Dandruff

dandruff

Those white flakes on your shoulder looking prominent on your favourite black garment can spoil the mood of celebration you all up dressed for. Dandruff, as we call, are those white flakes that not only spoil the look but requires medical attention.

dandruff free hair of a women decorated with flower and green background
Healthy scalp, healthy hair.
Photo credit: Pixabay

To understand the clinical condition of Dandruff it is important to understand the scalp.

The scalp is the skin that brain and from which the hair grows in a human being. It comprises five layers and the uppermost layer of the skin has hair follicles and sebaceous glands.

The hair follicles are the sac that has cells that help the hair growth and the sebaceous glands are responsible for secreting sebum which is an oily substance that maintains the scalp and hair from damage.

Dandruff

Dandruff or Pityriasis capitis is an extremely unpleasant scalp disorder, observed in nearly 50% of the world population.

Dandruff is a scalp condition in which the exfoliation of scalp skin is observed. It is the shedding of scaly material i.e. the white flakes from the scalp.

In the worse condition that leads to a condition called seborrheic dermatitis, The excessive discharge from the oily substance from the gland that might form cheesy plugs on the scalp and cause itching or burning sensation is observed.

Causes of Dandruff

Hay from the Skin Infection Clinic, Dermatology Department, King’s College Hospital NHS Trust, Denmark Hill, London reports that Malassezia fungi are responsible for causing dandruff or seborrhea dermatitis.

DeAngelis and colleagues in the Procter & Gamble Company, USA states the three main factors responsible for causing dandruff are

  1. Malassezia fungi
  2. The secretion of oily substance sebum from the sebaceous gland
  3. The sensitivity of an individual towards the fungi

Malassezia fungi show favourable growth in oily presence. Hence increase in sebum secretion will make an individual susceptible to the attack of the Malassezia fungi

Pyrithione zinc reduces scalp flaking and itch and thus killing Malassezia by reducing the toxic material releases from oily sebum due to the effect of Malassezia fungi.

In a report by Dawson again from The Procter & Gamble Company, USA, on conducting a detailed research he concluded that Malassezia globosa and M. restricta are those species that predominate on dandruff scalp.

The genetic analysis M. globosa and M. restricta indicate the organism’s adaptations to the skin environment plays a great role in infecting the person. Thus, certain alterations in the activities of Malassezia genes can help discover a promising treatment for dandruff.

Symptoms

A women lying on bed displaying healthy hair with no dandruff
No dandruff, happy you!
photo credit: unsplash
  1. The common symptom of dandruff is the white flaking launching on hair and shoulder.
  2. Scaly scalp
  3. Itching
  4. Burning sensation
  5. Reddish appearance of the  scalp

Seborrheic dermatitis is the worse condition of dandruff. In this case, symptoms become severe.  It turns malicious when the dead skin turns yellow and scaling appears on the scalp and hairline.

Dandruff can spread to eyelids, eyebrows, nose hair. Lesions on the neck are also observed. Cradle cap is the thick, yellowish, crusty rash on the scalp of a new-born. Well unlike other scalp problems dandruff is not responsible for causing hair fall. Yes! You read that right.

Dandruff is communicable and hence personal hygiene like the use of personal hair brush and towel, well-kept hair is crucial to maintain.

How does dandruff develop?

Sebaceous gland activity

Sebaceous gland is influenced by body hormones and especially androgen. Androgen is the hormone that is responsible for the development of secondary sexual characters like deepening of the voice, the growth of pubic and facial hair in men. Androgen is one of the male sex hormones but is present in small quantity in women. Hence greater the sebum availability, greater the scope of dandruff.

Fungal colonization

Malassezia is the fungi, that its growth is supported by the oily sebum in the scalp. Hence the fungi predominantly colonize i.e. form cluster at the sebum-rich areas.

This releases certain toxic substances that cause abnormalities in the scalp and hence in extreme cases lead to swelling and other symptoms as mentioned above and not just restrict to flaking. It is when medical attention is required.

Other reasons like; the scalp acts as a barrier against water loss and penetration of micro-organisms. Hence if its integrity is lost due to certain damage and not treated over time it will cause dandruff. Genetic factor and immune response of the body also plays a vital role in an individual’s susceptibility to dandruff.

Remedies

Drug to treat dandruff and a leaf indicating home remedies, in white background
Drugs and natural remedies to cure dandruff. photo credit; Pixabay

Antifungals are the choice of treatment for dandruff management. Drugs tropically administered i.e. applied directly on the scalp in form of a shampoo, gel or cream are Ketoconazole, Bifonazole, Miconazole, Selenium sulfide. Other drugs like Hydrocortisone, Desonide, and Betamethasone dipropionate are the used to treat the itchiness and reduce inflammation. Pimecrolimus is a drug available in 1 % cream dosage form. Itraconazole and Terbinafine are the antifungal drugs that are taken orally.

Home remedies include aspirin, which has salicylates that helps clean the dandruff layer from the scalp. Aloe vera is a natural healer which when applied to the scalp and massaged for 15 minutes improves blood circulation and help getting rid of the white flakes. Fenugreek seeds help cure dandruff. Proper intake of Omega-3 fatty, Zinc and vitamin B through dietary sources which are crucial for healthy skin is a natural method to cure dandruff. Curd has good bacteria and is rich in calcium and protein. This helps fight dandruff, reduce itching and heal the damage scalp. A mixture of curd and fenugeek when applied and kept for 15 minutes seen to be a good cure for dandruff. Apple cidar vinegar or lemon, they have organic acid that irritates the dandruff and help cleanse the scalp.  Neem is an antiseptic. boiling the neem leaves and applying the scalp can help in preventing other infections possibly caused due to dandruff. A good massage or acupressure both has the same target to increase blood circulation. With proper blood circulation the scalp receives nutrition that boost immunity of the cells. Dandruff is caused by fungus and increase in blood circulation can do great help.

Reference

http://teachmeanatomy.info/head/areas/scalp/

https://www.healthyhairplus.com/sebaceous_glands_oily_itchy_scalp_s/4175.htm

https://www.webmd.com/skin-problems-and-treatments/scalp-problems#1

https://medical-dictionary.thefreedictionary.com/seborrhea+sicca

https://www.ncbi.nlm.nih.gov/pubmed/16382685

https://www.ncbi.nlm.nih.gov/pubmed/18004291

https://www.ncbi.nlm.nih.gov/pubmed/21919896

https://www.ncbi.nlm.nih.gov/pubmed/25736318

https://www.ncbi.nlm.nih.gov/pubmed/16617752

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852869/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887514/

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