For those who don’t suffer from dandruff, the condition can seem like no big deal. But those who do suffer can have cases that range from the occasional and annoying to the chronic and humiliating.
The itchy scalp and telltale flakes that are the hallmarks of dandruff can have several causes or influences, according to the Mayo Clinic. You can develop dandruff if your scalp is simply too dry. Dandruff can also be caused by skin that’s too oily, for example if you don’t shampoo often enough to rid your scalp of excess oil and dead skin cells. You can also have dandruff if you have a case of psoriasis or eczema that affects your scalp.
Some people develop a condition called contact dermatitis—irritation resulting from exposure to hair care products. And for some, dandruff is caused by a common fungus (malassezia) gone out of control.
The majority of women and men with dandruff can control it for the most part by shampooing often with a gentle product. Some need to use a medicated shampoo to keep the flakes under control.
Other dandruff sufferers aren’t so lucky. Seborrheic dermatitis is another common cause of dandruff—a condition arising where oil glands are dense: on the scalp as well as areas of the face, ears, chest and sometimes the groin and armpits. Skin in the affected areas is often red and irritated, and flakes shed, particularly by the scalp, can be large and greasy or powdery. The exact mechanisms behind seborrheic dermatitis are not thoroughly understood, though the American Academy of Family Physicians reports that the malassezia fungus can be a factor, as well as oil (sebum) production, general health and cleanliness and environmental triggers.
Experienced physicians can usually spot the reason for a stubborn case of dandruff without extensive testing, and many doctors will take a hierarchical approach to the treatment plan, just as they do for other non life-threatening conditions. This means less aggressive measures will be tried first, and if they aren’t effective the physician will recommend stronger treatments until a solution is found.
If a routine of daily shampooing with a mild shampoo isn’t enough for your case, and when you’ve tried a variety of shampoos specifically formulated to fight dandruff that don’t do the trick, a prescription shampoo may be in order. Your doctor may even suggest a steroid lotion.
You should also know that there are steps you can take before, during and/or after your course of treatment (or even instead) to help manage your condition. The Mayo Clinic suggests reducing stress, as it is thought to contribute negatively to many health conditions including dandruff. While you may shampoo more often, you can try limiting your scalp’s exposure to styling products that can cause irritation and build up on your skin and hair. Eating a healthy diet and spending time outdoors when you can get a little sun (with care) are also good steps to take. According to the Mayo Clinic, tea tree oil, found in some shampoos, helps many people with dandruff (though some people are allergic to it).
Dandruff is a very common condition. It afflicts people of all ages, including some infants who have what’s called “cradle cap” temporarily during their first months of life. Estimates of the prevalence of dandruff cases in the U.S. range from about 15 to 20% of the population.
This doesn’t mean you can’t conquer or at least calm your own case. Implement some lifestyle changes and see a qualified doctor. Chances are you’ll soon be worrying less about looking flaky.