Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
Dr. Tariq Dandruff is related to Seborrheic Dermatitis (SD), which causes itchy and flaky skin, but it only occurs on the scalp. It’s so common that it affects about half of the global adult population. Most people focus on the flakes. Itching, on the other hand, may be the most uncomfortable side effect.
SYMPTOMS
Flakes and an itchy, scaly scalp are the main symptoms of dandruff. White, oily flakes typically accumulate in the hair and on the shoulders, and often get worse during the fall and winter months, when the air is dry.
Additional symptoms can include:
* Erythema, which is red patches on the skin of the scalp, and sometimes on the face
* Eyebrow dandruff
* Hair loss
* Dry flakes on the skin of the face
What causes dandruff?
Many factors can contribute to the development of dandruff, so pinpointing the exact cause of itchy, flaky scalp can be difficult. Here are a few likely causes:
* Secretions from the sebaceous glands
* Fungal colonisation on the surface of the skin
* Not shampooing enough, which may cause skin cells to accumulate and create flakes and itching, or over-shampooing and over-drying the scalp.
* Over brushing the hair on the head, creating too much friction with the sensitive skin on the scalp
* Yeast called Malassezia, which aggravates the scalp and causes excess skin cell growth
* Different personal care products may cause contact dermatitis, which makes the scalp red and itchy
* Too much exposure to sunlight
* Excessive pressure on the scalp from hats
* Fatty and greasy foods
* Exposure to dust or dirt
Some people may be more predisposed to dandruff than others, for reasons that are unknown. However, it’s known that men develop dandruff more frequently than women. People who tend to have oilier hair, or live with certain illnesses (such as Parkinson’s disease or HIV) are also at higher risk.
Symptoms can also be noticed around puberty, but dandruff can develop at any age.
DANDRUFF VS DRY SCALP
It may be difficult to tell the difference between dandruff and dry scalp, as they can both present similarly. Both can cause flakes and an itchy sensation on the scalp.
But while dandruff is related to seborrheic dermatitis, dry scalp is simply related to the skin losing too much water due to dehydration, or it can also happen from some hair products that might be used on the scalp that may be stripping the scalp of its natural oils. Living in a cold and dry climate may also make one more susceptible to having a dry scalp.
Treating a dry scalp usually involves switching to a gentle, unmediated shampoo that contains as few additives as possible that may remove moisture from the scalp.
TREATMENT
Getting rid of dandruff can consist of taking medications that can be purchased through prescriptions, or over the counter. Some home remedies are applicable.
The best way to get rid of dandruff is to use dandruff shampoo and scalp treatments.
The American Academy of Dermatology Association (AAD) recommends taking the following steps:
1. Follow instructions. Since there are many different types of dandruff treatment shampoos, and each comes with its instructions, it’s important to carefully read and follow the directions of the product of choice. Be sure to know if you’re supposed to leave the shampoo on the scalp for a certain amount of time before washing, or if it should be washed out immediately.
2. Different skin and hair types require different care. Africans may only need to wash once a week with a dandruff shampoo. Asians and those who are white may need to alternate between different dandruff shampoos, which contain different ingredients, to achieve the best results. Shampoos for dandruff can be medicated (which requires a prescription to purchase), or available over the counter. Usually, this means that the amount of medication in medicated shampoos is just higher.
Typical ingredients include ketoconazole, selenium sulfide, coal tar, and zinc pyrithione. These ingredients usually loosen the dandruff flakes from the scalp, or they fight the overgrowth of the Malassezia fungus, which may play a role in the development of dandruff.
Common dandruff shampoo brands
Some specific products you may see on the shelves include: Head & Shoulders and Jason Dandruff Relief, Neutrogena T/Gel, Selsun Blue, Nizoral
HOME REMEDIES
Some natural home remedies include:
* Baking soda. Gently rub it into the scalp in the shower, and rinse after a few minutes.
* Apple cider vinegar. Mix 1/4 cup with a 1/4 cup of water. Apply to the hair for a period ranging from 15 minutes to 1 hour, and then rinse out. Do this twice a week.
* Coconut oil. Rub 3–5 teaspoons into the scalp and leave for 1 hour. Then wash out.
* Lemon juice. Rub 2 teaspoons into the scalp and rinse out. Then rub one more teaspoon mixed with 1 cup water. Do this every day.
* Aloe vera. Rub into the scalp before washing hair.
* Olive oil. Rub 10 drops into the scalp. Cover head with a shower cap and leave overnight. Shampoo and wash the hair in the morning.
PREVENTION
Here are some tips for things that can be done to avoid dandruff:
* Practise good hygiene. Resist the urge to touch the scalp, especially if it’s already itchy. Scratching can increase irritation, and lead to a vicious cycle.
Scratching or touching can also introduce dirt into the mix, which can make dandruff worse.
* Find the right shampooing balance for the scalp. Shampoos are often enough to keep oils at bay, but don’t use too many products in the hair, as that can irritate the scalp.
* Reduce stress. Stress can aggravate, or even worsen, dandruff for some individuals. While Malassezia is not introduced to the scalp by stress, it can thrive if the immune system is compromised, which is exactly what stress does to the body. Do the scalp a favour and relax. Try taking a restorative walk or practising yoga.
* Breathe fresh hair. Research shows that including regular exposure to the outdoors, especially where the air is fresher, can help reduce oil buildup on the scalp.
* Massage the scalp. This may also help prevent dandruff symptoms.
* Brush those locks. Brush the hair when it’s damp (not wet) at least twice daily.
* Limit friction. Limit the wearing of hats and scarfs, especially those of synthetic materials.
The good news is that many cases of dandruff can be treated effectively with over-the-counter (OTC) shampoos and other lifestyle measures. That being said, dandruff isn’t the only reason why persons may have an itchy scalp. If the dandruff is particularly stubborn or itchy, this may indicate psoriasis, eczema, or true fungal infection. Talk to a health care provider.
