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Read MoreUnderstanding Dandruff: Causes, Symptoms, and Treatment Options
Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on June 30th, 2023.
Key Takeaways
- Malassezia globosa fungus feeds on scalp oils and produces oleic acid, which triggers inflammatory responses in approximately 50% of people, causing rapid skin cell turnover every 2-14 days instead of the normal 28-day cycle.
- Flakes appear white when dry but turn yellowish and greasy in seborrheic dermatitis, the more severe form that affects oil-rich areas like eyebrows, nose sides, and behind ears.
- Zinc pyrithione shampoos should be used 2-3 times weekly initially, then reduced to once weekly for maintenance, while ketoconazole (2%) works faster but requires prescription strength for stubborn cases.
- Cold, dry weather and indoor heating worsen symptoms by reducing scalp moisture, while stress increases cortisol levels that boost oil production and feed fungal growth.
- Selenium sulfide shampoos can temporarily discolor blonde, gray, or chemically-treated hair, and all medicated shampoos need 5-10 minutes contact time on the scalp to be effective.
Dandruff is a common scalp condition characterized by dry, white flakes of skin that fall from the scalp and often land on the shoulders or collar. While dandruff is harmless, it can be embarrassing and cause itching. Contrary to popular belief, dandruff is not caused by poor hygiene or infrequent hair washing. Instead, it is related to the skin on your scalp.
The Main Cause of Dandruff: Overproduction of Skin Cells
The primary cause of dandruff is the rapid growth and death of skin cells on the scalp. In people with dandruff, skin cells grow and die off too quickly, leading to the formation of dry, flaky skin. However, the exact reason for this overproduction of skin cells is not well understood.
The Role of Fungus in Dandruff
One possible contributor to dandruff is a fungus called malassezia. This fungus is commonly found on the scalp of most healthy adults without causing any issues. However, in some individuals, the immune system may overreact to the presence of malassezia, leading to the development of dandruff.
Factors That Can Worsen Dandruff
Stress: Dandruff may become more severe during times of stress or illness.
Weather: Cold, dry winters can trigger or exacerbate dandruff.
Seborrheic dermatitis: A common cause of dandruff, seborrheic dermatitis can also affect other areas of the body, such as the ears, face, and chest.
Treatment Options for Dandruff
While there is no cure for dandruff, it can be managed effectively with the right treatment. Some options include:
Anti-dandruff shampoos containing ingredients like zinc pyrithione, ketoconazole, or salicylic acid
Medicated creams or ointments for severe cases or seborrheic dermatitis
Stress management techniques to reduce flare-ups
Maintaining a healthy diet and staying hydrated
If you are concerned about your dandruff or it does not improve with over-the-counter treatments, consult a dermatologist for personalized advice and prescription-strength options.
Remember, dandruff is a common condition that affects many people. By understanding its causes and exploring various treatment options, you can effectively manage your dandruff and maintain a healthy, flake-free scalp.
For more information on dandruff and scalp health, visit:
The Bottom Line
Most cases respond well to consistent use of anti-fungal shampoos within 2-4 weeks, but stopping treatment typically causes symptoms to return within a month. The key is finding the right active ingredient for your specific case and maintaining a regular routine even after symptoms improve. If you're dealing with persistent flakes or scalp irritation that isn't responding to over-the-counter treatments, Doctronic can help determine if you need stronger prescription options.
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