Dandruff is a common condition that is harmless but annoying marked by itching and flaking skin on your scalp. The most common underlying reason for dandruff is dry skin resulting from dry air. Symptoms tend to worsen in dry winter conditions and may improve in the summer months. Seborrheic dermatitis, which is an oily scalp condition, can lead to larger white flakes or yellow scales from uneven shedding and clumping of dead skin cells. Conditions such as eczema and psoriasis may also contribute to itching, flaking, and inflammation in the scalp area. Dandruff can also stem from the overgrowth of a yeast-like fungus (malessezia) that normally lives on healthy scalps without causing any problems, and feeds on oils produced by your scalp, which can cause itching and flaking problems. As well, stress can trigger or worsen dandruff.
Dandruff is more common in younger people and will usually resolve itself by around middle age. Babies can also be affected by a form of dandruff called cradle cap, which involves a scaling scalp and some crusting. It is harmless and usually clears up on its own by around age 1.
The most important thing to do for dandruff control is to shampoo frequently, as an oily scalp can lead to clumping and uneven shedding of dead skin cells, which results in unsightly flakes. Using a gentle shampoo daily usually can help mild cases of dandruff. If this doesn’t work, there are many different dandruff treatment shampoos available. The medicinal ingredients will vary from one product to another, so you may have to try a few to find one that works best. The most common medicinal ingredients in dandruff treatment shampoos are:
- Coal tar slows down skin cell turnover (how quick cells grow and slough off).
- Salicylic acid is exfoliating, and helps to loosen and shed the dead skin cells to prevent clumping and flaking. In some cases, it can cause rebound scalp dryness.
- Selenium sulphide slows down skin cell turnover and may reduce fungal presence on the scalp. In some cases, however, it can also discolour blond, grey, or colour-treated hair.
- Ketoconazole is an antifungal agent that reduces the amount of malessezia on the scalp.
- Ciclopirox olamine is also an antifungal agent that reduces the amount of malessezia on the scalp, and is available in prescription strength.
Dandruff is usually an uncomplicated condition that can be effectively controlled with over-the-counter dandruff shampoos. If an itchy scalp persists after using a dandruff shampoo for several weeks, or if you notice redness and swelling of the scalp, you may need to talk to your doctor about a prescription-strength treatment shampoo. Click on the links below for more information on dandruff.