What is dandruff?

Having dandruff can be embarrassing. An itchy scalp can be uncomfortable, and flakes of skin falling from it can be noticeable to others. What can you do to fight those flakes? Depending on the severity of your condition, there are medical treatments available to relieve your symptoms.
If you notice flakes of skin falling from your scalp onto your clothes, you may have dandruff. Dandruff is a common condition where the scalp becomes dry, flaky, itchy, and irritated.
Dandruff is a mild form of a common skin disease known as seborrheic dermatitis. Seborrheic dermatitis can also affect babies in a condition known as cradle cap. It happens when a fungus called Malassezia develops on your scalp. The flaking skin you see is your immune system’s reaction to the fungus.
People who get dandruff can also get it on other parts of the body like the eyebrows, ears, and sideburns. Your dandruff may flare-up when the weather gets dry and cold.
Anyone can get dandruff. Contrary to popular belief, it's not caused by poor hygiene. Teenagers are more likely to get dandruff because hormonal changes can result in an oily scalp. Dandruff affects more men than women. Researchers aren’t exactly sure why this is, but have linked it to male hormone production.
Diagnosis for dandruff
Your doctor will usually be able to diagnose dandruff just by inspecting your scalp. They will be able to tell you if it’s a mild or severe case of dandruff. If your flaking is extreme and your scalp is inflamed, they may want to test for other potential skin diseases like eczema, psoriasis, and fungal infections.
Treatments for dandruff
Most dandruff medications come in shampoo form. Depending on your case and hair type, your doctor may prescribe a medicated shampoo for you or recommend you use an over-the-counter brand. These shampoos are classified by the active ingredients they contain to help fight dandruff.
Choose a shampoo with these active ingredients:
- Zinc pyrithione (Bioderma, Alpecin, Head & Shoulders)
- Salicylic acid (Neutrogena T/Sal Therapeutic, DHS SAL)
- Selenium sulfide (Selsun Blue, Free and Clear Medicated)
- Ketoconazole (Nizoral, Ketozolin 2%)
- Coal tar (Neutrogena T/Gel Therapeutic, DHS Fragrance-Free Tar)
You may find a shampoo works well at first but loses its effectiveness after a few weeks. Try alternating shampoos to ensure all dandruff goes away.
To get the maximum benefit of the shampoo, leave it on for five minutes before rinsing. If a shampoo isn’t effective for you, consult a dermatologist. They will be able to prescribe a different course of treatment.
Medications
In some cases, shampoo isn’t effective or effective enough. If this happens to you, you may need prescription-strength medication. The dermatologist may prescribe a topical corticosteroid which you apply directly to the affected area.
Dandruff is an immune response to the fungus Malassezia. The doctor may decide to give you a treatment called calcineurin inhibitors to soothe your body’s immune response.
Home remedies
Here are some ways you can reduce the symptoms of dandruff on your own:
- Wash your hair and scalp with dandruff shampoo and rinse well.
- Try to manage your stress. Stress can induce many health problems in people, and dandruff can be a side effect.
- Get some sun on your scalp. As long as your scalp isn’t sensitive, exposing it to some vitamin D can help reduce the fungus that causes dandruff.
- Increase your Omega-3 intake. These fatty acids can help regulate oil production in your scalp.
Alternative therapies
Applying a shampoo containing tea tree oil on the scalp has been shown to reduce dandruff. Throughout history, tea tree oil has been used for its medicinal, antifungal properties. However, tea tree oil can be strong and may cause an allergic reaction in some people.
Side effects of treatments
Shampoo containing coal tar can discolor blond, white, or gray hair. It can also cause the scalp to become extremely sensitive to the sun. If you use shampoo containing coal tar, wear a hat on sunny days and don’t expose your scalp to the sun for longer than 10 minutes at a time.
Health Solutions From Our Sponsors
American Family Physician: "Treatment of Seborrheic Dermatitis."
American Academy of Dermatology Association: "How to treat dandruff."
American Academy of Dermatology Association: "Seborrheic dermatitis."
Cedars Sinai: "Dandruff: What It Is and What to Do About It."
Harvard Health Publishing: "What is the best way to treat severe dandruff?"
National Health Service: "Dandruff."
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