Dandruff, characterized by the flaking of skin on the scalp, is a common concern affecting a significant portion of the population. While often mistaken for dry scalp, dandruff is typically associated with excessive oil production and the presence of a yeast-like fungus. This article provides a comprehensive guide to understanding and managing dandruff, incorporating expert advice and a step-by-step hair care routine.
Dandruff is not contagious and is not necessarily a sign of poor hygiene. The causes of dandruff are various. It can be caused by oily skin, dry skin, eczema and psoriasis, and sensitivity to hair care products.
The scalp, anatomically similar to the skin on the rest of the body, comprises five layers of tissue, contains more oil glands, and houses approximately 100,000 hair follicles. Each hair grows from an individual follicle, with sebum (oil) produced by sebaceous glands to condition the hair and surrounding skin. Sensory nerves at the base of the hair follicle alert us to feelings of pain when the hair is pulled.
A healthy scalp should not exhibit redness, irritation, scales, or buildup, nor should it feel tender or have an odor. Problems with the scalp can be a reaction to heavily-fragranced shampoos or as complex as an autoimmune condition.
There are a few common misconceptions about dandruff, including the idea that dandruff is contagious and that it’s a sign of poor hygiene.
Read also: Preventing Hair Loss from Dandruff
The causes of dandruff are various, including:
The same basic principles of skin care generally apply to scalp care, as well. Consistently removing debris, dirt, and oil on your scalp is vital, as is hydrating it. And just like your skin-care routine, your scalp-care routine should be reflective of the condition of your scalp. If yours tends to be dry, for example, avoid overstripping it with harsh scrubs.
The path to proper scalp care begins with removing debris and product build-up with shampoo. Brushing your hair before you get in the shower to suds up can help loosen debris so it can be easily rinsed away.
While shampooing properly is important for any scalp, there are some differences in caring for a dry one versus an oily one.
In a dry scalp, the skin gets irritated and flakes off because it doesn’t have enough oil and moisture. People with dry skin are also prone to dry scalp and both problems are usually caused by the same factors, such as genetic predisposition, dry air, excessive washing, and older age.
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Those experiencing dryness should consider a scalp toner, since many are formulated to be moisturizing. It’s also important to wash with a gentle, moisturizing shampoo, followed by a moisturizing conditioner. Try to shampoo your hair less frequently and use warm water instead of hot water. Running a humidifier is another way to prevent dehydration.
While the amount of oil produced by follicles varies from person to person, those with certain hair types can actually appear to have oilier hair and scalps than others, even if their follicles are secreting the same amount of oil. If you have fine, straight hair, that little blob of oil [that the glands of the scalp produces] is going to shoot right down to the tip of the hair and it's going to make it oilier. If you have kinky, curly hair, that means that little blob of oil has to make its way down that tight coil and that hair tends to be a little bit drier.
The first step to care for hair that’s on the oilier side is to shampoo more frequently. But resist the urge to regularly use clarifying shampoos. Instead, wash with a gentle, sulfate-free shampoo one day, and one that exfoliates the scalp the next (look for formulas that incorporate tea tree oil or salicylic acid).
Also, scalp exfoliators containing physical exfoliants like sea salt work great to remove the debris and buildup that often accumulate on an oily scalp.
Mild to moderate cases of dandruff can usually be treated at home with shampoos that contain ketoconazole, selenium sulfide, or zinc pyrithione. These ingredients have antifungal and antimicrobial properties, which allow them to reduce flake-causing fungus growth on the scalp. Salicylic acid shampoos are also used to help eliminate flakes.
Read also: Does Dove Men+Care Anti-Dandruff Work?
The fungus that causes flakes can regrow on the scalp fast, so use dandruff shampoo daily when you have a flare-up, and weekly after that. Allow enough time for the active ingredient to do its thing and massage the formula into the scalp for a few minutes. Experts say to avoid hair styling products for the first few weeks of treatment, since these products can leave a buildup that blocks active ingredients in your treatment products.
Dandruff can often be managed at home, but this isn’t always the case. If you’ve tried dandruff-fighting haircare products for several weeks without a change, or your dandruff is particularly severe, it may be time to visit a doctor or dermatologist.
Certain scalp conditions can result in hair breakage and even hair loss, so it’s vital to take the signs - like redness, irritation, and itchiness - seriously. A dermatologist can help correctly diagnose what may be going on, and outline the best treatment options for you.
Psoriasis is a condition that causes scaly patches on the body - including the scalp. Psoriasis is thought to be an immune system problem that causes skin cells to regenerate too quickly, forming in days instead of weeks. The body does not shed these excess skin cells, so they pile up on the surface of the skin and cause patches that are often red and itchy. Scalp psoriasis can look a lot like dandruff, as the scales often produce flakes, but they are two distinct issues. Only a doctor can accurately tell you which one you’re dealing with.
Over-the-counter and prescription products can help manage symptoms; they include shampoos, topical steroids, and oral treatments like methotrexate. The two active ingredients that you should look for in OTC shampoos are salicylic acid and tar (either coal or wood tar). Salicylic acid works to soften plaques and scales and ultimately remove them from the skin, while tar made from coal or wood works to slow skin cell growth and reduce inflammation and itching.
A common form of eczema, atopic dermatitis is a chronic condition that can appear on the scalp and typically begins in childhood.
Although the underlying cause is still unknown, the immune system becomes overactive and triggers an inflammatory reaction, leading to dryness and itchiness. Topical corticosteroids and other lotions, such as pimecrolimus or crisaborole, are common treatments. Oral antihistamines or prescription corticosteroids, such as prednisone, can also be used to control the condition.
Many of the symptoms of atopic dermatitis overlap with those of other conditions - so it’s important to get an official diagnosis from a dermatologist before attempting to treat it.
Significant hair shedding can be linked to the way hair is worn. It's called traction alopecia. We see it in anyone who's wearing a style repetitively that might be a little bit tight. That tension causes inflammation in the scalp, and inflammation causes hair loss. This type of damage can also lead to what’s called central centrifugal cicatricial alopecia (CCCA), a chronic condition characterized by scarring on the scalp which in turn causes permanent hair loss. It’s most prevalent in people of color, particularly Black women.
Loosen up your hairstyle and rule out any health issues with a visit to your doctor. Then you can explore ways to regrow your hair - options for which can range from supplements to OTC products with minoxidil, to laser or light treatments or even hair transplants.
This step-by-step hair care routine for dandruff features a range of anti-dandruff treatments and products that’ll help regulate oil production, slough away dead skin and reduce product build-up.
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