Everything You Need to Know About Dandruff

Itchy, flaky, dry scalp, otherwise known as dandruff, can be frustrating, even a little embarrassing if you’re a lover of black clothing. At my Monrovia Hair Salon, clients often ask me if there’s something they can apply to dry patches or a shampoo they can use to help manage their dandruff. While I do carry professional in-home treatments for various scalp conditions, the answer to keeping flaking at bay is not as easy as grabbing the dandruff shampoo off the shelf or clicking the “Buy” button on Amazon. So let’s dive a little deeper into the causes, treatments, and solutions to dandruff.

The exact causes of dandruff are unknown. One theory is that it is linked to hormone production, as it often begins around puberty, but there are other causes and factors of itchy flaky scalps. Once we can determine the reason, we can then treat dandruff.

The Causes of Dandruff:

• Irritated, oily skin (seborrheic dermatitis). Not all flaky scalps are caused by dry scalp. Many are due to the scalp producing too much oil. If you see red, greasy skin covered with flaky white or yellow scales. Seborrheic dermatitis may affect your scalp and other areas rich in oil glands, such as your eyebrows, the sides of your nose and the backs of your ears, your breastbone (sternum), your groin area, and sometimes your armpits. Seborrheic dermatitis is linked with Malassezia, a fungus that generally lives on the scalp and feeds on the oils that the hair follicles secrete. It does not usually cause a problem, but it becomes overactive in some people, causing the scalp to become irritated and produce extra skin cells. As these extra skin cells die and fall off, they mix with the oil from the hair and scalp, forming dandruff.
• Not enough hair brushing. Combing or brushing the hair regularly reduces the risk of dandruff because it aids in the normal shedding of skin.
• Not shampooing often enough. If you don’t regularly wash your hair, oils and skin cells from your scalp can build up, causing dandruff. When cleansing your hair, you must work the lather into the scalp and adequately remove the oils, dirt, and dead cells. I see many teens have oily dandruff caused by not knowing how to clean the scalp and the hair.
• A yeastlike fungus (Malassezia). Malassezia lives on the scalps of most adults. But, for some, it irritates the scalp and can cause more skin cells to grow. The extra skin cells die and fall off, making them appear white and flaky in your hair or on your clothes. Why Malassezia irritates some scalps isn’t known. People who are sensitive to yeast have a slightly higher chance of dandruff, so yeast may play a part in excess flaking.
• Dry skin. Flakes from dry skin are generally smaller and less oily than those from other causes of dandruff, and, redness or inflammation is unlikely. You’ll probably have dry skin on different parts of the body, such as your legs, face, and arms. People with dry skin are more likely to have dandruff. Cold winter air combined with overheated rooms is a common cause of itchy, flaking skin.
• Shampooing and skincare products. Certain hair care products can trigger a red, itchy, scaling scalp. Frequent shampooing may cause dandruff, as it can irritate the scalp. Some people say not shampooing enough can cause a buildup of oil and dead skin cells, leading to dandruff, but the evidence lacks that this is true.
• Sensitivity to hair care products (contact dermatitis). Sometimes sensitivities to certain ingredients in hair care products or hair dyes can cause a red, itchy, scaly scalp. To appease consumers, many shampoo manufacturers have raised the pH of shampoos to extend the shelf life of a product to rid their products of parabens. Increasing the pH will cause skin and scalps to become drier, causing dandruff.
• Skin Conditions. People with psoriasis, eczema, and some other skin disorders tend to get dandruff more frequently than others. Tinea capitis, a fungal infection also known as scalp ringworm, can cause dandruff.
• Medical Conditions. Adults with Parkinson’s disease and some other neurological illnesses are more prone to dandruff and seborrheic dermatitis. One study found that between 30 and 83 percent of people with HIV have seborrheic dermatitis, compared with 3 to 5 percent in the general population. Patients who are recovering from a heart attack or a stroke and those with a weak immune system may be more prone to dandruff.
• Diet. Not consuming enough foods that contain zinc, B vitamins, and some types of fats may increase dry scalp conditions.
• Age. Dandruff is more likely from adolescence through middle age, although it can be lifelong. It affects men more than women, possibly for reasons related to hormones.
• Stress. There may be a link between stress and many skin problems.

Almost anyone can have dandruff, but certain factors can make you more susceptible:

• Age. Dandruff usually begins in young adulthood and continues through middle age. That doesn’t mean older adults don’t get dandruff. For some people, the problem can be lifelong.
• Gender. Because more men have dandruff, some researchers think male hormones may play a role.
• Oily hair and scalp. Malassezia feeds on oils in your scalp. For that reason, having excessively oily skin and hair makes you more prone to dandruff.
• Illnesses. For reasons that aren’t clear, adults with neurological diseases, such as Parkinson’s disease, are more likely to develop seborrheic dermatitis and dandruff. So are people with HIV infection or those who have compromised immune systems from other conditions. Medications can also play a role in skin and scalp conditions.

Shampoos and scalp products are available to treat these scalp conditions.

My recommended product line is KINACTIF.

• KINACTIF Balance treats dandruff caused by extreme oily scalp conditions working to control excess sebum.
• KINACTIF Purity treats scalp conditions caused by both dry and slightly oily scalp conditions removing debris, cleansing the scalp, balancing pH, and soothes irritation and itching.  
• KINACTIF Calm is a gentle cleanser for scalp irritations caused by allergies and skin sensitivities. Calm is also great for babies and children.

It’s important to note any shampoo or scalp treatment can control seborrheic dermatitis, but they cannot cure it.

You may want to visit your Dermatologist to determine if your scalp condition is caused by excessive yeast or Malassezia. They may prescribe an anti-fungal shampoo for occasional use.

Before using any shampoo or treatment, individuals should carefully remove scaly or crusty patches on the scalp. Using a Denman brush on the scalp to lift off the debris will make the shampoo or treatment more effective. The same applies to men who have dry or flaky skin underneath their beards.

Look for these active ingredients:

Most anti-dandruff or anti-fungal shampoos contain at least one of the following active ingredients:

• Ketoconazole: An effective anti-fungal. Shampoos containing this ingredient can be used at any age.
• Selenium sulfide: This reduces the production of natural oils by glands in the scalp. It is effective at treating dandruff caused by excess oils.
• Zinc pyrithione: This slows down the growth of yeast.
• Coal tar: This has a natural anti-fungal agent. Tar soaps may also make the scalp more sensitive to sunlight. People who color their hair should be careful about using shampoos or treatments that contain coal tar because of increased staining of the scalp. Coal tar can also be carcinogenic in high doses.
• Salicylic acids: These help the scalp get rid of skin cells. They do not slow down the reproduction of skin cells. Many “scalp scrubs” contain salicylic acids. Treatment can sometimes leave the scalp dry and make skin flaking worse.
• Tea-tree oil: Derived from the Australian Tea Tree (Melaleuca alternifolia), many shampoos now include this ingredient. For those who prefer a natural approach, tea tree oil is nature’s anti-fungal, antibiotic, and antiseptic. *Please note some people have allergies to tea tree oil.

The best strategy is to select a shampoo containing one of these ingredients and shampoo the hair every day until the dandruff is under control. After which, shampoos and treatments can be used less frequently to maintain scalp conditions.

Hotter weather or excessive body heat can aggravate scalp conditions, or dandruff can worsen during the winter months and better when the weather is warmer because ultraviolet-A (UVA) light from the sun counteracts the yeast. If you notice your scalp becomes flakier during various seasons, use treatment shampoos more often in the seasons when your dandruff worsens.

Alternating dandruff shampoo with regular shampoo may help. A specific shampoo may stop being as effective after some time. At this point, it may be a good idea to switch to one with another ingredient.

Some shampoos should be left on the scalp for around 5 minutes, as rinsing too quickly will not give the ingredient time to work; some should be rinsed at once. Users should follow the instructions carefully for the best use.

Complications:

There are rarely any complications with dandruff, and it is not usually necessary to consult a doctor; however, sometimes dandruff can be a sign of more serious medical conditions. Medical advice should be sought if:

• There are signs of infection, such as redness, tenderness, or swelling.
• Dandruff is very severe, or it persists after home treatment.
• There are signs of eczema, psoriasis, or another skin condition; the scalp is very itchy.

Complications are rare with dandruff, but they may result from one of the treatments. If a shampoo or scalp treatment irritates, the individual should cease using it and seek professional advice from a hairstylist, pharmacist, or doctor. A person with a weakened immune system, for example, due to HIV or AIDS, should ask their doctor about any dandruff.

Dandruff in Babies:

Newborns and young infants often have a kind of dandruff known as cradle cap. There will be yellow, greasy, scaly patches on the scalp. It usually appears within the first two months after birth and lasts a few weeks or months. Gently washing with baby shampoo or KINACTIF Calm shampoo can help prevent the scales from building up. *If there are signs of skin cracking or infection, if itching, swelling, or bleeding occur, or if it spreads to other parts of the body, it is crucial to see a doctor.

New Solutions for Dandruff:

Research into ways to help people with psoriasis and other skin conditions is ongoing.

Green tea has shown potential for the treatment of dandruff and psoriasis. Researchers believe a unique formulation that can penetrate the skin’s waterproof barrier will combat excessive cell growth, oxidative stress, and inflammation. But until science has found a cure for itchy, flaky, irritated scalps determining the cause and treating it effectively can keep the snowflakes off your skin and clothing.