What is Dandruff?

Dandruff is a chronic scalp condition that causes scaling and flaking of the skin. The skin on our scalp sheds more than any other area. Flakes get trapped in the hair and mix with oil, causing dandruff. What causes this increased shedding of scalp skin is still unknown. Some experts believe it is caused by a yeast or fungus, which irritates the scalp. The body’s reaction to this irritation causes increased shedding of dead cells. Others believe factors such as stress, weather, oily skin, diet or hormones cause dandruff. 

Dry scalp and dandruff are not the same thing. Dry scalp is caused by a lack of moisture or natural oils on the scalp, which results in small, dry flakes, and itchiness. Dandruff is caused by the shedding of skin, which results in medium-to-large size, white, oily flakes. Having dandruff does not mean your scalp is too dry. It means you need to wash your hair more often.

Dandruff Treatment

Although dandruff can’t be cured, it can be controlled. Early treatment is the key. If you have dandruff, follow these guidelines:

• Use an anti- dandruff shampoo on a regular basis. Wet your hair and rub the shampoo into your scalp and hair. Leave it on the scalp for at least 5 minutes or as directed. Then rinse it out. Use it every day until the dandruff is gone.
•  Stop using hairspray and other hair preparations
• Continue to use the medicated shampoo 2 or 3 times a week to keep the dandruff away. Or alternate the dandruff shampoo with your regular shampoo.
• Contact a dermatologist if the dandruff persists, even with continued treatment, or if other skin problems arise. 

When to Consult a Dermatologist?

Consult Dermatologist when dandruff is uncontrollable:

•  If the over the counter treatment has not helped after 6 weeks.
•  If the flakes are not over the whole scalp but just in one or more places.
•  If you have scabs on the scalp with bleeding points on removal of the scales.
• If there is redness and itching over the face and back

How to Get Rid of Dandruff

Do’s in the Management of Dandruff:

1. Use mild shampoos for milder dandruff
2. Use shampoo powders with camellia seeds for mild cases
3.  Moderate dandruff sufferers use a medicated shampoo daily or alternate days, leaving the lather on for at least 10 minutes. Be sure to rinse thoroughly; shampoo and soap residue can actually aggravate skin problems.
4. When possible, let your hair dry naturally instead of blowing it dry.
5. Brushing your hair with a natural-bristle brush can also prove beneficial. Brush your hair from your scalp outward with steady, firm strokes. This will carry oil from your scalp, where it can cause dandruff, along the hair strands, which need the oil to stay shiny and healthy.
6.  Wash and rinse hair properly and regularly
7. Try to relax during the day; eat nutritious, well balanced diet, avoid snacks, regular exercise
8.  If you find that you are still scratching and shedding after trying over-the-counter preparations, see your doctor. You may be using the wrong shampoo for your condition. For stubborn dandruff cases you may need to use a prescription lotion or shampoo.

Don’ts in the Management of Dandruff:

1.  Do not use ordinary soap to wash hair.
2.  Do not wash hair intensively.
3. Avoid dyeing your hair (unless you absolutely must). We all have bacteria on our scalp, some of which are beneficial. These ‘good’ bacteria prevent dandruff yeast, and hair dyes reduce their numbers.
4.  After your dandruff has cleared up, use the medicated shampoo no more than once or twice a week, because it is too harsh for daily use.
5. If you have oily dandruff, never use oil on your scalp. Also avoid greasy ointments and gels.

Medicated Anti-dandruff Shampoos

There are many anti-dandruff shampoos available in supermarkets and over-the-counter in pharmacies. The most common contain one or more of the following active ingredients: Tar, Selenium sulphide, Zinc pyrithione/zinc omadine, Piroctone olamine, Ketoconazole or Miconazole, Salicylic acid 

Shampoos containing tar have been used for decades and can be very effective in controlling dandruff. In the past they may not have been as aesthetically acceptable in terms of scent and feel as other medicated shampoos, but a variety of newer preparations are usually well tolerated and simple to use.

Piroctone olamine is known as a “second generation” anti-dandruff agent. It differs from zinc pyrithione in that it is much less toxic and consequently products containing piroctone olamine do not have to carry a “WARNING – if swallowed seek medical advice” label, so they are safer for family use.

Ketoconazole and miconazole are other recent additions and are similarly generally well tolerated.

They are anti-fungal or anti-yeast agents and usually improve a variety of scaling and itchy scalp conditions.

Salicylic acid is found in several medicated shampoo’s. It helps to separate and lift off scalp scales.

• Dandruff: Frequently Asked Questions

Disclaimer

The information given in this article is for educational purpose only so that patients are aware of the options available for diagnosis and treatment of common skin, hair and nail diseases. No diagnosis should be made or treatment undertaken without first consulting your dermatologist. If you do so, the author will not be responsible for any consequences. The images provided are for illustration purpose only and should not be reproduced without the consent of the author.

About the Author of Skin Care Tips from Dermatologist: Dr Hanish Babu, MD

Dr Hanish Babu, MD is a dermatologist with more than 3 decades of experience in treating skin and sexually transmitted diseases in UAE and India. He has been practicing in UAE since last 22 years. He is a respected speaker during the Continuing Medical education Programmes for doctors, medical students and paramedical staff and is also a Stress Management Trainer. He organises group therapy sessions for patients with psoriasis, eczema and vitiligo.

He is available for consultation at Cosmolaser Medical Centre in Samnan, Sharjah (06 5678 200) from 9 am – 1 pm and at City Medical Centre, Al Bustan, Ajman (06-7 441 882) from 4.30 pm – 9.30 pm.

Visit his personal website  dr-hanishbabu.com for more details and for educational articles on Skin, hair, nail and sexually transmitted diseases. Click here to Book an Appointment with dermatologist Dr Hanish Babu, MD