Dandruff

Treatment

Dandruff and seborrheic dermatitis are common scalp conditions that affect many people worldwide. They both involve the scalp becoming dry and flaky, resulting in the shedding of small, white, or yellowish skin flakes. Seborrheic dermatitis tends to be more severe than dandruff, resulting in scalp redness and itching as well. While these conditions are not contagious, they can cause discomfort and embarrassment.

Dandruff and seborrheic dermatitis can cause white or yellowish flakes on the scalp, eyebrows, beard, and even central chest in some individuals. With seborrheic dermatitis, it may cause an itchy scalp, which may become red and irritated. There can be a greasy or oily feeling on the scalp. Rarely, mild hair loss can be noted in more significant cases of seborrheic dermatitis.

The exact causes of dandruff and seborrheic dermatitis are not fully understood, but several factors may contribute to their development. Malassezia yeast is a type of yeast present on the scalp that may overgrow, leading to inflammation and increased cell turnover. Sebaceous glands are oil glands on the scalp that can produce excess oil, contributing to dandruff and seborrheic dermatitis. Some individuals may have a heightened sensitivity to the yeast or the natural oils on their scalp, leading to flaking and irritation.

Dermatologists can usually diagnose dandruff or seborrheic dermatitis through a physical examination of the scalp and a review of the symptoms. In some cases, a small sample of scalp skin may be taken for microscopic examination to rule out other conditions.

Over-the-counter shampoos with active ingredients like zinc pyrithione, ketoconazole, selenium sulfide, or salicylic acid can help many people with these conditions. You typically have to leave medicated shampoo sit on the scalp for 10 minutes before rinsing out for maximum effectiveness and use 2-3 times weekly is recommended. For more severe cases, dermatologists may prescribe medicated shampoos, topical corticosteroids, or anti-yeast topicals, and even a combination of treatments.

Wash your hair regularly with a mild shampoo to remove excess oil and flakes. Avoid using hot water, as it can dry out the scalp further. Sometimes applying a few drops of coconut oil, tea tree oil, or aloe vera gel to the scalp can soothe irritation and moisturize the skin.

Managing dandruff or seborrheic dermatitis can take time. Consistency with treatment is essential for improvement. Identify and avoid factors that may trigger or worsen the condition, such as stress or harsh hair products.

Regularly shampoo and condition your hair to keep the scalp clean and free from excessive oil and dead skin cells. Use mild, non-irritating hair products, and avoid those containing harsh chemicals. A well-balanced diet rich in vitamins and minerals can promote overall scalp health.

Dandruff Overview

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FAQ

A board-certified Dermatologist is a medical doctor (MD or DO) that has completed 4 years of medical school as well as 1 year of internship and a minimum of 3 years of dermatology residency. They are the experts in over 3,000 conditions affecting hair, skin, and nails. They can see patients of all ages and are able to address medical, surgical, and cosmetic concerns.
Most people see a Dermatologist once yearly for an overall skin check. If there is a personal or family history of skin cancers, abnormal moles, or other conditions such as acne, eczema, or psoriasis, the frequency of visits can be increased.
Dermatologists recommend performing a once-monthly self-skin examination to check for new or changing spots. You should examine all aspects of your skin, using mirrors or a partner as needed. Do not forget to try to examine your scalp, look between fingers and toes, check the bottoms of your feet, and examine the groin area. Please have any new or changing lesions examined by a Dermatologist to determine if any treatments are needed.
UV damage is the biggest skin aging culprit. Daily sun protection measures (even in the winter) is the best preventative step. Avoiding smoking, excessive alcohol consumption, other drugs, staying hydrated, and eating a well-balanced diet can all have positive anti-aging effects as well.
Topical vitamin A products (retinols, retinoids) are the overall most effective topicals for addressing skin aging concerns such as loss of elasticity, fine lines, skin texture changes, and dyspigmentation. There are various over-the-counter products and prescription products that contain these active ingredients. People with very sensitive skin can sometimes have a more difficult time tolerating these topicals as they can be irritating to the skin.
Dandruff is a condition that causes dry, flaky skin on the scalp, eyebrows, and/or beard area. When there are other findings present in addition to dryness and flaking, such as redness on the scalp, itching, and irritation, it is likely that you are dealing with a type of scalp eczema called seborrheic dermatitis. Dandruff is most likely a very mild version of seborrheic dermatitis. Seborrheic dermatitis is caused by inflammation on the scalp as well as yeast overgrowth.
Mild dandruff can frequently be treated with once daily washing with a gentle shampoo, being sure not to aggressively exfoliate the scalp, which can worsen symptoms. Patients with seborrheic dermatitis are typically encouraged to shampoo daily as well.
Seek out shampoos that contain zinc pyrithione or selenium sulfide as the active ingredients. These are readily available by multiple brands (Head & Shoulders, Selsun Blue, etc). Other active ingredients that can be helpful for dandruff or seborrheic dermatitis include: salicylic acid (Neutrogena T-Sal) and ketoconazole (Nizoral).
When daily shampooing does not help control the issue, it would be helpful to seek dermatologic care. Also, if you are experiencing any symptoms such as itching, irritation, redness, crusting or scabbing, or hair loss associated with these symptoms, it is highly recommended that you see a dermatologist so you can be evaluated and treated appropriately.
There is no cure for these conditions, but regular use of specific shampoos and occasionally other topical medications should help to keep the symptoms and appearance under control. These issues commonly flare during the dry, cold winter months and treatments can be adjusted in frequency to minimize flares when they do happen.

The best dandruff shampoo varies from person to person, as it depends on individual preferences and the specific cause of dandruff. It's essential to choose a dandruff shampoo that contains active ingredients like ketoconazole, selenium sulfide, or pyrithione zinc, and to consult with a dermatologist for personalized recommendations purchased over the counter or provided through treatment.

Dandruff often forms due to the overgrowth of a yeast-like fungus called Malassezia on the scalp, which can lead to increased cell turnover and flaking of dead skin cells. This condition is typically exacerbated by factors like oily skin, hormonal fluctuations, and sensitivity to certain hair care products.

Yes, dandruff can often cause itching of the scalp as it leads to increased shedding of skin cells, which can irritate the scalp and trigger itching. The itchiness is a common symptom of dandruff, and it can vary in intensity depending on the severity of the condition.

Dandruff can be managed and controlled with proper skincare and the use of medicated shampoos containing active ingredients like ketoconazole, selenium sulfide, or pyrithione zinc. However, it may not always be permanently cured, and individuals may need to continue using these products regularly to keep dandruff under control.

No, "dandruff worms" are not real. Dandruff is caused by factors like an overgrowth of a fungus called Malassezia and has no connection to worms or parasites.

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