Dandruff is the most common scalp condition; it is usually chronic, presenting as white or grayish flakes of dead skin cells. The excessive shedding of flakes resulting in intense itching; which naturally leads to forcible scratching to relieve that itch, it weakens the hair follicles and ultimately leads to hair fall. Dandruff is often associated with either oily or dry scalp.
Dandruff and Hair Loss
Dandruff itself does not cause hair loss. It can cause itchiness, leading to scratching and severe dandruff. However, severe dandruff can cause constant and aggressive scratching of the scalp so that they injure the hair follicles. Repeated inflammation in the hair follicles can further damage the hair roots, leading to hair loss.
Dandruff and hair loss have a complex correlation. Dandruff is a skin condition involving the scalp, while hair loss involves injury or inflammation of hair follicles causing thinning and hair fall. Hence there is no direct relationship between dandruff and hair loss. It is the constant and vicious scratching activated by dandruff is the real offender responsible for hair fall.
However, dandruff can increase hair loss in people with androgenic alopecia , a condition that causes male or female pattern baldness.
Causes of Dandruff
The exact origin of dandruff is unrevealed.
Dandruff is associated with increased oil production and secretion and increases normal skin yeast Malassezia furfur .
Mild dandruff is a very common condition in almost every individual with all normal activity.
Dandruff may be triggered or worsened by the following:
- Too oily or too dry skin or scalp
- Weather-hot humid climate or dry and cold season
- Poor Hygiene-infrequent bathing
- Infrequent washing or shampooing
- A poor immune system such as HIV/AIDS
- Chronic illness such as Parkinson’s disease.
- Lifestyle-emotional or mental stress
- Improper diet.
- Excessive use of chemical-related products or hair cosmetics.
- Airborne irritants.
Dandruff may have a hereditary component, as it runs in few families.
Clinical features of Dandruff
Medical terminology refers to dandruff as seborrhea or seborrheic dermatitis.
Dandruff can occur at any age, from infancy to the elderly. Dandruff during infancy is called a cradle cap and in a teenage called druff in short. It is common between 15 to 50 years of age.
Almost everyone suffers from dandruff and hair loss at some point in their lives.
Dandruff affects any hair-bearing area, even with very small hair follicles; thereby it not only affects the scalp, but also the ears, eyebrows, sides of the nose, beard, and the central part of the chest.
The signs and symptoms include:
- White flakes on clothes.
- Itchy or scaly scalp
- White flakes on any hair-bearing area of the body.
- Scaly skin or rash over the face, eyebrows, ears, nose, beard, or chest.
Most of them do not have any scalp symptoms but complain of white flakes on their shoulders, particularly noticeable on dark clothes. In severe cases of dandruff may cause intense itching, burning, and non-stop scratching.
Other possible conditions that may have similar signs and symptoms are psoriasis, rosacea, Atopic or contact or allergic or photodermatitis, dry skin, lupus, and fungal infection of scalp and hair.
Untoward effects of dandruff
Dandruff is usually harmless; it is not exactly a disease but more of a physiological event. Moreover, dandruff in a complex situation may lead to acne and other related medical conditions.
Social embarrassment: Scalp itching due to dandruff may have an impact on individual life such as irritation and social embarrassment.
Disrupt daily activity
Disrupt daily activity: such as work and sleep due to severe itching.
Hair loss: due to severe itching
Acne: dandruff worsens acne, in acne-prone skin, suggested to keep hair falling on the face. Dandruff is the frequent cause of acne over the back in the adolescent.
Eye involvement: Blepharitis is the inflammation of eyelids affecting the eyelashes causing irritation and redness.
Seborrhoeic Intertrigo: skin folds such as the axilla, between breast and groin are usually involved.
The mainstay of treatment is shampoo the scalp. Use of medicated shampoo containing ketoconazole, salicylic, tar, zinc pyrithione or selenium sulfide at least twice a week keep your scalp free from dandruff. All the seborrhoeic or affected areas including the scalp, ears, face, and chest should also be washed with the therapeutic shampoo. However, few home remedies along with shampoo can achieve the best results.
Home tips for dandruff
- Shampoo more often can help to reduce the oils on your scalp.
- Daily combing or brushing your hair removes the flakes or dirt and improves scalp circulation.
- Have a coconut oil massage to improve the circulation of the scalp and remove dandruff and dirt. Massage using 10 drops of tea tree oil with 5 tablespoons of coconut oil, encourages hair growth.
- Avoid oily hair and skin products.
- Avoid excessive use of chemical-related or alcohol-based hair care products.
- Avoid milk and dairy products that increase skin yeast growth such as bread, cheese, fermented foods, and alcohol beverages and reduce the use of citrus fruits like lemon, tomato and so on, to prevent triggering of dandruff.
- Avoid tightly fitted caps, hats, head wraps, or helmets.
- Avoid scratching of the scalp if you suffer from dandruff to prevent hair fall. Regular and frequent shampooing only can help out from dandruff and hair loss.
Dandruff associated with scratching or inflammation may be treated with a mild topical steroid such as hydrocortisone 1%, once or twice a day to the affected skin areas to help decrease inflammation.
Dandruff involving eyelid has to be treated with gentle or baby shampoo; using a cotton tip applicator to clean the eyelash margin and avoiding shampoo getting directly into the eyes.