Dandruff

Causes of Dandruff:

• Seborrheic Dermatitis: A common condition that causes oily, irritated flaky skin and dandruff. It affects areas rich in oil glands, like the scalp, face, upper chest and upper back. The flaky skin can show underlying redness, with small round borders.
• Malassezia Fungus: This yeast-like fungus naturally lives on the scalp, but in some people, it can irritate the scalp and cause more skin cells to grow, leading to flaking. There are multiple factors which lead to multiplication of this fungus. Altered immune status, usage of antibiotics, altered sleep patterns, stress, debilitating illness, bad scalp hygiene, et cetera can be contributing factors. There is a genetic susceptibility for growing this fungus.
• Dry Skin: People with dry skin are more prone to dandruff. The flakes tend to be smaller and less oily than those caused by seborrheic dermatitis. Conditions including atopic dermatitis can lead to dry skin in the scalp. Lack of moisture in the scalp skin due to loss of natural moisturizing factors can occur due to excessive shampooing, usage of  extra hot water, prolonged exposure to chlorine water as in swimming.
• Product Sensitivity: Certain hair care products can irritate the scalp, leading to contact dermatitis and dandruff like flakes in the scalp. Certain shampoos, hairstyling gels, setting spray, hair, colour, bleach etc Can lead to irritation in the scalp. They can cause -itching, dry flaky scalp, and burning sensation in the scalp.
• Infrequent Hair Washing: Not washing hair often enough can lead to oil and dead skin cell buildup. The dead cells and Oil provide a good medium for the malassezia  fungus to grow.
• Diet and Lifestyle Factors: Poor diet, stress, and inadequate hair care can contribute to dandruff.

Treatment Options:

1. Anti-Dandruff Shampoos

• Zinc Pyrithion: This compound reduces the number of fungus on the scalp (e.g., Head & Shoulders shampoo). However, recently, there are many articles published that it may cause DNA damage. It is banned in the European Union. However, in India less than 1% formulation is allowed as rinse off  products. At this concentration, it is not known to produce such damages.
• Selenium Sulfide: Reduces fungus and slows down skin cell turnover (e.g., Selsun Blue). Selenium sulfide he is known to cause toxicity when ingested. However, topical application as shampoo is not known to cause any systemic toxicity as the absorption is less likely when the skin barrier is intact.
• Ketoconazole: Antifungal that targets Malassezia (e.g., Nizoral). It is used as 1% and 2% shampoos.
• Coal Tar: Slows down the turnover of skin cells (e.g., Neutrogena T/Gel).
• Salicylic Acid: Helps remove scales and flakes from the scalp.

2. Proper Scalp Care:

• Regular shampooing to reduce oil and skin cell buildup.
• Gently brushing hair daily to distribute scalp oils evenly.
• Avoiding harsh hair products that can irritate the scalp.

3. Lifestyle Changes:

• Managing stress, as stress can worsen dandruff.
• Eating a balanced diet rich in zinc, B vitamins, and healthy fat. Reducing the carbohydrate intake, especially the refined sugars, do help incorrect the hormonal imbalance.
• Getting adequate sunlight exposure, which helps to improve your vitamin D levels, which can help improve symptoms in patients with vitamin D deficiency.

4. Home Remedies:

• Tea Tree Oil: Known for its antifungal properties; can be added to shampoos. However, as a standalone treatment, it may not be of  use.
• Aloe Vera: Aloe vera is known for its anti-inflammatory and soothing properties .Soothes the scalp and reduces flaking. Direct application to the scalp from the plant is not advisable as it may cause irritation.
• Apple Cider Vinegar: Acetic  acid reduces the  scalp's pH and fights fungi. however, too much application can lead to dry scalp.

If over-the-counter treatments do not work, or if the dandruff is severe, consult a dermatologist for a tailored treatment plan.