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What is dandruff?

Dandruff is a skin condition that causes development of white to grey dry skin flakes on the scalp. It is a common condition of the scalp that equally affects both men and women. It is an unpleasant condition that can affect the social life of individuals. The incidence of dandruff in men is more than that in women. Globally, about 50% of the population is estimated to have dandruff. The extrapolated prevalence in India was found to be 195,785,036.

What are its main signs and symptoms?

The common symptoms include:

  • White, greasy flakes of dead skin on the scalp.
  • Scaly or itchy scalp.
  • Absent or mild inflammation.
  • Flakes on the eyebrows, eyelashes, and backside of the ears.

Dandruff occurs on the scalp, hence, in case of heavy dandruff, the flakes often fall over the shoulders. The scalp tends to become oily due to the overproduction or accumulation of sebum, a secretion of the sebaceous glands.

What are its main causes?

The main causes of dandruff are as follows:

  • Inflamed or irritated greasy skin
  • Inadequate use of shampoo
  • Fungal infection with Malassezia
  • Dry skin
  • Hair product allergy

Risk factors include:

  • Age: From young adulthood or puberty to middle age.
  • Male gender: Male hormone influence.
  • Excess sebum: Malassezia fungal infection consumes scalp oil and causes more dandruff.
  • Certain diseases: Parkinson’s disease (a neurologic disorder) and HIV infection.

How is it diagnosed and treated?

As dandruff appears scaly and flaky, it may be difficult to diagnose and differentiate an actual dandruff condition from skin conditions that cause similar symptoms such as seborrheic dermatitis, psoriasis, atopic dermatitis, tinea capitis, etc. Diagnosis is mainly done by patient’s medical history and physical examination. Sometimes, a skin biopsy may be ordered.

The most effective treatment is to use anti-dandruff shampoos and scalp treatments. Unfortunately, these treatments do not work for all patients. If dandruff doesn’t get better with anti-dandruff shampoos and scalp treatments then, based on the underlying medical condition, appropriate anti-bacterial or anti-fungal treatment may be given. Novel drug delivery systems such as liposomes, niosomes, and solid lipid nanoparticles are gradually being used as a part of dandruff treatment.

Self-care:

  • Scalp care must be taken.
  • Adopt good hair care practices such as oiling with herbal oils and washing hair regularly to avoid further dandruff progression.
  • Avoid repeated shampooing, as it strips off excess oil that is needed for maintaining the scalp health.
  • Do not comb your hair roughly.
  • Avoid hair styling treatments till dandruff resolves.

For effective management of dandruff, adopt an appropriate hair care regime and, if this does not reduce your dandruff, consult a trichologist to help you overcome this problem.

  1. Medicines for Dandruff
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Dr. Ragini Puvvala

Dr. Ragini Puvvala

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References

  1. Frederick Manuel, S Ranganathan. A New Postulate on Two Stages of Dandruff: A Clinical Perspective. Int J Trichology. 2011 Jan-Jun; 3(1): 3–6. PMID: 21769228
  2. Open Access Publisher. Dandruff. [Internet]
  3. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Dandruff, Cradle Cap, and Other Scalp Conditions
  4. Luis J. Borda, Tongyu C. Wikramanayake. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investig Dermatol. 2015 Dec; 3(2): 10.13188/2373-1044.1000019. PMID: 27148560
  5. B Satheesha Nayak et al. A Study on Scalp Hair Health and Hair Care Practices among Malaysian Medical Students. Int J Trichology. 2017 Apr-Jun; 9(2): 58–62. PMID: 28839388
  6. B Satheesha Nayak et al. A Study on Scalp Hair Health and Hair Care Practices among Malaysian Medical Students. Int J Trichology. 2017 Apr-Jun; 9(2): 58–62. PMID: 28839388
  7. B Satheesha Nayak et al. A Study on Scalp Hair Health and Hair Care Practices among Malaysian Medical Students. Int J Trichology. 2017 Apr-Jun; 9(2): 58–62. PMID: 28839388
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