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Dandruff is a common chronic scalp condition marked by flaking of the skin on your scalp. Although dandruff isn’t contagious and is rarely serious, it can be embarrassing and sometimes difficult to treat.
The good news is that dandruff usually can be controlled. Mild cases of dandruff may need nothing more than daily shampooing with a gentle cleanser. More stubborn cases of dandruff often respond to medicated shampoos.
- Dandruff is produced when the skin of the scalp exfoliates excessively.
- The white dusty flakes of material in the hair and on the shoulders are fragments of the superficial stratum corneum.
- Lack of shampooing can enhance dandruff by allowing flakes to accumulate on the hair.
- There are a number of scalp diseases than can produce dandruff.
Causes of Dandruff
Dandruff is caused when the natural cycle of skin renewal is speeded up.
This leads to patches of dead skin forming on the surface of the scalp, which come away into the hair, resulting in the flakes associated with dandruff.
What causes the skin renewal cycle to speed up is not always clear. Possible factors may include:
- seborrhoeic dermatitis – a common condition that causes oily skin; people with seborrhoeic dermatitis can also experience flaking on other parts of the body, such as the eyebrows, side of the nose and anywhere where skin folds together, such as the armpits
- malassezia – a type of fungus that normally lives harmlessly on skin, but if it grows out of control can accelerate new skin production
These are thought to be interlinked. The presence of the fungus on skin may provoke an abnormal response from the immune system (the body’s defence against infection), which can then cause skin to become oily.
In turn, oiliness of the skin may encourage further growth of the fungus, which then triggers symptoms of dandruff.
Other possible risk factors for dandruff include:
- emotional stress
- not washing your hair or, conversely, washing your hair too much – some people can irritate their scalp if they shampoo their hair too often
- using other hair products such as hairspray, hair gel and hair mousse
- very hot or cold climates
- other skin conditions such as psoriasis or eczema – two common skin conditions that can cause skin to become dry, red and flaky
- having a weakened immune system, which can be the result of a condition such as HIV or as a side effect of a treatment such as chemotherapy
For reasons that are unclear, people with neurological conditions such as Parkinson’s disease, stroke or severe head injuries often develop both dandruff and seborrhoeic dermatitis.
Symptoms of Dandruff
The hallmark sign of dandruff, or seborrheic dermatitis of the scalp, is white flakes on the scalp and in the hair. If the person is wearing dark clothes, the flakes will be more noticeable when they fall on their shoulders. The scalp may also feel itchy, tight or sore.
Adult individuals with seborrheic dermatitis of the scalp may have red, flaky, greasy patches of skin.
- There are while flakes of skin on the scalp, and in the person’s hair
- Flakes may be oily looking
- Head may feel tight and itchy
- Head may feel tingly
- Head may feel sore
- Red, flaky, greasy patches of skin (adults, Seborrheic dermatitis of the scalp in adults)
- Crusting and scaling rash on scalp (babies with Seborrheic dermatitis, or cradle cap)
Most cases of dandruff do not require a visit to the doctor. However, those who still find themselves scratching their scalp, if parts of the scalp become red or swollen, after a few weeks of self-treatment should see their doctor. The person may have severe seborrheic dermatitis or another condition that has dandruff symptoms.
Symptoms of dandruff in babies and children
Often referred to as cradle cap, signs and symptoms may appear when the baby is between 2 weeks and 6 months of age, especially between the ages of 3 to 8 weeks – this usually disappears after a few weeks; in some cases it may take months. Although cradle cap may be alarming to parents, it is not dangerous.
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.
If you have dandruff, you’re probably looking for ways to stop those white or yellow flakes of skin, which also may make your ears and face red and itchy.
Natural remedies that may help include:
Tea tree oil. Apply a small amount of this strong-smelling oil to especially scaly patches on your scalp, says New York holistic dermatologist Alan Dattner, MD. It can trigger allergies, though, so use it only for short periods.
Aloe. The thick fluid in the leaves of the aloe vera plant may ease dandruff, says New York dermatologist Michele Green, MD. In a small study, aloe eased itching and scaly skin in people with seborrheic dermatitis, a skin condition that can create dandruff. You can cut an aloe leaf and squeeze the fluid directly onto the affected area, or use store-bought aloe vera gel.
Baking soda. This familiar baking ingredient can also be helpful, Green says. Wet your hair and rub the baking soda on your scalp a few times a week. You may need to use it for several weeks before you see improvement, she says.
Olive oil. To temporarily remove dandruff flakes, apply a little bit of olive oil to scaly patches, then use a comb or brush on the area after an hour. Don’t overdo it, or you’ll have oily hair to deal with.
Calm your mind. In some people, depression and anxiety may be linked to dandruff flare-ups, Dattner says. Even if you’re not depressed or anxious, chronic stress is never great for your skin, and dandruff is a skin problem. If you’ve noticed a link between your mood and your dandruff outbreaks, these steps may help:
- Find healthy ways to release your stress. Meditate, work out, and don’t hesitate to get help from a therapist if your stress or moods get intense.
- Use a UV light during the winter if you have seasonal depression.
- If you’re considering taking supplements, such as St. John’s wort, tell your doctor so he can check on side effects. Do that even if the product is “natural.”