A woman checking for dandruff

Dandruff: Symptoms, causes and solutions

Dandruff is a skin condition that is difficult to hide, and is an issue that affects roughly 50% of the adults world’s population. If you suffer or know someone who suffers from a form of dandruff, it’s important to know about its causes and – most importantly – that it can be controlled and treated.


What is Dandruff?

Dandruff is a very common scalp condition that comes in two forms. Greasy dandruff, or seborrhoeic dermatitis occurs when oily, and yellow flakes or scales form on your scalp and stick to your head and hair. Dry dandruff occurs when dry, white and loose flakes or scales form on your scalp and fall from your head and hair. Other symptoms of dandruff can include itching, redness, and a greasy or dry scalp.

Scalp with dandruff
The distinctive flakes and scales caused by dandruff

What causes Dandruff?

Dandruff is caused by your scalp’s cell renewal process occurring too quickly, leading to the rapid shedding of your scalp’s horny skin cells, which stick together to form visible flakes.

Sensitivity to a yeast called Malassezia can also lead to the growth of extra skin cells that collect and flake off.

Malassezia globosa is a micro-organism that irritates your scalp, causing microinflammations and scalp itchiness. It thrives on the natural lipids or oils produced by the scalp, and can trigger the process of skin cells on the scalp maturing and being shed at a rapid rate, also known as skin hyperproliferation.

Skin hyperproliferation can be triggered by a variety of factors, including:

  • Genetic predisposition – dandruff tends to run in families
  • Climatic conditions – e.g. sun exposure, cold, heat, wind
  • Physical or emotional stress
  • Hormonal changes
  • Lifestyle factors, such as diet or alcohol intake
How dandruff develops
1. Skin hyperproliferation is triggered by Malassezia globosa 2. Microinflammations of the scalp occur 3. Visible flakes form

Microinflamations and your scalp

What are microinflammations? They’re mild inflammations of the skin. They’re so mild, in fact, that even clinical testing won’t pick them up. But if we study skin tissue affected by microinflammations, we can detect the presence of inflammatory immune cells – in other words, the skin is responding to irritation with inflammation and thereby attempting to repair itself. If these skin cells are then subjected to further irritation, the skin can flip into a “true” inflammatory response.

Illustration of healthy skin, microinflammation and inflammation
1. Healthy skin 2. Microinflammation 3. Inflammation (Erythem)

How are they related to scalp conditions?

There’s growing evidence that microinflammations of the scalp are involved in most common scalp disorders – from thinning hair and dandruff, to scalp dryness, itchiness and sensitivity.

If you experience sudden hair loss or brittle hair, you may have an underlying health problem such as thyroid disease, iron deficiency, or an autoimmune disease. Some medications can also cause hair loss. Contact a dermatologist in all instances to get further information.


Common Dandruff Myths

  • Dandruff can lead to thinning hair or hair loss
  • Dandruff means your hair and scalp are dirty
  • Dandruff can be treated with vinegar, natural oils or baby shampoo

There’s no evidence to suggest that any of the above are true.

A woman washing her hair
One common misconception about dandruff is that it occurs when you don’t wash your hair often enough.

You have greasy yellow or white flakes that stick to your hair and scalp: This is typical of greasy dandruff or seborrhoeic dermatitis.

You have dry white flakes that fall from your hair and scalp: This is typical of dry dandruff.

You’re experiencing scalp itchiness or irritation, as well as visible flaking or scaling: Many people with greasy and dry dandruff experience these symptoms too.

You have dryness, itching or irritation, but no visible flakes: You may have a dry, itchy or sensitive scalp.

You have red, scaly, silvery-looking patches on your scalp: You may have Psoriasis.

See your doctor or your dermatologist if you’re concerned, your symptoms are severe, or your scalp becomes inflamed, weepy or sore.

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