cream or gel which can calm the inflammation and irritation related to the condition. It is not always necessary to go to see a doctor but in some instances it is necessary to get the right treatment for severe cases of the condition.

Are there any Complications Associated with Dandruff?

Dandruff is usually a very mild condition which is treated easily. There is no underestimating the distress and embarrassment it can cause when not treated but once under control it usually disappears very quickly.
However, there are a small number of complications people should be mindful of. Excessive itching or scratching of the scalp can quickly lead to inflammation, lesions and even infection. An infected scalp will need treatment from your doctor and may require antibiotics and further topical treatments. The psychological impact of not managing dandruff can also be damaging so it is important to act quickly to deal with the symptoms before they become a more serious and upsetting problem.

In almost all cases dandruff doesn’t have to be a serious problem. Understanding the early symptoms such as that tight feeling as the scalp dries out and the first feelings of itchiness can be key in avoiding the unpleasant flaking. Many dandruff treatments can be found on the shelves in regular stores for a few dollars. Most people will find this type of treatment is more than effective in treating their dandruff and allowing them to manage it. The main thing to remember with dandruff is that it never really goes away permanently so continuing with regular anti-dandruff shampoos and being aware of those early symptoms is really important.

It is also important to remember the conditions which help dandruff-causing microbes and yeasts to form. Hotter weather, excessive sweating and stress are all instrumental in dandruff if you are already predisposed to the condition.

Dandruff doesn’t need to be a problem at all if you are ready and prepared to deal with the symptoms when they occur. It only becomes a problem when it is ignored or when it causes distress and upset when it becomes noticeable and the flakes are clearly visible on the clothes and in the hair. This can be avoided from day one with effective treatment. One thing to keep in mind is that not all treatments are right for all people so you may try a few before finding the solution for your particular scalp and skin type. The worst thing people can do when they find they have dandruff and are unhappy about it, is nothing. There are easily available treatments, so it makes sense to find the right one to treat the condition.