Dandruff is not contagious and it is rarely a serious disorder but still it is a major blow to confidence. Usually it is a chronic disease of the scalp, manifesting as small white flakes that stick to the base of hair, while in most cases it is accompanied by itching. Treatment can be quite difficult; however, there are a lot of specially designed products available in the market that can control the problem.

The… root of the problem

For the effective management of dandruff, it is important to find the root of the problem. The most common causes are:
Dry skin: The most common cause of dandruff is skin dryness – like for example dryness observed during the winter when the air is cold and interior areas often overheated. In this case, dandruff manifests as small flakes, similar to what happens when the scalp is exposed in the sunlight for a long time, which can cause irritation or sunburn.
Seborrheic dermatitis: It is a skin condition characterized by red, greasy skin covered by white or yellowish flakes. Seborrheic dermatitis may affect the scalp, as well as other areas of the body that are rich in sebaceous glands, such as the eyebrows, the sides of the nose, the back of the ear, the bone of the sternum, the groin and sometimes the underarms.
Infrequent shampooing: In cases of infrequent shampooing of hair, there is increased accumulation of oily substances and skin cells of the scalp, which can cause dandruff.
Psoriasis: This condition causes accumulation of dead skin cells on the scalp, which may then form thick, grey flakes. Despite the fact that psoriasis is usually observed on the knees, elbows and the trunk, it may also affect the scalp.
Eczema: If you suffer from eczema in any other part of your body, there is a possibility for the scalp to be affected too, resulting in dandruff.
Sensitivity to hair care products (contact dermatitis): Sometimes sensitivity to certain ingredients of cosmetic products or hair dyes (particularly allergy to paraphenylenediamine) may result in irritation, itching and the formation of flakes on the scalp. This may also be the result of very frequent use or overuse of styling products.
Mycosis: A yeast-like fungus called Malassezia lives on the scalp of most adults, without causing any problems, but for some, it can cause scalp irritation which leads to increased number of skin cells growing. The extra skin cells die and fall off, making them appear white and flaky in your hair or on your clothes. Why malassezia irritates some scalps is not known. Excess skin cells die and fall in the form of white flakes, as they become mixed with oily substances of hair and scalp. Although the exact cause(s) of the yeast-like fungus Malassezia is not known neither what causes the overgrowth, there are certain factors that may play an aggravating role, including hormonal fluctuations, increased levels of greasiness, stress, neurological disorders such as Parkinson’s disease, and the weakened immune system.
It is also worth noting that despite the fact that dandruff may occur in almost everybody, more prone to it is people in the first years of adulthood as well as middle-aged individuals. Moreover, dandruff seems to affect men more than women, as they have larger sebaceous glands and it has been proven that male hormones are another aggravating factor. Those who have oily hair are also included in the high risk group, as the yeast-like fungus Malassezia needs the scalp’s oiliness. Finally, people who follow diets low in zinc, vitamin B and certain types of fatty acids have increased chances of developing dandruff.

Healthy scalp

The good news is that in most cases it is possible to keep dandruff under control, although for the treatment to be successful consistency and persistence are required. In general, everyday shampooing with a neutral Ph shampoo to limit oiliness and cell accumulation is the first step in managing dandruff.
When this is not possible with common shampoos, pharmaceutical shampoos should be used. However, you should know that not all pharmaceutical shampoos are the same and you may have to try using some of them until you find the most effective for you. If you have itching, burning sensation or redness following the use of a shampoo, you should stop using it immediately. If you have an allergic reaction, such as rash or shortness of breath, you should seek medical advice immediately.
The anti-dandruff shampoos are categorized depending on the drug contained in them:

  • Zinc pyrithione. These contain the antibacterial and antifungal agent zinc pyrithione, which reduces the fungus on your scalp that causes dandruff and seborrheic dermatitis.
  • Tar-based. This is a by-product of the coal manufacturing process, which helps in the management of conditions such as dandruff, seborrheic dermatitis and psoriasis by slowing scalp’s skin cells death and flake off.
  • Salicylic acid. It could be characterised as the “scalp scrub” as it helps to eliminate the flakes. However it may leave your scalp dry, so it is advisable to use a conditioner after shampooing.
  • Selenium sulfide. These shampoos slow the process of skin cells’ dying and may also reduce the yeast-like fungus malassezia. However there is a risk of causing discolouration of blond, gray or chemically coloured hair.
  • Ketoconazole. This is a broad-spectrum antifungal agent that may work when other shampoos against dandruff fail.

Daily use of the above mentioned shampoos is recommended, or every other day, until your dandruff is under control. If one type of shampoo works for a time and then seems to lose its effectiveness, try alternating between two types of dandruff shampoos. In any case you should make sure that you massage the shampoo into the scalp well and then leave the shampoo on for at least five minutes.
Apart from frequent shampooing, to keep dandruff under control you should avoid using hair styling products (gel, mouse, etc). Another important thing is to keep stress levels at normal levels, as this is an aggravating factor, as well as to follow healthy diet, rich in vitamins, minerals and trace elements. Another option for alternative treatment is the use of tea tree oil, which is famous for its antiseptic, antibiotic and antifungal action and it is the main ingredient of numerous herbal shampoo.